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The milk "comes in" on the third or fourth postpartum day and there is some initial discomfort with the engorgement and fluid retention (edema) in the breasts along with milk leakage. This is nature's way of making sure the mother has enough milk to feed her baby (or babies, if more than one baby was delivered).
Nursing homebirth mothers should have a postpartum midwife visit about this same time and should have received instructions on how to relieve the discomfort.
Breastfeeding should have been established with the baby nursing on demand and receiving the colostrum for the first few days. But, extra help may be needed since the engorgement may create new problems (such as the baby having difficulty latching on to a full, hard nipple and breast and maternal frustration).
The midwife should instruct the mother about how to express excess milk using her hands and/or a breast pump to relieve the engorgement. This is done by taking both hands and placing them on each side of the full breast, one on the inside by the breastbone and the other up and under the arm. Firm stroke are to be done from the furthest point from the nipple... towards the nipple. This forces stored milk out of the milk glands and down to the nipple to be released. Warning, the milk can spray quite a distance, so it would be wise to place a clean towel, or container over the nipple area to catch the expressed milk (the shower is an excellent place to do this, not only for the mess, but the warm water feels great on the sore breasts and helps to provide a lubricated surface for the hands on the skin of the breasts). A simple breast pump may be placed over the nipple that may have a reservoir or container attached to it for storage of the breastmilk for later use. A mild oil (such as almond oil) or lotion (that may be washed off before breastfeeding begins) can be used on the breast to aid in the stroking motion, reducing friction and irritation if necessary. Continue to stoke and express until engorgement is relieved and the baby is able to grasp the nipple to nurse.
The mother should feed her baby frequently and as often as s/he is hungry. Some babies this is every 1 1/2 to 2 hours, others it may be closer to 3 hours. The baby should be fed on demand and not by any set schedule. This will allow the breasts to become regulated to the baby's hunger needs.
When breastfeeding, the breast that was last fed on in the previous feeding should be the first breast started on in the next feeding. This allows each breast to be completely emptied during feedings and prevents engorgement and mastitis. Partway through the feeding the baby is switched to the other breast and s/he nurses until full. It is this breast that should begin the next feeding, since usually it is not completely emptied at this time. Until your nipples are toughened up, be sure to use a vitamin E or a lanolin cream (read labels and use something specific for breastfeeding mothers) on your nipples to prevent soreness or cracking of the nipple tissue.
Be prepared between feedings to experience the "let-down" of milk. This is a tingling, sometimes uncomfortable feeling in the breasts where the milk is released and available to your baby. This sensation may occur when you are thinking about your baby, when you hear a baby cry, and when you begin to nurse your baby. This is your body's way of reminding you that you need to feed your baby. It is wise to wear extra thick cotton pads or nipple shields in your bra at this time. Change these often so the nipple is not exposed to excess moisture over a length of time. The milk will literally flow down the front of your clothes without protection.
For non-nursing mothers, the engorgement will start to decrease after 2 to 3 days. Pain and discomfort can be eased with the use of ice packs, mild pain medicine (acetaminophen) and wearing a support bra. Special drugs to suppress lactation are no longer available, but some herbal remedies, such as sage or parsley tea or eating parsley. Other suggestions, were not to stimulate the breasts (hot water, or other ways:), and to use ice packs, or frozen green peas wrapped in cloth molded to the breasts. Homeopathic remedies include lac caninum and sometimes pulsatilla. Some people recommend Urtica Urens 1X, every 6 hours to suppress milk flow.
