We need more breast kindness.

Katie’s breasts were severely engorged and she didn’t know what to do. Desperate for a solution, she turned to Google and found advice that told her to pump. She tried this but was not able to get much milk out, and the pain was just getting worse. Her 4 day old baby couldn’t latch due to the swelling so she was feeding him formula, which she had never planned to do.

Katie happened to come to the hospital the next morning because her baby needed a lab test done. She asked the nurse for a bottle of formula and the nurse came to get me, the lactation consultant on that day.

I asked Katie how breastfeeding was going and she told me her baby wasn’t latching, she couldn’t get milk out and she didn’t know what to do. She was in a lot of pain. She needed the pain to stop and for her baby to eat. When Katie spoke about her disappointment over not being able to breastfeed, the tears started flowing. She agreed to let me help while her partner settled their baby down with a small amount of formula.

For the next 45 minutes, I worked with her to reduce the swelling in her breasts so she could latch her baby. Once the baby latched and started gulping and her other breast started leaking, there was a collective sigh of relief. We came up with a plan for the next 24 hours and I helped her figure out who she could call for help if things got tricky again.

This situation happens all the time. We women really don’t understand our breasts and it’s not our fault. Our sex education does not include information on why and how our breasts grow in puberty, just that they do. We certainly don’t learn about what happens to our breasts should we get pregnant. During pregnancy, many providers never do a breast exam, or talk about what normal breast growth looks like during pregnancy. And most gynecologists no longer perform routine breast exams since we now have breast imaging.

We are failing to teach women about their breasts, not just during lactation, but all throughout the lifespan. It is only when there is a problem - mastitis, cancer or a lump - that we are given information about our anatomy. And what we are told is not always correct. As health professionals we need to do better.

During pregnancy, our breasts grow milk-making tissue, which is why most people will experience breast growth in pregnancy. Once the baby is born, there is a drastic drop in estrogen and progesterone, which allows our bodies to start producing lots of milk. It takes a few days for this process, called Lactogenesis II, to begin. This is what was happening when Katie came to the hospital with painfully engorged breasts.

Katie wasn’t able to get milk out because there was so much swelling in her breasts that the milk ducts were essentially being closed off. Her baby couldn’t latch because her breasts were like basketballs, and it’s downright impossible to grab onto a basketball with your mouth. Try it sometime. Now imagine a newborn doing this.

We started by reducing the swelling with cold packs which was a relief to Katie since her breasts were so warm from the building pressure within. Then we worked on lymphatic massage and gentle breast movement. Once her breasts were a bit softer and I knew the ducts were starting to open, I showed Katie how to hand express to begin moving milk out. As the milk started flowing, her breasts became soft enough for her baby to latch. Finally, as he latched and started sucking and swallowing, a look of calm came over both their faces. It was fabulous.

Now Katie understood why this had occurred, how to prevent it and what to do if it occurred again. Knowing what was going on in her breasts made it all feel a lot less scary to her. Basically, she felt empowered by understanding her own body. Perhaps this is why the medical community doesn’t teach us this stuff? Empowered females are a force to be reckoned with!

One of the techniques that I showed Katie was something that I first learned from Maya Bolman, a lactation consultant who has taught countless numbers of people how to perform what she calls “breast gymnastics.” I want all lactating people to know about this practice, as it is an easy way to improve fluid movement within the breasts, thus promoting milk flow and preventing complications such as engorgement, plugged ducts and mastitis. Check out Maya’s video below.

I had the pleasure of meeting Maya at a conference recently, and she was just as sweet and funny as you can imagine from watching this video. She and others in the lactation community have taught us to stop trying to squeeze milk out of our breasts like they are tubes of toothpaste, and instead move lymphatic fluid out of the breasts so milk can easily flow. We need to treat lactating breasts with the compassion that they deserve.

If you are lactating, or will be in the future, you can learn more about your breasts from people like Maya and her team at Breastfeeding Medicine of Northeast Ohio. These are the health care providers who are encouraging us to take our breast health into our own hands. Literally.