Breast engorgement: understanding the condition to avoid it

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Extract from the article: Some women are prone to breast engorgement at the beginning of breastfeeding or during a period without breastfeeding. The milk no longer flows because inflammation of the breasts compresses the milk ducts. This can cause discomfort and pain in the b

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Some women are prone to breast engorgement at the beginning of breastfeeding or during a period without breastfeeding. The milk no longer flows because inflammation of the breasts compresses the milk ducts. This can cause discomfort and pain in the breasts. What are the causes of engorgement, its symptoms, treatment and prevention? The point with Dr Bingo M'Bortché, Obstetrician Gynaecologist, Head of the medical division of the Togolese Association for Family Welfare (ATBEF).

According to Dr Bingo M'Bortché, Obstetrician Gynaecologist, Head of the medical division of the Togolese Association for Family Welfare (ATBEF), « breast engorgement is a production of milk secretion which, for several reasons, has not been able to flow and has stagnated in the galactophoric tree, that is the breast ». This leads to swelling of the breasts and inflammatory phenomena. It can occur before or in the middle of lactation.

When does it occur?

About two days after birth, the breasts fill with milk, increase in size and become heavier, but this is not painful in normal circumstances. In general, says Dr Bingo M'Bortché, Obstetrician Gynaecologist, « breast engorgement occurs at the beginning of the breastfeeding period ».

Consequences of untreated breast engorgement

« When breast engorgement is not managed, it develops into inflammatory mastitis or lymphangitis. Lymphangitis or inflammatory mastitis is a localised inflammation that most often follows breast engorgement », says Dr Bingo M'Bortché. The skin is red, warm, painful and taut. There is often a high temperature with chills, but this is an inflammatory stage and not infectious. Neglected lymphangitis can progress to infectious mastitis. « Infectious mastitis is an infectious condition that often occurs when engorgement is left untreated. It is either a superinfection, a neglected breast engorgement, a badly treated acute lymphangitis or a primary inoculation through the crevices », explains the gynaecologist.

Causes or risk factors

It can be seen in two circumstances: « Firstly, during the milking period when the breasts are not suckled early and frequently in a good position, with the areola correctly taken by the newborn, after delivery », says Dr Bingo M'Bortché. Then, during breastfeeding: « there is either a bad breastfeeding technique, too great a restriction in the duration and frequency of feeds, incorrect latching on, or maternal stress that blocks the oxytocic reflex », he continues. Stopping breastfeeding can be chosen by the mother for various reasons.

How does it manifest itself?

Clinically, breast engorgement is associated with « a generalized swelling of the breasts, pain, diffuse oedema, skin redness, skin that may appear shiny, a decrease in the flow of milk or a slight increase in temperature, but below 38.4°C », reveals the specialist. Breast engorgement is a physiological event in lactation. It can cause discomfort and pain, and measures to limit its intensity are essential and have an impact on the occurrence of complications or breastfeeding failure.

What should a woman do about breast engorgement?

The decongestion of the « breast overflow » is indeed largely possible at this stage, usually within 24 hours. According to Dr Bingo M'Bortché, « we suggest that the woman continues breastfeeding, helped by regular pressure on the breasts every two hours, either manually in the shower with a cloth or warm towels, or using a breast pump. The idea is to let the milk flow a little, very often, in order to obtain sufficient comfort in the breasts.

How can this anomaly be prevented?

The preventive treatment consists of « encouraging early and frequent feedings to both breasts in a good position, or areola correctly taken by the newborn, after the delivery », recommends the gynaecologist. It is also important to ensure that the baby latches on to the nipple properly. Avoid the absence of prolonged feedings.

What medical treatment is available?

Measures to relieve the woman can be proposed: « cold compresses after feeds, application of nifluric acid ointment (Nifluril) or ibuprofen. If the woman decides to stop breastfeeding for various reasons, drugs are available to dry up the milk in the breasts », says Dr Bingo M'Bortché, Obstetrician Gynecologist. Early and frequent suckling of both breasts is a means of preventing breast engorgement, a means of contraception when such suckling is associated with the absence of menstruation during the 6 months following childbirth and a means of child development.

Abel OZIH