If the baby is not effectively lactating or does not breastfeed for many hours in a row, engorgement can occur. Accumulated milk makes the breast swell and tighten, the skin becomes shiny and edemas or reddening can appear as well.
Engorgement is not only caused by milk accumulation, but also by inflammation of the breast tissue, which obstructs the milk ducts of the breast while at the same time impeding lymphatic drainage.
As a consequence, lactating becomes harder as the milk cannot flow easily and the nipple can flatten due to the inflammation, making it harder for the baby to latch on and empty the breast.
Breast engorgement can furthermore be very painful and if left untreated, it can lead to duct obstruction, mastitis and even breast abscesses.
There are also other factors that can predispose to the development of mastitis:
- Reduction of maternal defenses associated with the postpartum period and stress.
- Deficient nutrition.
- Injuries to the nipples, like wounds or fissures
- Having suffered previously from mastitis
- Being a carrier of staphylococcus aureus
- Certain variations in the breast anatomy (flat nipple or inverted nipple)
- Inadequate hygiene of expression tools or hands before and after expression and breast massages.
- Routine use of nipple creams that make it harder to achieve a good mouth-nipple adhesion
Mastitis is an inflammation of the breast tissue that sometimes leads to infection. The inflammation causes pain, burning, swelling, heat and reddening of the breasts. It can also possibly cause fever and cold shivers.