Milk came in today, hugely engorged with painful lumps. Help!

[artichokes]

dd is 3 days old.
feeding pretty well but not taking loads.

today milk came in rather dramatically.
my breasts are huge and both have several painful lumps.
the left breast has a very painful lump but massaging it seems to make it more tender. you can see the redness through the skin (although this could be aggrevated by massaging).

what can i do?
is this normal or beginnings of mastitis? do lumps often appear when milk arrives?
i have no pump and am unsure whether pumping might not stimulate more milk and make things worse.

If there's a definate red lump it might be the start of mastitis I'm afraid. Try and get dd to feed from that side if you can to try and clear it, and try and massage towards the nipple, as if it's a blocked duct it needs emptying! If not and you start to feel unwell don't hesitate to call the out of hours doctor- I left it with dd when I had mastitis and by the time he came I was very very ill They will bring some antibiotics straight to you, but hopefully it's just your milk coming in

feed, feed, feed. it is most likely normal, but if it was the start of mastitis the absolute best thing for it is to keep feeding.

hot shower and massage boobs will help too

Um, could be mastitis. If you start feeling fluey, get to your bed and take some paracetamol asap. And keep feeding from the affected boob.

If it's a blocked duct, whenever you feed your dd change feeding positions as she may not be accessing all of the ducts. Also put your dd to the breast regularly, not just when she is asking for it.

In the meantime, hop in the shower and direct the head on your boob. Make a fist and roll your fist down your boob (support it with your other hand) right from the top of the breast tissue down to the nipple. Be quite firm.

Congratulations and good luck

she just won't feed enough .
she is sleepy and overwhelmed by all the milk.
i am scared of getting ill...

No need to be scared artichokes I would hop in the shower like other people have suggested- it does make it much easier to express. In fact, with dd I knew my milk had come in when I stepped out of the shower and my feet were still getting wet...

keep offering breast, even if she isn't asking fo rit.

if you're worried then it isn't going to hurt to express to ease it a little, just to take the pressure off.

Does anyone you know have a pump you can borrow? Local NCT branches sometimes have one, and you don't have to be a member to use it.

She sounds like my ds2. I had to bf him, then express after the feed, then bottle feed him what I had expressed. I only had to do it for a couple of days as that was enough to get his appetite going and put some weight on.

You may not get ill. You may have nipped it in the bud before it comes to anything. I did with ds1, and with ds2 I felt fluey when my milk came in but it didn't come to anything.

You might find this technique helpful, especially if your baby is having trouble attaching because you're so full:

www.kellymom.com/bf/concerns/mom/rev_pressure_soft_cotterman.html

Also, I suggest you call the national bf helpline for some 1-2-1 support (0844 20 909 20)

(((hugs)))

oh this is still fesh in my mind as dd4 is only 5 weeks old. i ran a warm-hot bath, and sat upright, massgaing boobs towards nipples to release some milk. i am useless at expressing.

lots of feeding, massage and take acare of yourself. if you get any flu-like symptoms then call Gp for antibiotics.

hopefully this is just your milk coming in and not the start of mastitis.

Just my two pennorth... If you feel ill, it could just be a by-product of your milk coming in. I had flu-like symptoms on day four when my milk came in. My breasts were engorged and lumpy and I felt very cold and shaky. Half an hour in a hot bath, expressing by hand and drinking sugary drinks sorted me out. I've read on here of this happening to others too.

Thanks for all this advice.

I survived the night but my breasts are huge and stil lumpy. Ironically the number of lumps is of some comfort to me as I imagine mastitis might feature one painful not 10 in each breast??? Unfortunatly I have a biut of a cold so it is hard to detect whether I feel slightly shivery and off due to that or something more serious.

My problem is DD hardly wants any milk. She sleeps all the time and if I wake her she will gently suck for 10 minutes and then sleep again. No amount of stimulation, making her cold etc helps. I am slightly worried but the midwife is not coming again until Wednesday and has not weighed her yet. She did say that I should only worry if nappies are dry or DD is floppy - neither of which is true. DD1 was such an amazing eater. Is it normal for a 3-4 day old to be largely uninterested?

I borrowed a pump but it hurt my nipples sooooo much. I just can't go there.

Old fashioned remedy which really helped me (but smelled a bit ). Put chilled cabbage leaves in your bra (t-shirt?) - sounds strange, but I promise you it worked! Replace with new ones as soon as they're warm.

artichokes, some good suggestions here already, so I am loathe to complicate things more..but I disagree with your midwife that the only time to worry is dry nappies. An 'early warning' sign of things not being quite right would be (on day 4, which is what you are) that the baby is still producing mec nappies. Effective bf leads to green/khaki/yellow nappies by now.

If she still still producing brown nappies, or no poo at all, then it's not a sign to panic, but a sign to get breastmilk into her somehow - expressing in order to do this, if she is not feeding effectively yet.

This ensures she gets the calories and fluid she needs and the expressing protects your milk supply.

Would be useful to have her weighed before Wed, to get a fuller picture, too.

thanks tiktok.

she has had 2 khaki nappies since 4am so your advice is comforting.

the most i can get her to feed is 15 mins of medium energy sucking every 3 hours. to get that long requires constant dtimulation of her. is that too little? she does not get near emptying a whole breast (but then they are formidably large at the mo).

no chance of a weigh-in before weds sadly.

