Excessive Swelling, Epidurals, and IV Fluids: What You Need to Know for Breastfeeding

Postpartum swelling, often caused by IV fluids, epidurals, and fluid retention, is a common experience after childbirth. While these interventions are essential for many people during labor and delivery, they can sometimes create challenges with breastfeeding in the early stages. Let’s break down how swelling, epidurals, and IV fluids impact breastfeeding and explore ways to manage these issues.

Excessive Swelling (Edema)

Swelling in the breasts, nipples, and areola can happen as a result of fluid retention from IV fluids or hormonal shifts after delivery.

Impact on Breastfeeding:

• Engorged areolas can make it harder for the baby to latch deeply because the breast tissue may be too firm.

• Swollen nipples may flatten, which can make it difficult for the baby to maintain a strong suction.

• Pain from swelling may make breastfeeding uncomfortable or difficult.

What You Can Do:

Reverse Pressure Softening (RPS): Apply gentle pressure around the areola to push fluid away before latching.

Cold compresses: Use a cold compress between feeds to reduce inflammation and swelling.

Hand express or pump briefly before nursing if your breasts are too firm for baby to latch comfortably.

Epidural Effects

Epidurals provide pain relief during labor, containing medications like fentanyl and anesthetics that cross the placenta in small amounts and can affect both mom and baby.

Impact on Breastfeeding:

• Babies may be sleepy or less alert, making early nursing more difficult.

• Delayed milk production is common, with milk sometimes taking 1–2 extra days to "come in."

• Moms may feel disconnected from sensation in the abdomen or chest, which can affect positioning and responsiveness during feeds.

What You Can Do:

1. Focus on skin-to-skin contact immediately after birth to stimulate the baby’s feeding instincts.

2. Use breast compressions during nursing to encourage milk flow and keep the baby engaged.

3. If the baby is too sleepy to latch, keep them in skin to skin, hand express or pump only if necessary to stimulate milk production.

IV Fluids During Labor

IV fluids are commonly administered during labor to maintain hydration, especially with epidurals. However, fluid overload can contribute to swelling in both mom and baby.

Impact on Breastfeeding:

• Breast and areola swelling may make it harder for the baby to latch properly.

• Increased birth weight from fluid retention can result in early weight loss that seems larger than normal, which may prompt unnecessary concerns about the baby not getting enough milk.

• Excess fluid can affect milk composition, making it appear watery temporarily.

What You Can Do:

1. Be aware that fluid retention in babies can cause temporary weight loss. Ensure baby is evaluated based on hydration, diaper output, and feeding effectiveness rather than weight alone.

2. Track wet and dirty diapers to confirm adequate milk intake rather than relying solely on weight checks.

3. Keep up with frequent nursing sessions (8-12 times per day) to help regulate milk supply and ensure proper hydration.

Summary

While excessive swelling, epidurals, and IV fluids can temporarily affect breastfeeding in the early days postpartum, there are ways to overcome these challenges. Skin-to-skin contact, frequent feeding, and gentle techniques like Reverse Pressure Softening (RPS) can help you navigate this period and set the stage for a successful breastfeeding journey.

At Diamond Valley Birth Collective, we’re here to support you through these challenges and provide you with the resources you need for a healthy, empowering postpartum experience. If you’d like more information on managing engorgement, helping sleepy newborns latch, or any other breastfeeding concerns, don’t hesitate to reach out!