Other Breast Issues
Unfortunately, sore nipples and thrush aren't the only breast problems you might experience during your first few weeks postpartum. Engorgement and clogged ducts are also possibilities, but the good news is that a few simple methods can alleviate both problems fairly quickly.
When your milk comes in, you may experience swollen, engorged breasts. This is due not only to the milk filling your breasts, but also to increased blood flow to the area. Engorgement can be quite painful. Your engorged breasts may grow several cup sizes very quickly and feel warm and hard. It's a good idea to wear a supportive bra with enough room for your larger breasts. A halter top that supports from below without pressure may be a great solution.
Nursing often in the first few days is a good way to keep the milk moving and prevent breasts from becoming too engorged. Also, massaging your breasts in a warm shower or bath can feel good and can help move some of the milk out of the ducts.
Cold therapy is soothing on engorged breasts and can help decrease swelling. You can also try a refrigerated rice sock (see Chapter 1 for directions), an ice pack, a zipper-lock bag full of ice cubes, or a bag of frozen vegetables wrapped in a washcloth.
If your breasts are very engorged, cabbage leaves can make a soothing treatment. Buy a cabbage, peel and clean the leaves, and store them in the refrigerator. Get enough leaves to completely cover your breasts, all the way from one side to the other, and right up to the area under your armpit. Break the cabbage's “veins” by gently crushing them, and then tuck the leaves into your bra or lie on your back and relax with the leaves resting on your breasts. The leaves will be cool and soothing; you should start to feel some relief within a few hours. Replace the leaves whenever they look wilted, or every two hours. Only use cabbage leaves while you're engorged — if you use them too long, they can decrease your milk supply.
Bottle Feeding and Engorgement
If you won't be nursing, you will have to take measures to prevent engorgement in the first few days. Wear a snug-fitting bra, or wrap your breasts with stretchy bandages. Cabbage leaves and cold therapy, as described earlier in this chapter, may help with discomfort and relieve engorgement. You'll want to remove some milk from the breasts, but not enough to stimulate milk production — pumping just a little every four to five hours or hand expressing milk in the shower may do the trick.
Clogged ducts can happen when milk isn't moved out of the breasts often enough. If your breast is compressed by an underwire bra, by tight clothing, or by sleeping on your chest, you can also develop clogged ducts. If you can feel a hard spot in your breast, if there's localized soreness below the skin, or if your breast has an area that's red or warm to the touch, it could indicate a clogged duct.
Try massaging your breast from the armpit out toward the nipple to break up the clog and move it out. A little olive oil helps your hands to move smoothly over your tender breast without too much pressure. This can be more effective when done in a warm shower or bath, or after applying a warm, wet washcloth or heated rice sock to the breast for a few minutes. Some women find relief from clogged ducts by hovering on all fours over their baby and massaging the affected breast while nursing. This may feel silly (like you have udders instead of breasts), but letting your breast hang free can remove the compression that can sometimes slow the milk flow and cause or worsen clogs.