Dealing with Engorgement?

I switched exclusively pumping to nursing and one or two pumping sessions a day.  I had built a great supply while pumping for the first 5 weeks. I was getting 8-9 oz every time I pumped. Kaelynn only eats 3-3.5 oz at a time.

The last 3 weeks since she's been nursing I'm constantly engorged. At night is the worse. She sleeps 8 hours eats and then sleeps another 4 hours. So one side goes 12 hours without me pumping or her nursing on it. I usually get up and pump just because I'm in so much pain and soaking my breast pads. I've woke up several times in the night changing my pads and shirt because I've leaked everywhere. Especially if I'm sleeping on my side and my arm puts pressure on my chest.

I would have thought my supply would have adjusted by now. There is so much foremilk that she is not getting any hindmilk and her poos are green. I've looked that up and found out that it's caused by to much foremilk and not enough hindmilk. When I pump my right breast I dump out about 3 oz of very watery milk and then pump another 2-3 oz that looks like milk. So I know that if it takes 3 oz before I'm getting any hindmilk then she isn't getting it when she nurses that side.

Anyone know anything I can do to help with the engorgement?  I would have thought my body would have adjusted to supply and demand in the last 3 weeks.

[nola0805]

Wow - I can't believe you were able to pump 8-9 oz in one sitting.  I have never produced that much.  I am no expert in this at all and have never dealt with engorgement personally but you would imagine that your supply would start to reduce now that you are exclusively breastfeeding and Kaelynn is eating less than you were pumping.  I do remember reading (in books and on this forum) that skipping feedings cause a reduction in milk production.  Perhaps it will take longer to reduce your supply since you are not skipping feeding.  

Why are you still pumping those 2 times a day?  My only suggestion (and this is just me thinking out loud and I could be very wrong)  is to stop pumping and exclusively breastfeed.  You could hand express a little milk to deal with engorgement, but don't pump or it will encourage more milk.  However, I wonder if you may want to consider pumping the first 3 ounces and then feeding her after that so that she gets more milk and hindmilk.  I am not sure if this would lead to more milk or not.  Have you worked with a lactation consultant at all?  I would strongly suggest that - or contacting la leche.   If you hand express instead of pump in the night, you could try a warm compress or cabbage leaf to ease discomfort.  Best of luck.  I know that it is not easy

[KarenDiane]

I think nola has a good idea. I would pump the 3oz before feeding her. I would also get up in the night to express some milk. Not empty your breasts, just pump enough so you are comfortable. I know on the rare occasion that Liam sleeps 5 or 6 hours, my breasts feel like rocks so I can only imagine how you must feel. But I don't leak so maybe that's why it's so painful, I don't know. Contacting La Leche is also a good idea. Good Luck.

[jenstam]

I had the same problem for about 9 months and like you, found it hard to figure out how to balance that for my baby. I would pump first, then nurse. I would dump the foremilk, or mix it with creamier milk. It's a vicious cycle but sometimes, despite the "on demand" idea, our body is determined to continue making more than we need. Mine was. I have always had an oversupply of milk. Always, no matter what! I pump at work M-F and then on the weekends I still get engorged when I'm only nursing and my son will be one in less than three weeks!

[Brittny27]

I pump because I'm in so much pain. I take my bra off and I squirt milk everywhere. It doesn't just leak and run down my chest. A few times kaelynn has gotten a face full of milk I hate it.  

The last three days I've seen a drop in my production so maybe it's finaly starting to even out. I notice that she cluster feeds before bed and I'm completly empty. I wake up about 6 hours later rock hard and leaking. During the day I don't get hard but I do leak. I've been having sharp pains in my breast again I think I might have a clogged duct.

[nola0805]

I have the same experience but without the engorgement.  Finn cluster feeds in the evening and I feel very empty.  He then get ups to eat again in 4.5 to 6 hours and I am rock hard and leaking (but only a little leakage).  I leak mildly throughout the day but do not produce as much as you or have engorgement.  You must be miserable.  I wish I knew more about breastfeeding to help you.  All I can offer is sympathy and empathy at how darn hard breastfeeding can be - I had no idea and have found it very challenging myself (I am still struggling with Finn too but for different reasons).  I admire your perseverance.  I do have some good books on breastfeeding and I will read up on engorgement and let you know what they say.  

I know you pump because you are in pain but the more you pump the more milk you will make and the cycle will continue.  Try your best to pump as little as you can to relieve the pain.  Have you tried pumping a bit before feeding?  

Keep us posted and I will see what else I can find out for you.  Hang in there.  It will get better.

[30something13]

Did not read all the posts so sorry if I repeat something. I have BF 4 babies and always have engorgment problems. after a month I go to feeding just on one breast each feed, that is what I suggest you do and she will get the hind milk as well. Now with my 5 this time I again had the engorgment after I changed to the one breast so I nursed on one side for 2 feeds at a time till it was better and he was no thrshing and choking all the time. It took about 5 days. This is recomended by the le leche leage as well! Actually they said to feed one side for 4 hours for a week then 6 if that does nto work and up to 12. I seem to be leveled out now after that 2 feed strech. What you need to do is fully empty the breast so I suggest feeding on one side a time full time first for a week to see if that helps. What ever you do DO NOT pump!!! It will signal your body to produce more milk. I know that releiving the tightness is what you need but just let the leaking do that unless you stand in a warm shower and it will pour naturally without stimulation, that is the key. I know how hard it is and I hope this helps you! If you coulld send me a note to say which thing helped you the most, I am curious as I do not get to talk to to many woman with our problem:0 Best of luck to you! Go to the leleache leage site for more info

[Brittny27]

The shower has never helped I've tried that a few times.

It's been 3 weeks now and I've definately seen a reduction in my milk supply. I'm only engorged when I wake up after 6 hours of her not eating. I'm nolonger engorged throughout the day.  My breasts feel bruised still near my armpits. I've been doing lots of massage and I think I just worked through some clogged milk ducts. I was having shooting pains which would get stronger when nursing. It took about 3 days to stop.