Between the third to sixth day, you will find that your breasts start to feel a lot fuller than they did when you first started breastfeeding on the first day. This is when your breast milk starts coming in. This is also a sign that your baby is breastfeeding well enough to establish a good supply of milk. It is quite normal for your breasts to feel full before a feed and you will also be able to feel your baby drain the milk from your breasts as she feeds. Your breasts should feel significantly softer at the end of the feed.
When your milk first comes in, it is not uncommon for your breasts to be slightly engorged as your body adjusts to the demands of your little one. However, you would want to be vigilant at this time and be careful to empty your breasts well in order to prevent your breasts from becoming painfully engorged.
If your baby is not drinking enough to empty your breasts, it is advisable to pump out the excess to prevent blocked ducts and severe engorgement. You will know that you are engorged if your breasts are hard, tight and extremely sensitive to touch. Emptying your breasts can also be a challenge if your breasts are very engorged. It is advisable to take a warm shower or to use a warm pack and massage your breasts prior to nursing or pumping to encourage the flow of milk.
If you detect the early signs of engorgement, it can quite easily be arrested with gently massaging and regular emptying of the breast whether by nursing your baby or using a breast pump. If your baby is an efficient suckler, she would be able to do the job better than any breast pump available in the market. So it would be advisable that you always start by nursing your baby and pump out the excess when she has had enough.
In pumping, one should also not get carried away by pumping too much, always remembering that your supply of milk is triggered by the demand, therefore the more you pump, the more you are likely to produce. In cases where the mother is producing a lot more milk than the baby requires, it could be a sign that she is pumping too much and this might actually potentially make the engorgement worse. In such cases, one would do well to pump just enough to prevent the ducts from getting blocked and let the supply adjust to your baby's needs. At this stage, you would also want to look out for redness in the skin (a possible sign of early mastitis) and to seek medical advice if the infection progresses.
It is important to wear a well fitted bra, making sure that your breasts are well supported and that the bra does not compress any part of your breast. If you breasts feel sore and sensitive, you might want to place a cold pack (wrapped in a towel) on or around your breasts to ease the swelling and the pain. Some women prefer placing cabbage leaves (kept cool in the refrigerator) on their breasts. This is an easy and economical remedy which works for some women. Whether it be a cold pack or cold cabbage leaves, this should be done after a feed and not before a feed as you do not want the coolness to inhibit the let-down reflex.
If you do not have a breast pump on hand, you can always express milk by hand. This can also be particularly useful if you are targeting specific blocked ducts which sometimes cannot be drained by using the regular breast pump. It also helps to apply a warm compress over the hard (and blocked) area for a few minutes before gently massage the area and expressing by hand. Sometimes a gentle massage with a warm compress is all that is needed to get the milk flowing and the duct cleared. Be patient and you will find the area soften as you massage and always be gentle when expressing if you do not want to end up feeling sore and painful. You can also ask your spouse to help massage the tender areas. This can be very relaxing and therapeutic for you and can also give your spouse the opportunity to support you in breastfeeding. Such are important moments for you to bond with your spouse during a time of change, apprehension and anxiety.
The article above is meant to provide general information and does not replace a doctor's consultation.
Please see your doctor for professional advice.