Breast engorgement

Breast engorgement
Classification and external resources
ICD-9-CM	676.24
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Breast engorgement occurs in the mammary glands due to expansion and pressure exerted by the synthesis and storage of breast milk.

Engorgement usually happens when the breasts switch from colostrum to mature milk (often referred to as when the milk "comes in"). However, engorgement can also happen later if lactating women miss several nursings and not enough milk is expressed from the breasts. It can be exacerbated by insufficient breastfeeding and/or blocked milk ducts. When engorged the breasts may swell, throb, and cause mild to extreme pain.

Engorgement may lead to mastitis (inflammation of the breast) and untreated engorgement puts pressure on the milk ducts, often causing a plugged duct. The woman will often feel a lump in one part of the breast, and the skin in that area may be red and/or warm. If it continues unchecked, the plugged duct can become a breast infection, at which point she may have fever or flu-like symptoms.

The first signs of the condition are the swollen, firm and painful breasts. In more severe cases, the affected breast becomes very swollen, hard, shiny, warm, and slightly lumpy when touched.

The condition may cause edematous and flushed nipples. In cases when the breast is greatly engorged, the nipple is likely to retract into the areola. Commonly, patients experience loss of appetite, fatigues, weakness and chills.

A fever may occur in 15%, but is typically less than 39 degrees C and lasts for less than one day.

Breast engorgement is caused by an imbalance between milk supply and infant demand. It often occurs in women who decide not to breastfeed.

Breast engorgement can occur due to four main factors such as a suddenly increased milk production that is common during the first days after the baby is delivered or when the baby suddenly stops breastfeeding either because it is starting to eat solid foods or it is ill and has a poor appetite. Breast engorgement may also be caused when the mother does not nurse or pump the breast as much as usual.

After the first 3 to 4 postpartum days, the quantity of colostrum is quickly replaced by an increased milk production. When milk production increases rapidly, the volume of milk in the breast can exceed the capacity of the alveoli to store it and if the milk is not removed, the alveoli become over-distended which can lead to the rupture of the milk-secreting cells

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