• Colostrum appears within 12 hr, and milk appears in ~72 hr postpartum. Breasts become engorged by postpartum day 3 or 4 and should subside spontaneously within 24 to 36 hr.
• Assess breasts for infection and assess nipples for irritation.
• Encourage use of bra between feedings.

Complications

• Pain: Assess for mastitis, abscess, milk plug, thrush, etc. Proper positioning of infant (football carry) minimizes soreness. Breast shields prevent clothing from rubbing on nipples.
• Engorgement: Apply moist heat for 5 min before breastfeeding. Use ice compress after each feeding to reduce swelling and discomfort. Avoid bottles and pacifiers while breasts are engorged because it may cause nipple confusion or preference.
• Mastitis: Encourage rest and continuation of feeding or pumping. Administer prescribed antibiotics. Note: Breast milk is not infected and will not harm infant.