What is engorgement?

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-Within the first few days after birth the breasts produce a thick translucent substance called Colostrum.
-As the final stage of breast maturation occurs for lactation and the rise in milk volume occurs the breasts become enlarged, tight and tender, called Engorgement. This engorgement is not solely due to the increase in milk but also the breast tissue reaction to hormone changes and increase in blood supply to the breast. This will resolve within several days.
-To help correct engorgement you can massage the breasts during a hot shower, massage the breasts during a feed, maintain correct positioning and attachment, increase frequency of feeding, avoid soothers, bottles and pacifiers. If long breaks between feeds then expressing is advised. Also between feeds cold packs can be applied to reduce swelling. Cold packs can either be bought from the chemist/supermarket or chilled cabbage leaves placed in the bra.
-If the engorgement does not resolve it can result in the breasts becoming hard, hot to touch, shiny skin, lumps in the breast, areola engorgement and flattening of the nipple. If this type of engorgement is left then the baby will have trouble with proper attachment, therefore poor milk transfer, can result in poor weight gain and finally mastitis.

Reference: Nicols F.H & Zwelling E. 1997 "Maternal-Newborn Nursing", W.B. Saunders Company, USA.