By far, the best 'treatment' for engorgement is preventing it happening in the first place. This can be done by allowing your baby to feed freely, learning how to latch your baby correctly, not restricting the time the baby feeds at the breast and not complementing your baby with formula or water. If the breasts do start to become engorged, the most important thing to do is to continue feeding as often as the baby wants to, without limiting the time the baby feeds, or regularly expressing the breast milk if your baby is unable to feed. This helps to drain the milk and relieve any developing engorgement. Sometimes it may be necessary to wake your baby to feed, if you start to feel uncomfortable, or expressing some milk off for comfort if your baby is reluctant to feed.
There have been many approaches used in the past with the aim of relieving breast engorgement. However, in the last couple of years, research has failed to support the effectiveness of many popular approaches. These include:
Cabbage leaves. Cabbage leaves have been used for the last decade or so, with the aim of being a natural way to reduce milk engorgement. They entail using raw, white, chilled cabbage leaves, and placing one leaf around each breast, leaving them on until the cabbage became warm and soft, or almost 'cooked'. Recent research has failed to demonstrate any tangible benefits from using cabbage leaves. However, some women feel they help ease the pain and hotness of the breasts, perhaps working in the same way as cold packs.
Cold packs or compresses. These are often used in between feeding the baby, with the idea that they will reduce blood flow to the breasts and therefore help with engorgement. It has been shown that cold packs do not reduce engorgement, but they may play a role in pain relief.
Ultrasound. Caregivers used to order ultrasounds for breast engorgement.