Breast engorgement is a common postpartum issue that is excruciatingly
uncomfortable and stressful. It can also lead to other breastfeeding issues
if left untreated.
Let’s go over breast engorgement and what to do.
What is breast engorgement?
Breast engorgement is the formation of hard, swollen, and sore breasts due
to an excess of breast milk. Breasts that are engorged may become
incredibly big, tight, lumpy, and painful. The swelling may extend to your
armpit, and the veins on the skin of your breasts could become more
prominent or even protrude.
Breast engorgement symptoms include:
Swollen, heavy, and sore breasts.
Nipples that have been flattened.
A mild fever of about 100.4°F (38°C).
Underarm lymph nodes may be slightly swollen and sensitive.
TRUE! Breast engorgement is common during the first few
weeks after milk production increases. More than 66% of moms report pain by
the 5th day after delivery.
You may experience this generally around 3-5 days after delivery or as late
as 14 days after delivery. It takes a few weeks for you and your baby to
sort out a shared feeding routine that fits both the baby's inconsistent
appetite and the ability of your breasts to accommodate it.
Breast engorgement can also occur if :
You can't nurse or pump as much as usual.
If you suddenly stop breastfeeding or wean too quickly.
When your baby suddenly starts breastfeeding less than usual.
Don’t worry. You feel better soon as most breast engorgement usually
subside within 1-2 days. If you are breastfeeding or expressing milk this
will help in relieving the engorgement.
If the engorgement does not go down after three or four days or if you have
a fever greater than 100.4°F (38°C) contact your healthcare provider.
YES! If you chose not to breastfeed or express milk you
are not in the clear. You can still feel breast engorgement. It will likely
occur within the first few days after childbirth or within the first few
days after you stopped nursing or pumping. Your body will produce milk, but
it will ultimately cease if you do not express it or feed it.
Breast engorgement is not just due to increased milk. It is also caused by
increased blood flow in your breasts in the days
following childbirth. The increase in blood flow helps your breasts produce
enough milk, but it can likewise trigger pain and irritation.
Some studies show that some moms may be more likely to develop severe
breast engorgement. Women who experience premenstrual breast tenderness may
be more likely to develop more severe engorgement postpartum as are women
who have had breast surgery or lumpectomy.
Yes. If engorgement is not treated, it can lead to
blocked milk ducts and mastitis, which is a breast infection.
Other common complications from prolonged engorgement include:
clogged milk ducts
decreased milk supply
Pain and infection is not the only concern of engorgement.
Around 80% of mothers with breast engorgement experience
difficulties in feeding the baby.
Moms with engorgement are more likely to introduce formula and to
breastfeeding before intended.
With breast engorgement you may have flattened nipples. This makes it
difficult for the baby to latch. Just hand expressing a little milk prior
to nursing can help with this problem.
Try the following to help prevent breast engorgement for those who are
Feed your baby often and on demand, with at least 8 to 12 feeds in
the first 24 hours. Look for signs of hunger such as sucking on
fingers and or rooting.
Wake your baby for a feed if your breasts become full and
Stick to breast milk unless needed for a specific medical reason.
Ensure your baby is positioned and latched correctly, to maximize
the amount of milk they are getting.
Empty your breasts with each feeding. Empty one breast completely
before you switch to the other side. Alternative sides you start
with and use both breasts. When your baby's sucking slows down a
lot or stops or you no longer hear your baby swallowing is a good
time to switch breasts.
Here are some things to try to help relieve your breast engorgement:
Cold cabbage leaves: Yes you can try this, it
may help with your discomfort!
Warm compress/ cold compress: Apply warm
compress before breastfeeding and then cold compress after .
Breast massage: Either a gentle downward massage
toward the nipple while your infant is nursing or reverse from the
nipple toward your chest prior to latching to relieve flattened
Express some milk prior to latching just soften
the areola to ensure proper attachment of the baby to your breast.
Pain relievers such as acetaminophen and
anti-inflammatory medicine like NSAIDS if needed. Both safe to take
Increase frequency of feeds.
What about if you are not breastfeeding? Here are some
tips for you!
Express just enough milk to relieve pain if you need, but not not
pump too much or your body will make more milk.
Apply a cold pack to your breasts for 15 minutes at a time every
hour as needed.
Take mild pain reliever and anti -inflammatory like ibuprofen (i.e.
Wear a bra that fits well and provides good support.
You are now ready to tackle this challenge should you be faced with it.
Remember most mothers go through this and not only can it get worse if not
addressed, this is one of the causes of early unintended weaning.
Be proactive when you feel your breasts about ready to burst!
Reach out to your healthcare provider or a licensed lactation counselor if
You can also use MaternalWell text support for any general questions or
talk to our license lactation specialists for guidance or support.