4

According to some websites, it does not affect your milk supply if you express breast milk during engorgement, so long as you only express enough to relieve discomfort. Even this medical foundation website gives this information, but there are no citations on it or the others.

Is this information true or untrue? Why or why not?

Note: A lactation consultant can and will be consulted for all of my family's lactation needs. However, I don't expect such a person to be able to quote to us specific studies or articles on the subject (even if they are able to!) We'll trust their judgment, but I still want to know the basis for that judgment.

2 Answers2

5

It may possibly affect the milk supply, but not substantially or permanently.

Engorgement is caused by the increase in milk production, which fill up the breasts. It can also be caused by swollen lymph nodes and excess other fluids as a result of labor and delivery.

Expressing or pumping enough milk to relieve the discomfort was recommended to us not only by a number of websites, but by our own professional lactation consultant (a physician).

However, it's important to realize that since not all the discomfort is being caused by excess milk, expressing milk alone may not be sufficient to relieve the discomfort. As such, you should be careful to not express an excessive amount when trying to relieve discomfort, when other methods may be necessary.

Our physicians have all recommended the continued use of my wife's prescribed anti-inflammatory medication (ibuprofen), and cold/ice packs after feedings, in order to treat the swelling and inflammation not caused my excess milk.

While I've been unable to find any studies or facts regarding the effects expressing milk during engorgement, I was able to find a somewhat related study. Unfortunately, I only have access to the abstract, but it's currently sufficient enough for me as other resources are in agreement.

This study tested the influence of the number of feedings and total feeding times on the milk supply. It confirmed that reducing feedings reduces milk supply, and increasing feedings increases milk supply. What is interesting is that the increases to milk supply were not observed for approximately 48 hours after the increased feeding amounts. I believe this is assuming that the increased amount is held constant (and not done sporadically as you may do to relieve discomfort).

To me, if there is an increase to milk supply, the 48 hours it takes to happen may put the increase after engorgement has subsided for some women.

For our family, we will keep pumping open as an option for relieving discomfort without worry about a cycle of overproduction.

  • I'm perplexed about your word, overproduction. Are you talking about an overactive letdown reflex? That's the only situation I can imagine in which an overproduction might be a bad thing. And I'm not sure even that would actually be overproduction. I think the overactive letdown reflex resolves itself as the knob on the faucet learns to apply a finer control at start-up. – aparente001 May 31 '15 at 06:13
  • @aparente001 The body can't really tell the difference between a breast emptied from nursing and one emptied from pumping/expressing. So, if you continually express more than the child needs, the body will think it needs to keep producing more milk. Producing more milk than the infant needs == overproduction. See this wiki section for more info on the process. So, if you're trying to combat discomfort, you won't want any more milk than necessary! –  May 31 '15 at 22:17
  • Can you give us an idea about the approximate volume being expressed per 24 hours, @CreationEdge? – aparente001 Jun 06 '15 at 03:23
  • @aparente001 No, it'll vary between every woman and the amount their infant is consuming. I think going by volume would also be a false route, as it should be just enough to relieve comfort, regardless of how much or little. I've also never seen, and we've not be told, any amounts/volume when looking this up or talking to the medical professionals. –  Jun 07 '15 at 19:29
  • "it should be just enough to relieve comfort" -- that's my point. I don't think it will be a significant enough amount to open the flood gates. - - I think the main point here is that engorgement isn't a simple matter of oversupply. Hopefully your wife's engorgement woes are long gone, but if not, it would be an interesting experiment, to see approximately how much milk is being pumped to relieve discomfort. – aparente001 Jun 09 '15 at 15:03
  • @aparente001 Well, no, that's my point. It's meant to contrast with the possibility of pumping all the milk out, which isn't recommended and could affect supply. The whole point of my answer is to show that expressing that small amount to get relief won't affect supply (but it may also not help with engorgement). I'm guess I'm not sure what else your comment is trying to get at besides sort of summarizing my answer? –  Jun 09 '15 at 20:42
  • Oh, wow, that's not what I had understood! Thanks for clarifying. – aparente001 Jun 10 '15 at 03:23
2

Okay, I think I understand your question better, having reviewed the section on engorgement in my La Leche League Breastfeeding Answer Book -- which is mainly aimed at La Leche League leaders and lactation consultants. By the way, if you don't have a copy of The Womanly Art, I recommend it! I don't have a personal copy, but I imagine it has a section on engorgement too.

Here's the paragraph that helped me understand your question:

"Some mothers are reluctant to express even a little milk for fear that this will increase their milk supply and make their engorgement worse. If the mother mentions this concern, assure her that expressing some milk will make it easier for her baby to removed the milk from her breasts, which will lessen her engorgement. Explain that the engorgement is caused in part by other fluids --lymph and blood-- as well as milk, and that removing a little milk will allow the baby to nurse well, which will relieve her congestion."

There are references at the end of the chapter about engorgement -- let me know if you still want them.

And congrats on the new baby!

aparente001
  • 5,037
  • 11
  • 35
  • 1
    Thank you, great reference! It matches the information I found, as well. Feel free to include the reference information, because it's not just for me, but any parent that would need the info! –  May 31 '15 at 22:19
  • @CreationEdge, I think the references were given for scholars. Also, my copy is pretty old -- I imagine there's a more recent edition with more recent additional references. I think what the woman and her support network mainly need is to understand what's going on, and what to do about it. - - - At any rate, I would hope, as I believe you also said, the engorgement would subside in less than a week. It seems to me that the human milk factory adjusts pretty quickly to reduced demand; in fact, I guess that's why bottle supplementing so often puts breastfeeding at risk. – aparente001 Jun 05 '15 at 03:57
  • 1
    Scholars can be parents, too ;) –  Jun 06 '15 at 02:32