How to Relieve Breast Engorgement

Why It Happens and What You Can Do About It

Mother breastfeeding while watching television
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Breast engorgement is the development of hard, swollen, and painful breasts when too much breast milk accumulates in the milk ducts. Engorged breasts can become extremely large, tight, lumpy, and tender. The swelling may go all the way up into your armpit, and the veins on the surface of your breasts may become more visible or even stick out.

This condition frequently occurs when breast milk first comes in, though it certainly can happen at other times as well. It can be quite uncomfortable, but can be relieved by releasing the excess milk from the breast and taking steps to ease discomfort.

Breast Engorgement After Birth

It's normal to have some degree of breast engorgement during the first week or two after the birth of your baby. An increase in blood flow to your breasts along with a surge in your milk supply often results in your breasts getting overly full.

Engorgement that happens in this period is often the most intense a mother will experience. The majority of new mothers experience it to some degree.

If you're breastfeeding, this stage of breast engorgement typically starts to get better within a few days as your feeding habits take hold and your milk production adjusts to meet your baby's needs. However, you may experience engorgement after this time if you miss a few feedings or pumping sessions.

What Is Milk Fever?

Milk fever is another name for breast engorgement during the first week or so after breastfeeding. It is so-named because it can cause fever and an overall run-down feeling. If you experience this, continue to breastfeed, as that's the best way to relieve symptoms.

However, since a fever could also be a sign of a breast infection called mastitis or another illness, you should consult your doctor to ensure you have the correct diagnosis.

Those who aren't planning to breastfeed also experience breast engorgement. Since your body doesn't know your feeding plans, it will make breast milk. You'll begin to feel the telltale fullness when your milk comes in between the third and fifth day postpartum.

If you don't remove the breast milk, your body will gradually stop making more. The uncomfortable part of engorgement should only last a few days, but you'll continue to make milk for a few weeks until production fully tapers off.

Other Causes of Engorgement

Whenever breast milk builds up in your breasts and it's not removed regularly or fully, swelling and firmness can develop.

The following situations can result in breast engorgement.

Schedule Changes

Whether you nurse, pump, or do a combination of the two, schedule changes can have a big impact on your milk supply. When milk that is normally expressed at a certain time isn't, it sits in the breasts and causes them to fill, which can quickly lead to breast engorgement if not managed.

Such schedule changes might include:

  • Your baby's nap schedule changes and you find that they are now sleeping during what would normally be a feeding time.
  • You go back to work, which involves commuting time that makes it difficult to stick to your normal pumping schedule.
  • Your late-day feeding must now be delayed because you've enrolled your baby in daycare and need to pick them up.

Even when you can nurse or pump, there may be a change in your day-to-day that leads to your baby having trouble feeding. For example, your child may have trouble nursing if they are sick and have a stuffy nose.

While not releasing enough milk from the breast can obviously lead to engorgement, so too can pumping too much.

You may be tempted to do this if you're not sure when you can fit in your next session. However, overpumping can cause an overabundance in the following days if your new pumping habits aren't maintained, which can also cause engorgement.

Go easy on yourself: Nursing parents are tired and busy, so it's easy for breast engorgement to sneak up on you.

Overabundant Milk Supply

Generally, the amount of breast milk your body makes is based on demand. The more your baby nurses, the more milk is produced, optimally at just the right level to keep your baby full but not engorge your breasts.

However, this process can occasionally get out of whack, particularly when your supply is just getting established. And producing too much milk, too quickly can cause engorgement.

Some possible causes of hyperlactation, or excess milk production, include:

  • Genetics: You may simply have a biological predisposition to make a lot of breast milk.
  • How you breastfeed: Excess milk production is often the result of not adequately draining both breasts or other nursing management issues. This can happen if you tend to breastfeed more on one side or the other.
  • Overpumping: It can also occur if you pump excessively, which prompts more milk at that session as well as future sessions.
  • Hormone level: You may have an overabundance of the hormone prolactin, which is responsible for stimulating milk production.
  • Baby strike: An overabundant supply can also happen temporarily if your baby is refusing the breast.
  • Baby growth spurt: They may suddenly start nursing much more, which can stimulate an overproduction of milk that results in engorgement. (Your body may temporarily produce more milk than your baby needs in response to their uptick in suckling.)
  • Medications: Galactagogues, drugs that may be taken to treat other conditions or specifically to boost milk production, may lead to an oversupply.
  • Breast implants: Breast implants may block the flow of breast milk from your breasts. In this case, your baby's suckling keeps stimulating more milk, but it sits in your breast instead of being expressed.

Weaning or Supplementing

Breast engorgement also can happen when you make adjustments to your baby's diet, such as adding first foods, supplementing with formula, or switching to formula or milk. (Note: The American Academy of Pediatrics does not recommend cow's milk for babies until age 1.)

If you're supplementing your child with formula between feedings, they may not drink as much while nursing, which can result in a temporary oversupply.

Also, if weaning takes place too rapidly, the same situation occurs, which is why gradually reducing the length and frequency of feedings is recommended.

How to Relieve Breast Engorgement

Whatever the cause, the fullness and pressure of breast engorgement can be painful and make nursing harder. Luckily, this condition is typically short-lived; relief can usually be found in a day or two.

