right boob- upper half engorged

[b0nni3]

Hi all, I was wondering if anyone has any solutions to a problem I'm having:

I've always had a harder time nursing from my right boob than from my left. I used to feed one boob  per feed but engorgement on the unfed side at any given time was so problematic that I started alternating, which seemed to ease the engorgement. So now I feed about 10-15 min per side and feeds are generally 20-30 min long.  My left one always feel soft/supple after a feed...i.e., feels like they used to feel!) but the right one often continues to feel engorged after a feed. I've tried to let him feed slightly longer on the right side but it doesn't seem to help. The weird thing is that the upper half of the boob stays pretty rock hard while the bottom part gets soft. I'm guessing it's the milk ducts emptying better on the bottom where his chin is, but I'm not sure how to change that (I try to alternate, if I remember, between cradle and clutch hold). I've tried breast compressions and hot presses but nothing helps - the top part still stays rock hard and slightly lumpy (some soft spots amidst the generally hard top part!) as if I haven't fed him from that side. Does anyone know why or how to remedy that? I also have some excess breast tissue in my underarms causing some lumps in my armpits (checked today by breast specialists, benign, they said it's probably just lactation-related -- hormones + bf activity induced) and it's always worse on the right side than on the left.

Any thoughts or comments would be greatly appreciated!

Bonnie

[Bryony]

Do you think you might have a blocked duct? 

[~Faye~]

Blocked duct was my first thought. Does your bra fit ok? Sometimes if it's a bit small then it can push on the glands and cause them to block. Does it fit properly when you are at your fullest? It could be one boob is bigger than the other.

[b0nni3]

i know i'm not supposed to overstimulate the engorged breast since engorgement is due to OS but I did it tonight...what a relief. I'll probably have to live with the consequences tomorrow but it was so engorged (but only the top half) that my nipple was bent out of shape from the pressure. Might have to top-up with a little bit of formula tonight but my son was in poor form today and didn't sleep or feed well at all, which probably aggravated the engorgement. I had just never ever had an engorged upper half of a breast!

[Canwi]

It really sounds like you had a partially blocked duct to me, BonnieZ.  The fact that you were able to relieve the pressure makes me even mor suspicious of it.
I would do some gentle massage on the hardened area while your DS is nursing and let his sucking help to remove the blockage.  It won't hurt him.  He might get a fright from the gush that may come when the plug comes away.
Or pump and do the massage at the same time.  You may find you get better relief after a warm shower or wrapping your breasts with a blanket to warm them up.
Stay away from formula for as long as you can.  If you are getting engorged, then you will have more than enough milk for your LO.  If you pump when you try to relieve the blockage, then feed him the EBM.
HTH

[monopod]

Everyone has given great advice already so my post is just FYI: I had an engorged side of breast (only the right side of my right breast) a couple of times when DS was younger - in my case it was a blocked nipple pore that was causing it. It was agony but I was able to get relief by 'scraping out' the milk plug (which you could see in the form of a white blob underneath the skin of the nipple) and then massaging the area HARD while in a hot shower. I understand that engorgement is not so much due to OS as inadequate drainage (at least in these circumstances) so wouldn't worry about it.

[b0nni3]

Thanks everyone for the helpful tips - your diagnoses were all correct! I think it was a blocked duct, and I expressed, which relieved the engorgement _and_ I did not wake up with another engorged boob (contrary to what I would have thought!). We ended up using the formula but will be using the expressed milk tonight.

[Sarah and JT]

HIya,

Just in case it happens again....
I'm a mum of 6 month old twins so I'm producing loads of milk at the mo - and this has been a very frequent problem with me as everytime they go slightly longer between feeds I get blocked ducts.  You really need to get a blocked duct clear as soon as you can (I've had to be very persistent at times) because it can easily become mastitis as the sitting milk is a haven for bacteria apparently.  (I;ve had mastitis 4 times in 6 months & it has been really miserable - I seem to be honing my prevention skills tho!  THese are my personal tips:

~ putting a hot water bottle on the area - particularly before feeds
~massageing the area quite hard - I do this in the shower or bath with my breast under the hot water and whilst I am feeding is particularly helpful
~stuffing my bra with savoy cabbage leaves - I was very resistent to this at first but now completely swear by it - its amazing (apparently they are now using cabbage leaves to help reduce swelling for arthritic knees too!(another tip?) )- it really helps engorgement after a few hours & if you keep the leaves cool, it is really soothing.  You need to take off the first few tougher leaves off the cabbage and get rid of them.  Then take a leaf, cut out the main stalk and roller it with a rolling pin or bottle or something - you need to crack the veins in the leaf so that the sap can get out.  Then arrange the leaves around your breast under your bra - the leaves wrap round quite well!

hope this is helpful

Sarah