The use of cabbage leaves is a very old treatment for postpartum breastmilk engorgement relief and to suppress milk flow. It has been used in England as far back as 25 years ago. Cabbage leaves have also been used for various other complaints over the years. The cabbage belongs to the "Brassicacae Family" and contains mustard oil, magnesium, oxalate and sulphur heterosides. Sulphur in amino acid methionine acts as an antibiotic and anti-irritant, which in turn draws an extra flow of blood to the area. This dilates the capillaries and acts as a counter irritant, thus relieving the engorgement and inflammation and allowing milk to flow freely. Use fresh, cold cabbage leaves frequently for the postnatal women with breastmilk engorgement. Separate two fresh (not cooked) leaves and gently bruise the inner side with a kitchen utensil i.e. rolling pin. Then one leaf is placed on each breast for 15- 20 minutes. This can be repeated as often as desired. It works fantastically and feel very soothing as well as reduces the supply.
Lots of moms are very conscientious about drinking lots of fluids while they are nursing. This may stimulate additional letdown. So if you are trying to reduce the letdown, consider NOT drinking fluids right while you are nursing and notice how this changes your letdown. It is important that nursing moms drink plenty of fluids to keep their milk supply up.
Another suggestions for engorgement or for encouraging breastmilk letdown is to take a small disposable diaper and put about a cup of water in it and microwave it just for a few seconds. You have to experiment with it and really feel around so it's warm, not scalding hot. Then you take the diaper and mold it around your breast in your bra. It fits great, doesn't get you all wet like a washcloth and can be reheated over and over. Some women found this works wonders during those first days when they were too stressed out to get a good letdown right away, or when they needed to pump and their baby wasn't able to inspire them. The warm diaper worked like a charm.
MoonDragon's Breastfeeding Information
HELPFUL PRODUCTS FOR BREASTFEEDING
Herbal Remedies: Healthy Mom Fish Oil Pregnancy Supplement, High Potency Omega 3, EPA DHA, Nutrition During Pregnancy & Lactation, Lemon Flavored, 90 Softgels
Healthy Mom Fish Oil Pregnancy Supplement is a pure and pristine source of molecularly distilled, pharmaceutical grade fish oil formulated with the ideal dose and ratio of DHA and EPA to address the health and nutrition priorities of pregnant and lactating women.
Herbal Remedies: Indigo Wild Nipple Reliever, Chapped Nipple Moisturizer, 0.75 oz.
Nip chapped runners' nipples, and other chapped body parts, with moisturizing shea butter, certified organic calendula, balsam of Peru and certified organic yarrow.
Herbal Remedies: Lanolin Oil, 100% Pure Liquid, NOW Foods, 4 fl. oz.
Pure Lanolin Oil (Liquid Lanolin) is a very high quality thick liquid and may be thinned with, Olive oil, Emu oil or cocoa butter. Pure lanolin oil can be used like petroleum jelly on chapped skin and as a moisturizer.
Herbal Remedies: Mammary Care, Balanceuticals, TCM Formula, 100% Natural, 60 Caps
This time-honored formula is used in Chinese medicine to promote blood circulation and remove stasis, inhibit inflammation, and maintain healthy internal secretion and consistency of the breasts.
Herbal Remedies: Neuromins DHA Supplement, Nature's Way, 100 mg, 60 Softgels
Neuromins brand high quality DHA Supplement is sourced from microalgae and fortified with Vitamin C and E.
Herbal Remedies: New Mother Natural Nursing Pads, Natracare, 25 Pads
New Mother Natural Nursing Pads have a cool and comfortable design to protect your clothes. Made from totally chlorine-free, natural and sustainable materials.
Herbal Remedies: Nursing Mom, Woman's Fenugreek Tea, Yogi Tea, 16 Tea Bags
Organic Woman's Nursing Mom tea is a delicious, organic way to promote healthy milk flow and provide the best groundwork for your baby's lifelong nutrition. This formula includes Organic Fennel Seed (Foeniculum vulgare) suggested by Bartram's Encyclopedia of Herbal Medicine to support milk production in nursing mothers and Organic Fenugreek, used as a breast tonic by Middle Eastern practitioners along with Organic Anise, another good tasting herb. These three seeds were traditionally used as galactagogues, a group of agents that promote lactation. For minor digestive upset sometimes accompanying nursing, enjoy the soothing support of Organic Chamomile Flower, which German Commission E recognizes for the digestive tract. They have also added fragrant and calming Organic Lavender for releasing the stress of a new baby. The yogis believe that mother's milk offers everything a child needs physically to support a healthy digestive and immune system.
