Edema.
It is most commonly known as postpartum edema (swelling) or water retention. Edema can make breastfeeding a very painful experience if your baby is not able to latch on to the areola properly. After childbirth, your body will continue to retain water due to your increased blood volume and progesterone. Edema can also be caused by the administration of excessive IV fluids such as Pitocin.
Progesterone is a hormone produced by the placenta which inhibits lactation during pregnancy. Lactation begins once the placenta is delivered. Most mothers who deliver their baby by C-section will experience postpartum edema — or swelling.
*** OAN Lactation is inhibited during pregnancy by progesterone until it is time to deliver. Experiencing temporary low milk supply? You could be expecting, honey.. congratulations.
OK...edema.
Too much hydration, i.e. excessive fluids, during delivery can cause the dilution of cell plasma protein creating excess fluid aka water. This excess water surrounds the duct and slows milk ejection by not allowing them to fully expand during the milk ejection reflex which causes your milk to sit in the breast which is a huge no-no for milk supply.
Reducing your swelling is extremely important for programming your milk supply during the first seven days after delivery. Many mothers find challenges during days 3-5 after delivery and hastened support with edema can diminish your supply . A lactation consultant or professional should be able to to work with you to reduce the swelling, attempt the latch and begin breastfeeding initiation.
Here are a few tips for breastfeeding with edema.
Feed Your Baby
If your baby is still not able to latch just yet, use hand expression or a manual pump to remove some milk and feed your baby by spoon or cup which is less inhibitive to breastfeeding.
Skin to Skin
Calms baby and allows your baby to self-attach.
Reverse Pressure Softening.
If edema is severe, fluid must be removed before attempting a latch by reverse pressure softening. It moves the swelling slightly backwards into your breast for a short period of 5 to 10 minutes allowing the shape of your areola to change easily and attaching your baby easier.
Cold Compress
Application and removal of cold packs for 15-20 minutes each. Cold packs decrease swelling and inflammation.
Medication
Anti-inflammatory medications provided you're given the OK by your provider.
Breast edema is common and short lived. Edema shouldn't last much longer than a week after delivery. If edema persists longer than one week, seek the advice of your medical provider.
Click here for a demonstration on reverse pressure softening.
Tips to Reduce Postpartum Swelling
Do not stand for too long. Rest and prop feet up to increase circulation.
Keep moving, Light exercise given the OK by your provider improves circulation.
Drink lots of water to flush excess fluid out.
Limit processed foods which contain high levels of sodium which increases bloating and water retention
Stay cool. When the skin temperature is increased it causes fluid to move out of the blood vessels and into the cell tissue causing more swelling.
Sources:
Wambach, K., & Spencer, B. (2019). Breastfeeding and Human Lactation (6th ed.). Jones & Bartlett Learning.
Cotterman KJ. Reverse Pressure Softening: A Simple Tool to Prepare Areola for Easier Latching During Engorgement. J Hum Lact 2004 20: 227-237.
Timmons, J. T. (2016). 7 Natural Treatments for Postpartum Swelling. Healthline. https://www.healthline.com/health/pregnancy/postpartum-swelling
******This blog post is not meant to replace the advice of your medical provider. It is simply meant to keep families abreast of evidence based information to make better informed decisions.
Jada Metcalf | is a mom of two, Certified Breastfeeding Specialist, trained Birth and Postpartum Doula, ROSE Community Transformer, Community Health Worker in training, 2021 IBLCE candidate and a postpartum wellness business owner of the Milk + Honey Co. Health information on this site is based on peer-reviewed medical journals, textbooks and highly respected health organizations and institutions including the CDC (Center for Disease Control), AAP (American Academy of Pediatrics), WHO ( World Health Organization), NIH (National Institute of Health), ABM (Academy of Breastfeeding Medicine) Breastfeeding and Human Lactation, 5th Edition, Wambach Spencer)