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Newborn and Infant Care

Engorgement

01/26/1999

Question:

if I've decided to stop breastfeeding after the first month, will the engorgement last for 2 days and then the milk will just disapper or am I going to have some medications?

Answer:

I have forwarded your question to the Breast Feeding and Newborn Care expert. Please look for an answer to your question in the Breast Feeding and Newborn Care section within 48 hours.

You've given your baby a very nice start by breastfeeding, or providing your breastmilk, for your baby's first month. If breastfeeding basically has been going well, I hope you'll consider continuing. It often takes 4-6 weeks to learn to work well with your breastfeeding baby.

Any breastfeeding difficulties usually occur during this early learning time and most have worked themselves out by about 6 weeks (or less). If you have been experiencing a difficulty for several weeks, there probably are certified lactation consultants or mother support leaders in your area who can help.

Perhaps there is some other reason you are thinking of stopping breastfeeding. If you are interested in other options, please write again. Breastfeeding does not have to be all or nothing, and any is better for babies than none.

If you choose to wean completely, it is unlikely that medications would be suggested. "Dry up" medications are associated with some dangerous side effects and they don't work at a month. You can expect to become engorged if you suddenly stop breastfeeding, but how long it might last depends on how much your baby is breastfeeding at the time. If your baby is completely breastfed, suddenly stopping is likely to result in uncomfortable engorgement and it could last several days. It also could lead to plugged ducts or a breast infection. You probably would become less engorged if your baby has been receiving a number of formula supplements each day.

I would strongly urge you to wean slowly if your baby has been completely breastfed or breastfeeds several times a day at this point. It is easier on your body and it is easier for the baby. Should your baby have a problem with formula, slow weaning would allow you to move the baby back to the breast.

To wean slowly, substitute one or two breastfeedings for a bottle-feeding (with a formula your baby's doctor recommends) for several days. (Most mothers start with one evening or night-time feeding.) Your body should adjust after several days, and then you could substitute another feeding--giving your body another few days to adjust. Continue to slowly drop feedings. This slower weaning takes 2-3 weeks, but is healthier and more comfortable for both you and your baby.

If you decide to go ahead with a sudden weaning anyway, your baby still will need you--and may need you more since she or he also will be dealing with a big change. Here are a few ideas to help decrease engorgement: 1) avoid foods that are high in salt (and may cause you to retain extra fluid), such as sausage and other processed meats or canned foods; and 2) drink lots of water or juice. If you become uncomfortably engorged, lay a towel over your chest and place ice bags all around your breasts to reduce the swelling. You might want to pump your breasts, but limit the number of pumpings and pump only to the point that relieves some discomfort. Some women find it helps to bind their breasts by wrapping an elastic bandage evenly around their chests/upper body, but avoid putting pressure on milk ducts--more likely to cause a plugged duct. The idea is to support your breasts--not squeeze them. Also, you could ask your doctor about taking something like ibuprofen to reduce inflammation.

All the best to you and your baby as you consider what to do next. If you have questions or would like additional information, don't hesitate to write again.

Karen Kerkhoff Gromada, MSN, RN, IBCLC

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Response by:

Karen Kerkhoff Gromada, MSN, RN, IBCLC
Adjunct Clinical Instructor
College of Nursing
University of Cincinnati