How to Deal with Breast Engorgement

When you first start breastfeeding, your breasts will produce colostrum. Which is the first milk your baby will ever eat. This is produced in small amounts that gradually increases over the first few days. By around day 2 to day 4, your breasts will start making much larger quantities. This change is known as your milk “coming in.” How to Deal with Breast Engorgement - Mom Breastfeeding Baby

A sign that your milk is coming in is that your breasts feel firmer and fuller. The swelling the breasts aren’t just caused by the greater quantities of milk, but also by an increase in blood flow as well as extra lymph fluids in the breast tissue. Engorgement happens when your breasts are full of milk and are rock hard and uncomfortably full. (1)

It is important to note, that even if you have decided not to breastfeed, you can still experience engorgement. It can happen in the first few days after delivery. Your body will make milk. If you don’t pump or express the milk, eventually the milk production will stop. 

Related: 9 Common Breastfeeding Concerns

What Causes Breast Engorgement?

Breast engorgement is an increased blood flow in your breasts that occurs in the days after the delivery of your baby. The increased blood flow is important in helping your breasts make enough milk to cater to your baby’s needs, but it can also cause pain and discomfort. Engorgement can occur a few days after delivery up yo a couple of weeks after. It can also occur at any point when you are breastfeeding. (2)

There are certain events or situations that make it more likely that you will experience the swollen fullness (and yes this can be painful) that is commonly associated with engorgement. These include:

  • Missing a feeding
  • Weaning too quickly
  • Skipping a pumping session
  • Nursing a baby that is ill
  • Creating an overabundance of milk
  • Supplementing with formula between nursing sessions, which can reduce nursing later on
  • Not expressing breast milk when it first comes in
  • Difficulty with sucking and/or latching

What are the Symptoms?

Symptoms of engorgement will vary from woman to woman. With that being said, breasts that are engorged may feel:

  • Swollen
  • Lumpy
  • Heavy 
  • Full
  • Hard 
  • Tight
  • Tender 
  • Warm to the Touch

Swelling can be contained to one breast or can extend to both breasts. Swelling can also extend up the breast and into the nearby armpit. Also, the veins underneath your breast may show more due to the increased blood flow as well as the tightness of the skin over the veins, so don’t be alarmed if this happens to you. 

Sometimes with breast engorgement, women might experience what is referred to as milk fever. In the first few days of milk production, a low-grade fever and fatigue might happen. Breastfeeding can still occur if this happens to you. But it is a good idea to let your doctor know that you have this fever.

There are infections that occur in the breast that need to be treated before they become a bigger issue. One such example is Mastitis, which is an infection that causes inflammation of the breast tissue. Most commonly, it is caused by milk trapped in the breast. 

If left untreated, it can cause complications such as a collection of pus in the clogged milk ducts. Let your doctor know your symptoms, so they can monitor you for signs of illness or infection that need immediate medical treatment. (3)

How do you Treat it?

Here are treatments for breast engorgement. 

  1. Gently massage your breast from the chest wall toward the nipple before breastfeeding
  2. Nursing for as long as your baby is hungry
  3. Massage your breast while breastfeeding
  4. Hand-expression
  5. Use a pump when you are unable to nurse
  6. Feeding more regularly. Or at the very least every one to three hours
  7. Cabbage leaf compress
  8. Apply a cold compress to relieve pain and swelling
  9. Alternate breasts at feedings so your baby fully empties your supply
  10. Alternate feeding positions to drain milk from all areas of your breast
  11. Take a warm shower or use a warm compress to encourage milk let down. Just be careful not to let the water spray directly on your breasts or it could stimulate them, doing the exact opposite of what you want, more milk. 

Can you Prevent it?

In the first few days after giving birth, it is impossible to prevent engorgement. Until your body learns to regulate your milk production, you may make way too much. 

However, it is possible to prevent later episodes of breast engorgement by following these tips:

  • Feed or Pump Regularly

Your body will make milk regularly, regardless of your baby’s nursing schedule. So it is important to nurse your baby every one to three hours. If your baby isn’t hungry or you are going to be away from them, then pump. 

  • Remove Small Amounts of Breast Milk

If you need to relieve the pressure, you can remove small amounts of breast milk by hand expressing or by pumping. Just make sure you don’t pump or express too much. Your body will produce more milk to compensate for the amount of milk that was lost. 

  • Use Ice Packs to Decrease Milk Supply

Ice packs can help decrease milk supply because they turn off the “let down” signal in your breasts that tell your body to make more milk. 

  • Wean Slowly

If you wean your child too fast, you could end up with too much milk. So, wean slowly so your body can adjust to the decreased need until there isn’t a need anymore. 

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Wrapping Up

Breast engorgement is swelling and inflammation of your breasts that occur in the days to weeks following your baby’s delivery because of increased blood flow and milk supply. Until your body knows just how much milk you need to produce, it may make too much which leads to breast engorgement. 

There are many ways to treat it. Reach out to a lactation consultant and your doctor if treatments aren’t working to get additional help and support. 


Did you ever experience breast engorgement while breastfeeding?

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