Guest Article

Engorgement: What Happened and How I Solved it — A Mother’s Story

I experienced engorgement with my first child and it was not only a physical discomfort but an emotional challenge.

My first son was born by vaginal birth in the fall of 2000 and weighed over four kilograms (nearly nine pounds). I had back labour and went to our Vancouver-area hospital at about 9 a.m. My GP ruptured my membranes at some point during the labouring, I think late afternoon. I didn’t want to have an epidural, but finally relented when I was completely worn out by early evening. My son was born shortly after 1:30 a.m. with no complications. He had passed meconium in the womb, but the paediatrician checked him over and he was fine.

I was able to nurse him within 30 minutes of giving birth and he took to the breast well and nursed vigorously. He was wide awake; my husband and I both remember his alert little eyes. Any time I offered him the breast, he took it. I was transferred to maternity from labour and delivery about 4 a.m. and baby roomed in with me.

My husband had started a new job and had no time off to be with us other than the unpaid day he took to be at the delivery. We didn’t have any family support in the city either. The maternity nurses of course asked about such supports and in all fairness I am sure wanted to help me establish good milk production as soon as possible. I was nursing without too many challenges, just the typical fumbling first-timer with positioning and jittery nerves, but although baby latched and fed well I was strongly encouraged by more than one nurse to pump as much as possible. Having nursed three children now to toddlerhood, I am mystified by this decision. But at the time, I didn’t challenge the advice given to me by nursing staff and followed their instructions to the letter.

The nurses brought me an electric breastpump, showed me how to operate it and I was instructed to feed my baby every two hours at a minimum and pump in between feeds. I was told to also try to get him to take as much of the pumped colostrum as he would take in between feeds, and the first day nurse made me give him a few ounces of formula as well despite my tearful protests. My husband, who knew nothing about breastfeeding, sided with the nurse as the “medical expert.” I sat in the area where they showed us to bath the babies, the nurse standing over me, my husband sitting beside me reassuring me she would know what was best, feeding my baby a bottle of artificial milk with tears running down my face. It was the last thing in the world that I wanted to do, but I felt I had no choice. Gerard had lost a few grams (a few grams I now know is to be expected) and she said we had to make sure he didn’t lose any more.

We were in the hospital for two nights and kept this schedule of pumping and nursing up around the clock. I only gave him the formula the one time and then flat out refused after that as I was pumping plenty of little vials of colostrum and giving him that as well as his vigorous feeds. His wet and dirty diapers were numerous and so that, as well as other breastfeeding-advocating nurses, helped me fight off the one formula-pushing nurse.

We went home from hospital and I had a single girlfriend who had flown in earlier that day waiting to help with baby care and household chores. A day after our arrival home I was resting in bed after nursing Gerard when my breasts got very, very warm and a tingling sensation started. I got up, grabbed my robe and headed to my friend in the living room. The two of us watched with mixed horror and amazement as my small bosoms literally went from an end-of-pregnancy small C cup to enormous DD breasts (I have stretch marks from this). I still remember watching dumbfounded as they swelled like balloons before my eyes. Baby was still sleeping and within 20 minutes I was very uncomfortable. My breasts were football-sized, hard, the veins were visible and I was very sore. And scared.

I finally decided to wake my baby up and try to latch him, but we were unsuccessful after several attempts as my breasts were rock hard. I started to panic, and of course my girlfriend had no suggestions on what to do. Tearful and frightened and feeling so wretched that I couldn’t nurse my newborn successfully at home, I called the hospital maternity hotline and was fortunate to get a very knowledgeable nurse who quickly gave me a few options to try — and try them I did.

First I applied hot compresses, which offered me some relief but I was unable to manually express any milk. I’m not sure if this was due to my nerves — as by this point the baby was wailing and my breasts engorged even further. Next, I tried expressing in a hot shower, but that wasn’t very successful for me either. By this time, I was more frightened, the baby was crying frantically, my friend was flustered and I had tears streaming down my face.

I had been given the Avent Isis manual breastpump, so set my friend to sterilizing it and trying to figure out how to put it together as I tried again to latch my poor hungry babe. The trouble we had trying to figure out how it worked is funny in hindsight, but at the time we were both in such a state of terror that this was very stressful. We finally sorted it out and I was able to pump enough milk that Gerard could latch. As I nursed on one side, my friend tried to pump a bit off the other for me to give me some relief. My son fell asleep after nursing greedily on the left breast and so my right breast was very painful until his next feed and I began to develop a temperature.

I called the local La Leche League number later that evening and was told to pump just enough to allow baby to latch and to continue feedings at least every two hours. After I had told her our short history of nursing, she pointed out that between nursing and pumping pretty much every hour from the time my baby was born until I left the hospital that my body probably thought it was nursing multiple babies. That helped me understand what was happening and was such a relief to me. I remember thinking, “Oh, that makes sense!” and relaxing immediately. “It’s not my fault” I thought, as though I had been defective as a woman or something. Funny the thoughts that go through your mind.

I was also advised that cabbage leaves placed in my nursing bra might offer some relief. I was so desperate that had my husband pick one up on his way home. I tried it and I’m not sure if it was psychosomatic or really offered help, but I felt marginally better.

My low-grade fever continued and by the next day I had a very tender, painful hot spot on my right breast. I again called LLL as I felt that they were less rushed than the busy nursing staff had been. The leader who called me back advised me to continue trying to nurse frequently and to position my baby so that his chin was toward the sore spot. I did this with the help of my husband, friend and several pillows, and it hurt at first, but truly helped relieve the pressure quite quickly. The LLL Leader had also advised me to gently rub the sore spot as he nursed and I did that as well.

My symptoms improved, my breasts adjusted to the volume required for my baby and our nursing relationship strengthened. I felt much more confident once we had overcome this engorgement challenge and cannot express enough how much I appreciated the support and advice from the nurse at the maternity hotline and then from the LLL leader. I wish I could remember their names to give them credit! I particularly feel so much gratitude to the LLL leader who was available late in the evening and was so reassuring. She really took her time to talk through the situation and offer me advice, answer my questions, and soothe my fears.

Having that woman-to-woman advice was so important because in that state of panic I needed to have a knowledgeable expert not only tell me what to do, but calm me down so that I could truly hear what she was telling me. All the books or pamphlets in the world at that crisis point wouldn’t have really helped me understand what steps to take or calmed me down. I was a new mother who, really, needed mothering and was fortunate enough to be able to find it when I needed it.

Karen Murphy Corr nursed her three sons until they self-weaned as toddlers. She had her fourth child in October 2006, and delivered with Midwifery Associates North Shore.

Editor’s note: the photo depicts another breastfeeding family than the one in this story — but you get the idea!