Mothers Value and Utilize Early Outpatient Education on Breast Massage and Hand Expression in Their Self-Management of Engorgement

Breastfeed Med. 2016 Nov;11:433-439. doi: 10.1089/bfm.2016.0100. Epub 2016 Aug 30.


Background: Breast engorgement is a major cause of pain and weaning in the early postpartum period. While protocols reinforce the need for anticipatory engorgement advice and continued outpatient health professional breastfeeding support, there remains limited information on the efficacy of focused postdischarge engorgement education. This study sought to explore if outpatient postpartum engorgement education changed mothers' home management and if mothers found instruction on specific massage and hand expression techniques helpful.

Materials and methods: This was a prospective descriptive cohort study. Subjects received engorgement-specific postpartum support from a healthcare professional at the posthospital discharge (PD) newborn visit. Email surveys at 1, 2, and 12 weeks postpartum collected data on engorgement home management, clinical course, and postpartum education.

Results: After the office visit, mothers changed their engorgement home management. Significantly more mothers utilized massage toward the axillae (25% versus 1%, p ≤ 0.001), reverse pressure softening (18% versus 3%, p = 0.001), and feeding more frequently (32% versus 16%, p = 0.04). Sixty-one percent would not have used massage and hand expression before education in the office. At 12 weeks, 96% of women reported massage and hand expression instruction as helpful. Mothers reported engorgement peaked at a median of 5 days postpartum, corresponding well to the office visit at a median of 4 days postpartum.

Conclusions: Maternal engorgement symptoms are commonly present at the PD newborn visit. Education on engorgement, massage, and hand expression at this visit significantly changes home management strategies. Mothers find massage and hand expression instruction helpful.

Keywords: breastfeeding support; engorgement; massage; outpatient lactation.

MeSH terms

  • Adult
  • Breast Feeding / methods*
  • Female
  • Humans
  • Infant, Newborn
  • Lactation / physiology*
  • Lactation Disorders / prevention & control*
  • Massage*
  • Maternal Health
  • Mothers / education*
  • Mothers / psychology*
  • Outpatients / education
  • Outpatients / psychology
  • Patient Education as Topic
  • Patient Satisfaction*
  • Postnatal Care / psychology
  • Postpartum Period / physiology
  • Postpartum Period / psychology
  • Prospective Studies
  • Self Care* / methods
  • Self Care* / psychology
  • Social Support