This article is an excerpt from "The Nursing Mother's Problem Solver" by Claire Martin.
Q: My breasts are so engorged that they look like balloons. My newborn can't latch on, or if he does manage, he loses his grip. I tried expressing some milk, but my breasts are still too hard. What can I do?
A: Most new moms have engorged breasts-it's common, but painful. As the milk comes in for the first time, the vessels surrounding the lymph nodes are flushed with blood. Engorged breasts are hard, are hot, can hurt, and-as you pointed out- can make it difficult for a newborn to latch on because the aerola is too firm. There are several ways to relieve engorged breasts:
Take a very warm (but not unbearably hot) shower. Stand with your back to the shower, and gently massage out the milk by hand. (Don't worry-you'll still have plenty of milk left for the baby, and it will take a while for your breasts to replace the expressed milk.) Express until your breasts are soft enough to allow the baby to latch on and suckle. Your breasts will still feel huge, but more pliant.
Place raw cabbage leaves-whole or torn-in your bra. No one really knows why this works, but something in the cabbage leaves reduces engorgement.
Warm a couple of hand towels in the dryer or microwave. (They're ready when they're hot enough to barely handle, like the heated towels that customers use at Japanese restaurants.) Lay the warm towels on your breasts. The heat probably will inspire some letdown, which will relieve the pressure, and the towels will absorb the milk.
Use a breast pump (electric pumps are better than hand pumps) to empty some milk from your breasts. This is easier than taking a shower if you're still recovering from a c-section, and you can save the milk in the freezer to use later.
Let the baby nurse as often as she wants. This will help your milk supply stabilize more quickly and reduce the engorgement. Feeding sessions may last 15 to 40 minutes at first. As your baby gets older, she'll become more efficient at nursing and may nurse for only 10 to 15 minutes or so.
Find the number for your local La Leche League club, and call the leader; she can share practical advice and lend support.