In the first few days after birth your breasts produce colostrum, a thick, yellowish substance, rich in proteins and antibodies. This colostrum has been in your breasts since before birth. It is the perfect food for your baby these first few days and he doesn't need anything else.
Your milk will "come in" around the third or fourth day after birth. When it does, you may experience a fullness and tightness in your breasts.
After delivery, the hormones that stimulate milk production, also cause increased amounts of blood and lymph in the breast. These fluids together with the milk volume itself; cause your breasts to become full, heavy and tender. This fullness is a normal condition, which subsides at about ten days after delivery if the baby is nursing frequently.

This breast fullness may however develop into engorgement when the breast is not emptied frequently or adequately. When breastfeeding is delayed or interrupted or the time that baby nurses at the breast is restricted the breasts can become overfull or engorged.

Symptoms of engorgement include:

* Breasts feel extremely full and painful
* Breasts are warm, hard, skin can be shiny and transparent
* You may have low-grade fever
* Your nipples may be difficult to grasp due to engorgement of the areola.

Prompt treatment of engorgement will prevent possible complications as:

* Feeding problems or slow weight gain if baby is unable to latch on well to the breast
* Sore nipples due to the inability of baby to grasp the nipple and latch on properly to the   breast.
* Increased risk of plugged ducts and breast infections due to inadequate milk flow and   pressure within the breast.

MEASURES FOR IMMEDIATE RELIEF OF ENGORGEMENT

* Use warm compresses or heating pads on your breasts or take a warm shower about 15   minutes prior to   nursing, to promote letdown and milk flow,
* You can accompany this with some gentle massage with your finger tips, massaging
  from the chest wall toward the nipple area in a circular motion
* Use cold compresses on your breast in between feedings to relieve pain and swelling   (crushed ice in a plastic bag, or a bag of frozen vegetables work well).
* Nurse frequently, at least every 1 ½ to 2 hours, you may have to wake up a sleepy baby
  for a feed.
* Nurse from both breasts and don't restrict feeding time
* If baby is too sleepy to nurse or hasn't nursed long enough to soften the breast, hand   express the milk or use a breast pump.
* If your baby has difficulty latching on to your engorged breast, hand express or pump
  some milk until your areola has softened and it is easier for your baby to latch on.
* Take a pain medication that is compatible with breastfeeding (such as Paracetamol ).
* Avoid use of supplementary bottles and pacifiers, all baby's nursing should be at the
  breast
* Wear a well fitting, non-binding bra for support

When you follow carefully the above measures you will feel more comfortable, your engorgement will subside soon and further difficulties will be prevented.

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