Intro

Your body undergoes many changes during pregnancy. You'll experience everything from morning sickness to weight gain to heartburn. As your due date approaches, you’ll no doubt look forward to putting uncomfortable pregnancy symptoms behind you.

But bodily changes don't stop after the birth and delivery of your baby. Your breast milk will come in shortly after giving birth. When this happens, you may experience a condition called breast engorgement.

This is a common postpartum occurrence. You may experience it for the first time within a couple of days of giving birth, and it may happen periodically for as long as you breast-feed.

Breast engorgement occurs when your breasts overfill with milk. The condition can be painful. Here are some steps you can take to relieve and prevent discomfort.

Symptoms of breast engorgement for breast-feeding moms

Breast engorgement is common for breast-feeding moms. It’s easy to recognize symptoms of this condition. You’ll experience the following:

  • full feeling of the breasts
  • swollen, hard, or painful breasts
  • lumpy breasts
  • hard areola
  • swollen and sore area in the armpit

If your breasts are painful and uncomfortable, you can usually care for this yourself. There are no specific tests to diagnose this condition, but your doctor should be able to identify engorgement by looking at your breasts.

Breast engorgement is common and gradually disappears on its own, but you shouldn’t ignore signs of severe engorgement. This is when breasts become extremely swollen and painful. This is not only uncomfortable and painful, but severe engorgement affects how much amount milk your baby receives. If the condition does not begin to resolve in a couple of days, see your doctor.

The inability to breast-feed because of painful breasts and nipples has a domino effect. If your baby doesn't drink enough milk, your breasts can’t empty. And when your breasts can’t empty, engorgement worsens. Severe engorgement increases the risk of a blocked milk duct and a breast infection.

Causes of breast engorgement

Breast engorgement is caused by your body producing too much milk, or more milk than your baby needs. Typically, the breasts start producing milk two to five days after delivery. This doesn’t mean you have to wait two days before you can breast-feed. Prior to your milk coming in, your breasts will produce the perfect yellowish nutrient-rich liquid called colostrum that your baby needs.

As your milk production begins, your breasts may tingle, swell, and feel warm. It’s also normal for your breasts to increase in size. This excess fullness is not just caused by too much milk. It may resolve within a couple of days, and it may never occur during breast-feeding again. It will become more severe if the baby is not breast-feeding effectively.

This condition can also occur if you choose not to breast-feed after giving birth, because milk accumulates in the breasts. It can cause heaviness and painful breasts. Symptoms should disappear after a couple of days.

You can also experience breast engorgement weeks or months after delivery. Your breasts will continue to produce milk as long as there’s stimulation. If your baby has not breast-fed or you have not pumped for several hours, your breasts will feel full and engorged.

This can also happen if you suddenly stop breast-feeding, or if your baby’s nursing habits suddenly change. Your milk supply will adjust accordingly. But until your body makes this adjustment, your breasts can continue to produce more milk than your baby drinks. You’ll likely experience some mild or moderate engorgement until your milk supply reduces. The breasts will respond to a decreased need within a couple of days.

Treating breast engorgement at home

If breast engorgement results from a change in your breast-feeding routine, your body may eventually adjust and begin producing less milk. In the meantime, there are several things you can do to relieve pressure and pain caused by uncomfortable and swollen breasts.

Apply warm compresses to your breasts before feeding. A wet towel warmed in the microwave wrapped around the breasts or a warm shower will help the mild flow. Express a little milk to soften the areola.

Breast-feed often and empty the breast completely before offering the second breast.

Apply a cold compress to your breasts after breast-feeding. Wrap an ice pack in a towel or cloth and apply directly to your breasts. Some women have successfully relieved pain and swelling by placing clean, cold green cabbage leaves directly on their breasts.

  1. Don't use cabbage for more than two days. Change leaves once they are limp and after each feeding.
  2. Wear a nursing bra to support your breasts, which allows for comfortable movement. You can also take your bra off before feedings.
  3. Take medication to reduce inflammation and pain. Talk to your doctor about which medications are safe while breast-feeding.
  4. Change breast-feeding positions to see if you can relieve engorgement during feedings.
  5. Gently massage your breasts after or during breast-feeding (in between sucks) to help drain milk and decrease engorgement. Move your hands in a circular motion starting at the outside of the breast and work toward the nipple.

You can also manage breast engorgement by not skipping feedings and emptying your breasts each time you breast-feed. Of course, this is easier said than done, especially because your baby may stop feeding before your breast is empty.

If you’re going to be away from your baby and unable to breast-feed, consider investing in a breast pump to remove milk from missed feedings. If you're unable to breast-feed, pumping every three to four hours around the clock also helps maintain your supply.

Breast milk is ideally used immediately. It can be stored:

  • at room temperature for up to four hours
  • in the refrigerator for up to 72 hours
  • in the freezer for up to six months

Next steps

Breast engorgement can be painful. It can also make breast-feeding difficult. Sticking to a breast-feeding schedule and pumping excess milk can prevent and reduce the likelihood of your breasts overfilling with milk.

You can reduce engorgement by breast-feeding your newborn within an hour of birth and with early feeding cues for the first two weeks. It also helps to increase feedings as your milk comes in.

If engorgement does occur, the good news is that discomfort is often temporary. You can improve symptoms with home remedies. But you shouldn’t ignore severe pain. See a doctor if your condition doesn’t respond to home treatments, you develop a fever or flu-like symptoms, or if symptoms worsen. You may be suffering from an infection or a blocked milk duct.