Herbal Remedies: Prenatal Multi-Vitamin & Mineral, 100% Natural Complete, Nature's Way, 180 Caps
Nature's Way Woman's Prenatal Multivitamin and mineral supplement provides specially balanced prenatal vitamin and mineral potencies for pregnant women or postnatal lactating women.
Herbal Remedies: Prickly Pear Powder, 4 oz. Bulk
Prickly Pear is particularly useful in providing nutrients to the pancreas and liver, which support digestion and maintain blood sugar balance.
Herbal Remedies: Red Raspberry Tincture, 100% Organic, 2 fl. oz.
Red Raspberry supplement is said to be good for common female problems, but it's healing properties for other uses are sometimes overlooked. Red Raspberry Supplement is beneficial for pregnant women as it tones the uterine and pelvic muscles, preparing for an easier labor, as well as for the prevention of miscarriage. Red Raspberry Supplement relieves morning sickness. It also helps to increase the flow of the mother's milk, brings balance into the menstrual cycle, and will help alleviate excessive bleeding and cramps. This herb can also be combined with Marshmallow to increase and enrich breastfeeding mother's milk supply. Red Raspberry Supplement is safe and effective for children to use for diarrhea and stomach complaints. 30-90 drops in water or juice 2-3 times daily or as needed.
Herbal Remedies: Sage Essential Oil, 100% Pure, NOW Foods, 1 fl. oz.
Sage is used to help dry up breastmilk when weaning your baby.
Herbal Remedies: Sage Tincture, 2 fl. oz.
Sage is used as a mouthwash and gargle for mouth infections, bleeding gums, sore throats, tonsillitis, and it can prevent an excessive flow of saliva. It can also reduce indigestion. Sage leaves in a small pillow can help promote sleep. Sage can also help dry up milk supply when you want to stop nursing. Use: Take 6-12 drops in liquid or under the tongue, 1-3 times/day.
Herbal Remedies: Wise Woman Herbal For The Childbearing Year, By Susus S. Weed, Janice Novet
This is a complete herbal pharmacopoeia for dealing with every problem that might arise before, during and after pregnancy and childbirth. Simple, safe, remedies for pregnancy, childbirth, lactation, newborns. Includes herbs for fertility and birth control.
Herbal Remedies: Breastfeeding / Nursing Supplements & Products
Herbal Remedies: Pregnancy / Pregnancy-Related Problems Supplements & Products
This has herbal and holistic remedies for dealing with various breastfeeding and postpartum concerns.
POSTPARTUM CARE INFORMATION
Postpartum Care: Index
Postpartum Care: Weight
Postpartum Care: Diet
Postpartum Care: Bowel Movements & Urination
Postpartum Care: Bathing
Postpartum Care: Breasts & Breastfeeding
Postpartum Care: Perineal Care
Postpartum Care: Vaginal Bleeding (Lochia) & Menstruation
Postpartum Care: Exercise & Back Care
Postpartum Care: Sexual Intercourse
Postpartum Care: Contraception
POSTPARTUM VISITS
PostPartum Visit: Day One
PostPartum Visit: Day Three
PostPartum Visit: Day Seven
PostPartum Visit: 4 to 6 Week Visit
POSTPARTUM CONCERNS
Baby Care & Concerns
Fatigue & Exhaustion
Postpartum Depression (The "Baby Blues")
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or your family member has questions about postpartum care.
You or a family member develops any unexpected and/or unusual symptoms or problems.
PREGNANCY RELATED LINKS
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Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 2nd Edition
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 4th Edition
Prescription for Herbal Healing: The A-To-Z Reference To Common Disorders
-- by Phyllis A. Balch
The Complete Guide to Natural Healing
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