Yay for the khaki nappies

They will be yellow tomorrow and that is a good sign.

The aim of bf is to feed the baby, not to empty the breasts - which is imposs. anyway.

The length of time on the breast is not significant as long as she is feeding often and effectively - she needs to be on both breasts each session at least and if you suspect she is a bit too sleepy still swapping from breast to breast is a way of keeping her going.

Honestly though, all sounds well, and you are being watchful and alert in case it is not, so no worries, from what I can tell.

ooohhh. i have been limiting her to one breast per feed so she gets hind milk. will try swapping after she falls asleep on first breast.

gp has sent anti-biotics over. i will only take them if fever hits. at the moments i think it is engorgement plus a cold (fingers' crossed).

I second the chilled cabbage leaves (savoy!). You do smell once they heat up though!

Mastitis is a definite fever, rather than a bit of a cold but can take a while to develop. If you start running a temperature I wouldn't hesitate to ring NHS direct and ask for a doctor to bring you antibiotics. When I did this the girl on the phone asked if I could be pregnant . Given the time of year, it might be worth ringing your GP and asking for a prescription just in case, save you having to do it at 2am on Christmas eve.

I got myself into a terrible flap for the first few weeks with all the fretting but my HV was great. She basically said that it often takes a while for babies' appetites and mothers' milk supply to sync up in the early states. They are designed to withstand this! It maybe that you're already producing gold top and you're baby doesn't need much, or has an incredibly powerful suck!

She also told me that many HV disagree with weighing newborns as it causes so much stress for the mother. My DS didn't put on any weight for 6 weeks, cue hysterical weeping from me and husband suggesting formula, cue more hysterical weeping from me. I didn't reach for the bottle and it all settled down in the end.

Sounds like you are doing fine to me...... and congratulations!

sorry, x posts

artichokes - big myth that babies should only have one breast per fed There is so much misunderstanding about foremilk and hindmilk.

Some babies are just fine with one breast per feed, but two breasts should always be on offer, especially at first. When the baby seems to have had what he/she wants on side one, then they need to be offered side two. Purposefully restricting them to one side minismises the production line stimulation. Fine in a mother who makes gallons anyway, or for a baby who is feeding literally 15-16 times in 24 hours.... not fine in other mothers.

Babies sort out their own foremilk and hindmilk - we do not need to worry about it if the baby is feeding well.

Purposefully restricting to one side is what mothers with over-supply have to do, or mothers who want to wean from the breast in order to switch to formula - because one side only reduces milk supply and that is a Bad Thing in the early days.

You can read more about this at www.kellymom.com

Don't agree with your HV at all, fruitstick! Good practice is to weigh newborns at birth and then on day 4-5 - it's in the NICE guidelines and is evidence based. It does not need to make mothers stressed if it is done properly and with good support and information.

Most babies are fine without weighing, of course. It's part of 'screening' for problems. The few who do have problems can be spotted soon, before things get too difficult to fix.

Hope that you are doing well - I found that cabbage leaves were great too - always had a cabbage in my fridge for the first few weeks as supply took a while to settle down. Really hope that you don't have mastitis as it is horrible - make sure that you rest up and get everyone else to do the running around for you.

dh returned with a savoy cabbage which is really helping .

meanwhile dd shows no more sign of hunger. even when awake for a few minutes she rarely wants to latch. is she does feed its often for 5 or 6 minutes. however, her nappies are wet and we had another khaki poo.

i just don't know whether her sparse and short feeding is a worry or not at this stage.

Do you think that's why cabbages have evolved their cup shaoed leaves?

Don't worry artichoke. If there is a problem (and there probably isn;t) then your baby will give you lots of signs --> nappies, behaviour, weight etc. You sound like the type of person who knows what to look out for. I think you're great. I was on serious after a few days at home. Feltlike my milk never cam in yet my friends were like you. I was told feeling full and baby feeding little and often was normal. Your boobs and baby wil settle ad maybe santa willbring you loads of cabbages.

Love and luk to you

First congratulations. Glad the cabbage is really helping. My MIL came round with a dwarf cabbage and we had to send her back out for a full size one!

My DD also wasn't hungry in the early days. We just had to keep stimulating her to make her feed- eg. by blowing on her a little, changing nappy in between sides, tickling her feet etc. My boobs were killing me and I found that lying in the bath with a wet flannel and moving it from side to side helped.

Wet nappies and khaki poo sounds good though. Sounds like it would also be good to get her weighed as well, that will help to answer your question about worrying.

Also, just thinking of my own experiences, you might want to have a good look at your DD because it turned out that my DD was very tired because she was jaundiced, so she fed ineffectively and we had to go back into hospital because she lost quite a bit of weight. (Nothing serious and easily fixed by a go under a special lamp, and gave me the opportunity to get lots more advice on establishing bf). Just carry her to a a window tomorrow morning and have a check that she is not very yellow. (We spent a long time admiring DD's olive skin and trying to work out what part of the family that came from, when of course it was jaundice, what idiots ).

well dd woke up ay about 10pm last night and decided to demonstrate just how alert and hungry one baby can be... this carried on 'til 1.30am. then she fed at 3.3am and 6.30am. she is feeding well today too .

thanks everyone.

now i just need to move that hungry alert period to the daylight hours (one can dream).