This document discusses breast engorgement, which occurs when milk production causes swelling and hardness in the breasts. The key causes are when milk "comes in" a few days after birth or if feedings are missed. Symptoms include pain, swelling, redness, and difficulty latching. Treatment involves frequent feeding or pumping to remove milk, applying hot or cold compresses, and using supportive bras. Medications like proteolytic enzymes or bromocripine may also help in severe cases. Preventing engorgement requires early and frequent breastfeeding on demand.

1. BREAST ENGORGEMENT
DR. MAHESWARI JAIKUMAR
maheswarijaikumar2103@gmail.com

2. DEFINITION
• Breast engorgement occurs in
the mammary glands due to
expansion and pressure exerted by
the synthesis and storage of breast
milk
• It is also a main factor in altering
the ability of the infant to latch-on.

3. NORMAL/ENGORGED BREAST

4. • Engorgement changes the shape
and curvature of the nipple
region by making the breast
inflexible, flat, hard, and
swollen.

5. • The nipples on an
engorged breast
are flat or
inverted.
Sometimes it may
lead to striae on
nipples, mainly a
preceding
symptom of
septation mastitis

6. CAUSES
• Breast engorgement is due to
exaggerated normal venous and
lymphatic engorgement of the
breasts which precedes lactation.
This in turn prevents escape of milk
from the lacteal system.

7. • The primiparous mother and the
patient with inelastic breasts are
likely to be involved

8. • Engorgement usually happens
when the breasts switch
from colostrum to mature milk
(often referred to as when the
milk "comes in")

9. • However, engorgement can also
happen later if lactating women
miss several nursings and not
enough milk is expressed from
the breasts.

10. • It can be exacerbated by
insufficient breastfeeding and/or
blocked milk ducts
• When engorged the breasts may
swell, throb, and cause mild to
extreme pain

11. ONSET
• It usually manifests after the
milk secretion starts ( 3rd or 4th
day postpartum)

12. • Engorgement may lead
to mastitis (inflammation of the
breast) and untreated
engorgement puts pressure on
the milk ducts, often causing a
plugged duct

13. • The woman will often feel a
lump in one part of the breast
and the skin in that area may be
red and/or warm

14. • If it continues unchecked, the
plugged duct can become a
breast infection, at which point
she may have a fever or flu-like
symptoms

15. SYMPTOMS
• Considerable pain and feeling of
tenderness or heaviness in both
the breasts

16. • Generalized malaise or even
transient rise of temperature
• Painful breast feeding

17. • Breasts are swollen
and oedematous, and the skin
appearing shiny and diffusely red
The woman may have a fever that
usually subsides in 24 hours.
• The nipples may become stretched
tight and flat which makes it
difficult for the baby to attach and
remove the milk.

18. PREVENTION
• To avoid pre lacteal feeds
• To initiate breastfeeding early
and feeding at frequent intervals

19. • Exclusive breast feeding on
demand
• Feeding in correct position

20. TREATMENT
• The treatment for breast
engorgement can be divided into
non-medical and medical
methods

21. NON MEDICAL TREATMENT
• The non-medical methods
include hot/cold packs

22. • Warm compress may be applied to
the breast or a warm shower
before expressing, helps the milk
to flow
• The mother can use cold
compresses after feeding or
expressing, which helps to reduce
the oedema

23. • The baby should be put to the
breast regularly after manual
expression of milk
• To support the breasts with a
binder or brassiere

24. SUPPORT WITH BRASSIERE

25. • Regular breastfeeding can and
should be continued
• Manual expression of any
remaining milk after each feed
and keeping the interval short
between feeds

26. REGULAR BREAST FEEDING

27. FEEDING / EXPRESSION OF MILK

28. HOME REMEDY
• Cabbage leaf may be applied to
relieve congestion

29. CABBAGE LEAF APPLICATION

30. MEDICAL TREATMENT
• Medical methods include
administration of proteolytic
enzymes such as serrapeptase,
protease, and subcutaneous
oxytocin.

31. • To administer tablet
bromocripine 2.5 mg daily for 2-
3 days in obstinate cases where
the breasts remain tight in spite
of suckling and expression
• Analgesics may also be
administered

32. THANK YOU