Engorgement, Staying Comfortable & Hand Expression

Encouraging your milk supply while avoiding breast discomfort are two factors which go hand in hand. Whether you’re feeding at the breast or planning to exclusive pump, here are a few tips to keep in mind when getting started!

More time expressing milk in the first 48 hours is associated with less engorgement (ABM Protocol #20).
It’s also very important to mention that if you’re engorged, mechanically pumping is not always the best way to resolve this issue. Pumping an engorged breast can add to any existing swelling/edema, furthermore causing restricted milk ducts and trouble removing milk. ABM Protocol #20 also states therapeutic breast massage during lactation (TBML); massage toward the arm pit alternated with hand expression can significantly reduced breast tenderness and engorgement. Other options which lack studies but still have found to reduce engorgement are cold compress, cabbage leaves and herbal remedies.

⚡️More on hand expression⚡️
Hand expression is under-appreciated these early hours and days of lactation. Hand expression can be associated with removing colostrum and/or reducing pressure to either satisfy mom’s needs or baby’s ability to latch.

If you find baby is having difficulty latching, hand expressing until comfort can assist baby when latching without over encouraging milk production, or removing too much milk.

Colostrum has a thicker viscosity than mature milk and is more easily expressed by hand. As an exclusive pumper this is important to keep in mind when getting started because colostrum is more easily lost within pump parts due to its low volume. Since we aren’t expecting larger amounts of colostrum like we do mature milk, hand expression can be less time consuming and easier to perform. Of course, if you find yourself tired of hand expressing or simply unable to, mechanically pumping colostrum is still an option.
💡Getting the approval from your provider to practice and express colostrum toward the end of your pregnancy is an excellent time to get familiar with your breasts and the act of hand expressing. Antenatal hand expression typically can begin around 36 weeks.

ABM Protocol #8