Breast fullness is a physiological, transient condition, which is proof of proper lactation development.
The amount of milk suddenly increases. Typically it occurs 2-4 days after delivery and it affects both breasts simultaneously. The process can be delayed (5-6 days) on account of perinatal stress, in mothers with diabetes, after a C-section or it can be stopped, because of a fragment of the placenta left behind. During an episode of breast fullness breasts become engorged, heavy and hard. The gland is highly stretched, which produces an unpleasant sensation of fullness and discomfort. Breast may become warm, but not painful. Mother’s body temperature is not heightened. Milk production during that time does not correspond to the baby’s needs and there is much more of it that the baby needs. Milk flows normally and during suckling, swallowing is audible. Because breast fullness is a physiological condition, no specialist therapeutic course of action is required. It is important during these days to observe the rules for the first 4-6 weeks of lactation.
- Feeding according to the infant’s needs 8-12 times a day.
A new-born baby has a different daily rhythm of suckling than an infant, which is why a feeding method also differs in the first few weeks. Starting from the second day after birth the baby shows increased activity and signals its need to feed every 1-3 hours. If the baby does not wake up on its own and sleeps for more than 4 hours it should be woken up for feeding. Feeding times during that period are irregular and there may be more afternoon feedings, but once lactation stabilises, feeding rhythm becomes more predictable. Both too low and too high frequency of feedings calls for checking the position and manner of feeding, because it may be proof of an incorrect technique. Child observation permits to catch hunger signals early and thereby allowing the infant to feed when it is still calm and willing to suckle. It is not recommended to wait for late signals of hunger, such as crying or tilting the head backwards. It is decidedly more difficult to make an irritated child latch on to the breast. That is why we need to calm the baby down before putting it to the breast. It is recommended to feed the baby from one breast, and once it has been emptied, to offer the other breast during one feeding session. Changing between breast offers an opportune moment to hold the baby, allowing it to burp or to change it. Then feeding should be resumed from “an unfinished breast”.
- Feeding according to the mother’s needs during the day and night
A baby sleeping through feeding times should be woken and fed at the mother’s convenience, preferably from both breasts at one feeding. It has significant importance during a spell of breast fullness. It prevents an unpleasant sensation related to the accumulation of milk in the breasts (breast fullness), protects against breast engorgement and stasis. Frequent breast feeding means frequent emptying of breasts, resulting in the production of adequate amount of milk and quicker stabilization of lactation.
- Feeding should be effective and last a minimum of 10 minutes
Proper breastfeeding technique and adequate length of feeding has an impact on the effectiveness of breast feeding. The length of sucking may vary: the first feeding sessions may last 30-40 minutes, while at a later stage an infant needs merely a few minutes to empty the breast. Feeding technique needs to be checked if a new-born sucks for too short or too long.
- Exclusively breastfeeding
Feeding a baby other liquids than mother’s milk disturbs still developing lactation. If a baby requires supplementary feeding, the first choice is mother’s milk. Babies fed with supplementary milk replacers without medical indications may show less willingness to suck from the breast, and consequently making it more difficult to revert to exclusive breastfeeding.
- Not using dummies
Giving a baby a dummy during the period when lactation is stabilizing (four weeks after delivery) decreases the frequency of sucking from the breast, which in turn may contribute to reduction in milk production.
During a spell of breast fullness, particular attention must be paid to expressing:
- small amounts of milk before feeding in order to soften the areola
- when a breast is becoming tight from fullness
- between feedings (if a child has had enough to eat and no longer wants to suck) – only to feel some relief
What should a mother do if breast fullness occurs?
- remember about frequent nursing day and night;
- always when she feels that the breast is becoming full with milk, she should try to nurse the baby, and if the child is full and does not want to suckle, she should extract a small amount of milk until she feels a relief in the breasts;
- she should also extract a small amount of milk, when the nipple hides inside the breast filled with milk and when its areola is engorged, which makes it difficult for the child to properly latch on it;
- pay attention whether the child suckles properly, often suckling technique needs correcting;
- it is beneficial to apply cold compresses on the breasts after feeding (pre-cooled white cabbage leaves or ice cubes wrapped in a cloth can be used) as well as drinking sage infusion during an intensified episode of breast fullness (1-2 sachets a day).
Breast should never be kneaded or forcefully massaged!