Something that took me by surprise once my baby was here was the need to deal with engorged breasts after pregnancy. I don't know why I hadn't heard about this but whoa.. Since I needed to pump to establish my milk supply I was not expecting this at all and it was quite a surprise once my milk arrived.
So when does the engorgement start
I spent the week after my first baby was born pumping to establish my milk supply. I was so excited once I started to see some milk come in, within a day though I was suddenly engorged with what I started referring to as "porn star boobs". All of a sudden they were ridiculously huge and swollen. And painful. Here I wasn't even sure if I was going to produce milk and be able to breastfeed but all of a sudden my body caught up.
In my case it was a few days late due to my slow breastfeeding start, but in general your milk will come in 2-5 days after your baby is born. It doesn't affect all women but most will experience some kind of engorgement after pregnancy. This is when your breasts may feel heavy, full, warm, hard and the skin may be stretched and feel tight. The good news is that the initial engorgement does not usually last more than 24-48 hours.
Once the engorgement has gone down you may still experience it from time to time until your milk supply levels out. Even once it is leveled out you may experience it if you miss feedings or go longer than normal between feeding or pumping. Usually it will be quickly relieved by feeding your baby and should not be anything like the initial engorgement right after your milk comes in.
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Relief
For the initial engorgement right after pregnancy, keep on nursing frequently and on demand, make sure your baby has a good latch and taking in milk properly, try using cold compresses or ice packs to help with the swelling, and take ibuprofen if needed for the pain and swelling.
The best way to relieve engorgement anytime it occurs is to feed your baby. If your breasts are very engorged to the point that it is hard to latch your baby on you may want to hand express or pump a little to soften them.
If you feed your baby and still feel engorged you may want to hand express or pump a little milk. Do not pump more than a few minutes though because this will lead to your body producing more milk.
There is evidence that cabbage leaves can help with breast engorgement. There is not much known about this but it seems to work. I have not personally tried it but it sounds pretty cool and I kind of wish I had tried it back in my early nursing days.
It must be green cabbage, applied to the breast twice daily for about 20 minutes. It should not be much more than that because there is concern that it could negatively affect supply.
Using a sleep nursing bra or nursing tank can also help. I slept in a nursing bra for the first few months. While you do not want anything constricting at all, having a little support can make you more comfortable.
If you are unable to get relief from your engorgement and you have a fever, red streaks or any symptom of mastitis call your doctor.
My experience
With my first baby the engorgement caught me off guard and was pretty bad. Since I had been pumping to establish my milk supply it came on very suddenly and was very uncomfortable. It did level out but I continued to deal with engorgement off and on for a few months. Once my baby started sleeping longer stretches at night I would also wake up engorged. I took to sleeping with a manual pump in my bathroom so I could pump off an ounce or two for relief.
I also had mastitis twice with my first baby.
The second time around I did not experience as much engorgement at all. I think since we got off to a better breastfeeding start my supply was much more level from the beginning.
Conclusion
Dealing with engorged breasts after pregnancy can be a pain but luckily it is brief and the initial pain should subside within a day or two. You may continue to experience engorgement off and on while your milk supply levels out but with plenty of nursing and some care you should feel better shortly.
Please let me know if you have any questions or thoughts!