How to deal with breast engorgement

Content

What is breast engorgement?

What do engorged breasts feel like?

How to know if it’s breast engorgement vs a blocked milk duct or mastitis?

What causes breast engorgement?

Does breast engorgement affect moms who don’t breastfeed?

How can I treat engorged breasts?

Tips for pain relief in breasts

What to do when the breast pain doesn’t go away

What is breast engorgement?

Breast engorgement happens when your breasts become overly full of milk. They may feel hard, tight, and painfully sore as well as tender. This often occurs in the early days of nursing, as you and your baby adjust to a breastfeeding and pumping schedule.

One of the first signs of milk coming in is fuller and firmer breasts. The swelling comes from the increased amount of milk and also from the greater blood flow and extra lymph fluid in your breast tissue. For many moms, when their baby feeds often, the feeling of heaviness passes without issues.

But some moms produce more milk than their breasts can comfortably hold, causing them to feel rock-hard and uncomfortably full. While breast engorgement usually goes away, the period of 24 to 72 hours in which it lasts can be quite painful.

What do engorged breasts feel like?

Engorged breasts can feel like throbbing and swelling or a tightening and pulling sensation from the armpit in one or both. Your breasts might feel hot and lumpy, and your breast skin may look shiny and stretched. Some mom’s nipples become hard and flat. Engorgement can cause your body temperature to rise, reaching up to 101°F/ 38°C .

Beyond being painful, breast engorgement can make breastfeeding more difficult. If your nipples are flatter and your breast tissue is firmer, your baby may struggle to latch properly, which can lead to soreness in your breasts. Additionally, a poor latch means your baby may not drain the breast effectively. If left untreated, engorgement can lead to blocked ducts, a breast infection (mastitis), and reduced milk production.

How to know if it’s breast engorgement vs a blocked milk duct or mastitis?

Blocked milk ducts, also known as clogged milk ducts, feel like a firm, sore lump. They might look red and inflamed and be warm to the touch. They’re common in breastfeeding moms.

Mastitis is a breast infection that appears as a painful, hard, wedge-shaped red area on the breast, accompanied by fever and flu-like symptoms. If you have mastitis, contact a doctor, as it should be treated immediately.

If you think your breast pain might be something else besides engorgement, learn more about Clogged Milk Ducts and Mastitis Treatment for symptoms, causes, and treatment.

What causes breast engorgement?

Breast engorgement usually starts when a baby isn't feeding frequently enough (at least eight times every 24 hours). Other causes might be due to pressure from a badly fitting bra or tight clothing. These kinds of clothes can worsen the discomfort and may lead to blocked ducts or even mastitis — so stay cozy and comfortable as much as you can.

Does breast engorgement affect moms who don’t breastfeed?

Yes. Breast engorgement can also affect women who don’t or can’t breastfeed. The hormonal changes that trigger increased milk production after the delivery of the baby and placenta can occur whether you breastfeed or not.

For moms who breastfeed, engorgement may also happen when they suddenly reduce breastfeeding sessions—perhaps because the baby is sick, sleeping longer, starting solids, or beginning childcare.

And while breast engorgement can affect any new mom, research shows it’s more common in women who have had previous breast augmentation or other breast surgeries.

How can I treat engorged breasts?

As straightforward as it sounds, the most effective treatment for breast engorgement is a hungry baby! Try to empty your breasts as much and as often as possible to keep your milk flowing—aim to feed or pump on demand, at least 8 times every 24 hours, especially in the early days of your newborn’s life.

Keeping your baby in skin-to-skin contact with your chest as much as possible during the day and when you're awake at night can also help. This way, your baby can sense the aroma of your milk and has easy access. You're also more likely to notice their hunger cues early on, ensuring they feed frequently. It’s also good to let your baby take in as much milk as they want from one breast before offering the other.

If you have any doubts, it can be reassuring and helpful to have your baby's latch and positioning checked by a lactation consultant or breastfeeding specialist. Getting a bit of coaching can feel very empowering as you navigate these new rhythms and routines with your baby. There are many different techniques to make sure your sore breasts are pain free as you go through this period.

Tips for pain relief in breasts

Remember that skipping feeds or suddenly stopping breastfeeding can make the pain of breast engorgement worse. So it’s best for your newborn to be fed at least eight times every 24 hours with a good latch and a comfortable breastfeeding position. On top of that, try these additional tips to get the relief you need.

Massaging and expressing milk techniques to relieve breast pain:

Before breastfeeding, express a little milk by hand or with a breast pump to soften your nipple, making it easier for your baby to latch.
During feeding, gently massage your breasts to help drain the milk effectively.
After a feed, if your breasts still feel very firm and full, express again until they feel comfortable. You can also try ‘reverse pressure softening’, a technique that helps move excess fluid from the breast. (A lactation consultant or breastfeeding specialist can show you how to do this.)
If your breasts are leaking milk, take a warm shower or apply a warm wet washcloth just before breastfeeding or expressing to soothe them and encourage milk flow. However, don’t apply heat for more than a couple of minutes, as too much warmth may worsen swelling.
If your breasts aren’t leaking, apply a cold compress, chilled gel pad, or even a bag of frozen peas wrapped in a cloth for 10 minutes after feeding to reduce swelling and relieve pain.

Additional measures to reduce the pain and swelling in breasts:

Tuck clean cabbage leaves inside of your bra. Yes, really! Many moms find that this helps reduce swelling and discomfort.
Take anti-inflammatory painkillers, if needed. (Always consult a healthcare professional and follow the manufacturer’s and pharmacist’s guidance. Read "Breastfeeding while you or your baby are sick" for more information on medications while nursing.)
Wear a well-fitted nursing bra and avoid underwires—or, if more comfortable, consider going without a bra.
If your baby is unable to breastfeed and latch on, replace the feeds with pumping. (Learn more about tips for pumping here: How to use a breast pump: 12 top tips)

What to do when the breast pain doesn’t go away

Seek medical advice if you develop a fever of over 101 F/ 38°C, or if your baby is unable to breastfeed. A doctor and lactation consultant can walk you through this moment to help you get to a place where breastfeeding and pumping happen without pain and stress.

Remember to be patient with yourself. After birth and during the growth cycle of your baby, your body is also adjusting to many new changes, from producing milk, feeding and sleeping on a new schedule. Fortunately, most moms find the pain in their breasts goes away as they settle into breastfeeding and pumping.