Dealing With Breast Engorgement

0-4 Months

Whether or not you breastfeed, breast engorgement is common after delivery, and it’s not fun (think swollen, hard breasts). The good news: Engorgement can be easily managed, and there are some things you can do to help relieve the pain and potentially prevent it from happening again. So try not to let this minor hiccup get in the way of your breastfeeding goals.

When breast engorgement happens

The most common occurrence of breast engorgement is when a woman’s milk first comes in, around 3 to 5 days after birth.* (This is your body’s natural response after birth for all women.) When this happens, your breasts become full or heavy, tender or warm to the touch, and some women complain that they’re hard. That’s all normal. However, if you experience a sudden fever, chills, fatigue, breast tenderness, or if a breast is hot (not warm) to the touch or you notice red streaks on the breast, you may be showing signs of an infection known as mastitis. Even if you have mastitis, know that it is still safe (and recommended) to continue to breastfeed; however, you should seek medical help from your doctor. Engorgement can also occur if you are away from your baby and can’t nurse or pump as often as you need to, if you suddenly stop breastfeeding or if your baby’s breastfeeding intake suddenly drops.

*Before your breastmilk officially comes in, you produce a small amount of milk called colostrum. While you don’t make a lot of colostrum, your baby doesn’t need much in those first few days because colostrum is packed full of immunity boosting nutrients (proteins, carbohydrates and some fat), and your newborn baby’s tummy is tiny!

Dealing with breast engorgement

Not only is engorgement painful, but when it happens post-delivery, you’re experiencing it during an already-stressful time for your body. You probably aren’t sleeping much, you may be recovering from a difficult labor or delivery, and you likely have post-partum hormones that are causing extra chaos. So, take some time to be kind and gentle to yourself, and follow these tips to help you deal with the engorgement:

  • Try hand expressing. Latching a baby can become more difficult and painful when your breasts are engorged. If your baby is having a tough time, hand expressing a small amount of milk can relieve some of the fullness and soften the breast enough to allow your baby to get a good latch. There are many hand expression videos available on the web, and many women find this technique so helpful that they continue to practice it throughout their breastfeeding experience.
  • Feed your baby on demand. During the first few weeks, your body doesn’t know how much milk to make, and feeding your baby on demand “teaches” your body how much milk it needs to produce.
  • Wear loose clothing and a non-binding bra. Cold compresses and an anti-inflammatory (as allowed by your doctor) can also help.

How to avoid future engorgement

  • Nurse your baby often, and don’t skip feedings—especially at night. Many women will let their spouse or someone else bottle-feed at night (so they can get their much-needed rest); however, going too long in between feedings can cause the production of milk to back up, resulting in engorgement. To make things easier on you, let someone bring your baby to you to feed. Let that person burp, change and put your baby back to sleep while you get back into bed.
  • Avoid pacifier, bottles and supplements until breastfeeding is well-established (which for some moms can take a few days and others up to 6 weeks). That gives your body a chance to learn and adjust to your baby’s needs, so you don’t end up under- or even over-producing milk.
  • Make sure your baby’s latch is correct, continue to feed on demand, allow your baby to empty the breast and don’t limit feedings to a certain period of time.
  • Use hand expression to relieve fullness.
  • Avoid extra pumping. Just remember that the more milk you remove, the more you will make—which can make the problem worse.