What is breast engorgement?

Breast engorgement is breast swelling that results in painful, tender breasts. It’s caused by an increase in blood flow and milk supply in your breasts, and it occurs in the first days after childbirth.

If you’ve decided not to breastfeed, you may still experience breast engorgement. It can happen in the first few days after delivery. Your body will make milk, but if you don’t express it or nurse, the milk production will eventually stop.

Breast engorgement is the result of increased blood flow in your breasts in the days after the delivery of a baby. The increased blood flow helps your breasts make ample milk, but it can also cause pain and discomfort.

Milk production may not occur until three to five days postpartum. Engorgement may occur for the first time in the first week or two after delivery. It can also reoccur at any point if you continue to breastfeed.

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Certain conditions or events may make you more likely to experience the swollen fullness that’s commonly associated with breast engorgement. These causes include:

  • missing a feeding
  • skipping a pumping session
  • creating an overabundance of milk for the baby’s appetite
  • supplementing with formula between nursing sessions, which may reduce nursing later
  • weaning too quickly
  • nursing a baby that’s ill
  • difficulty with latching and sucking
  • not expressing breast milk when it first comes in because you don’t plan to breastfeed

The symptoms of breast engorgement will be different for each person. However, breasts that are engorged may feel:

  • hard or tight
  • tender or warm to touch
  • heavy or full
  • lumpy
  • swollen

The swelling may be contained to one breast, or it may occur in both. Swelling can also extend up the breast and into the nearby armpit.

The veins running under the breast’s skin may become more noticeable. This is a result of the increased blood flow, as well as the tightness of the skin over the veins.

Some with breast engorgement may experience a low-grade fever and fatigue in the first days of milk production. This is sometimes called a “milk fever.” You can continue to nurse if you have this fever.

However, it’s a good idea to alert your doctor to your increased temperature. That’s because some infections in the breast can cause fever, too, and these infections need to be treated before they become bigger issues.

Mastitis, for example, is an infection that causes inflammation of the breast tissue. It’s most commonly caused by milk trapped in the breast. Untreated mastitis can lead to complications such as a collection of pus in the clogged milk ducts.

Report your fever and any other symptoms you’ve recently experience to your doctor. They will want you to monitor for signs of an illness or infection so you can seek immediate treatment.

The treatments for breast engorgement will depend on whether you’re breastfeeding or not.

For those who are breastfeeding, treatments for breast engorgement include:

  • using a warm compress, or taking a warm shower to encourage milk let down
  • feeding more regularly, or at least every one to three hours
  • nursing for as long as the baby is hungry
  • massaging your breasts while nursing
  • applying a cold compress or ice pack to relieve pain and swelling
  • alternating feeding positions to drain milk from all areas of the breast
  • alternating breasts at feedings so your baby empties your supply
  • hand expressing or using a pump when you can’t nurse
  • taking doctor-approved pain medication

For those who don’t breastfeed, painful engorgement typically lasts about one day. After that period, your breasts may still feel full and heavy, but the discomfort and pain should subside. You can wait out this period, or you can use one of the following treatments:

  • using a cold compress or ice packs to ease swelling and inflammation
  • taking pain medication approved by your doctor
  • wearing a supportive bra that prevents your breasts from moving significantly

You can’t prevent breast engorgement in the first days after giving birth. Until your body knows how to regulate your milk production, you may overproduce.

However, you can prevent later episodes of breast engorgement with these tips and techniques:

  • Feed or pump regularly. Your body makes milk regularly, regardless of nursing schedule. Nurse your baby at least every one to three hours. Pump if your baby isn’t hungry or you’re away.
  • Use ice packs to decrease supply. In addition to cooling and calming inflamed breast tissue, ice packs and cold compresses may help decrease milk supply. That’s because the cool packs turn off the “let down” signal in your breasts that tells your body to make more milk.
  • Remove small amounts of breast milk. If you need to relieve the pressure, you can hand express some breast milk or pump a bit. Don’t pump or express too much, however. It could backfire on you, and your body may end up trying to produce more milk to make up for what you just removed.
  • Wean slowly. If you’re too quick to stop nursing, your weaning plan may backfire. You could end up with too much milk. Slowly wean your child so your body can adjust to the decreased need.

If you don’t breastfeed, you can wait out breast milk production. In a matter of days, your body will understand it doesn’t need to produce milk and the supply will dry up. This will stop the engorgement.

Don’t be tempted to express or pump milk. You’ll signal to your body that it needs to produce milk, and you may prolong discomfort.

Breast engorgement is swelling and inflammation that occurs in your breasts because of increased blood flow and milk supply. In the days and weeks after giving birth, your body will begin to produce milk.

Until your body knows how much you need, it may produce too much. This can lead to breast engorgement. Symptoms include hard, tight breasts that are swollen and tender. Regular nursing or pumping can help prevent breast engorgement.

If you continue to experience the painful swelling of breast engorgement, reach out to a lactation consultant or a lactation support group at your local hospital. Both of these resources can help you with your questions and provide support.

Also, call your doctor if the engorgement doesn’t subside in three to four days or if you develop a fever. They’ll ask you to monitor for other signs that may indicate a more serious problem, such as a breast infection.