Here's what you can do to cope and prevent it from happening again.

Breastfeed Often

Breastfeed your baby (or pump) frequently.

Offer your child the breast very often, ideally every one to three hours throughout the day and night. Let your child breastfeed for as long as they want, but aim for at least 20 minutes at each feeding. If you have a sleepy baby, wake them up for feedings.

Unless otherwise directed by your pediatrician, avoid giving your baby formula in between breastfeeding sessions as they'll take less breast milk when it's time to nurse.

If you are supplementing, pump or hand express milk when your baby is fed formula to relieve and prevent engorgement. Be careful not to express too much to avoid excess production.

Make Breastfeeding Easier

Take a warm bath or shower, or apply warm compresses to your breasts, just before nursing or pumping (not in between feedings, as this can worsen swelling). The warmth can help with your let-down reflex and get your milk flowing. Avoid direct breast contact with the shower spray, as this may be painful on your swollen breasts.

Use a hand expression technique or a breast pump to remove a little bit of breast milk before each feeding. This will help relieve some of the tightness to soften your breasts, reduce the speed of the milk's flow, and make it easier for your baby to latch on.

Massage your breast as your baby nurses to further help relieve tightness and remove more milk.

Use Different Breastfeeding Positions

Alternate breastfeeding positions to drain all the areas of your breasts. Breastfeed from only one side for an entire feeding to help empty that breast fully. Then, start the next feeding on the opposite side.

Contact your doctor or a lactation consultant if you have any questions or concerns about your breastfeeding positions and/or technique.

If you are pumping, be sure to pump each breast so that both sides are fully drained and one breast doesn't inadvertently get overstimulated. You can, however, do one breast and then take a break and do the next breast an hour or a few hours later, if desired. Just be sure that both sides are adequately drained.

Soothe Pain

Placing a cold compress or cabbage leaves on your breasts after each feeding can provide significant relief from pain and swelling. Slip them under your bra to help them stay in place.

Don't do this more than needed to reduce swelling or beyond the engorgement period, though. Excessive use can result in reduced milk supply.

Talk to your doctor about taking an over-the-counter pain medication such as Tylenol (acetaminophen) or Motrin (ibuprofen) to help ease the pain and inflammation.

Wearing a snug, but not uncomfortably tight, supportive bra and getting plenty of rest can also help.

Complications of Engorged Breasts

While breast engorgement usually goes away on its own with proper management, it can create problems for both the breastfeeding parent and baby.

Common risks and complications of this condition include the following.

Problems for the Baby

The pressure from the backup of milk in your breasts can eventually lead to an overactive let-down reflex. A very fast flow of milk can cause your baby to briefly gag, choke, and swallow excessive amounts of air as they're trying to latch on and feed.

However, after the initial few minutes of nursing, your baby will usually have siphoned off enough milk to be better able to control the flow. (If this is a recurrent problem, pump a bit of milk before each nursing session.)

Low milk supply may not seem like a likely outcome of engorgement, but it is possible if the issue is persistent. Engorgement makes your breasts full and hard, which can cause your nipples to become flat. This can cause poor latch (when your baby has difficulty connecting to the nipple properly).

When milk stays inside the breast, it signals the body that it's not needed, which actually slows the production of more breast milk.

Some babies may also go on a nursing strike during engorgement due to frustration from trying to latch on or coping with a strong letdown. Low milk supply aside, this alone can cause poor weight gain and erode breastfeeding confidence.

If engorgement, low milk supply, or poor latch continue or you have any other nursing or breast health concerns, seek advice from your doctor, pediatrician, and/or lactation consultant.

Problems for the Breastfeeding Parent

Many women leave the hospital within a few days of childbirth, so breast engorgement often begins at home. Since breast engorgement can be painful, unexpected, and cause difficulty with latching on, it's a common cause of early weaning.

Many women expect breastfeeding to be easy but find that getting the hang of it can actually be challenging, especially as struggles like breast engorgement can make a new parent feel inadequate, frustrated, or lost. Know that it's not your fault and these are common issues.

In addition to the discomfort and related breastfeeding challenges caused by engorgement, it can lead to potentially serious issues, including painful blebs (blistera covering a nipple opening), plugged milk ducts, sore nipples, or mastitis.

Also, consult your doctor to ensure you have the correct diagnosis to prevent and address these complications, as some of them, like mastitis, need treatment beyond nursing management. Consulting a lactation consultant can also make a world of difference.

A Word From Verywell

Knowing what breast engorgement is, when it's likely to occur, and how to treat it can help you deal with this common nursing problem quickly—and get your breastfeeding experience back on track.

Remember, this condition is temporary and tactics like consistent nursing, fully draining breasts, weaning slowly, nursing equally on each side, and using ice packs or cabbage leaves to help reduce any swelling can help tremendously.

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10 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
  • American Academy of Pediatrics. New Mother’s Guide to Breastfeeding. Bantam Books. New York. 2011.

  • Lawrence RA, Lawrence RM. Breastfeeding A Guide for the Medical Profession, Seventh Edition. Mosby. 2011.

  • Riordan J, Wambach K. Breastfeeding and Human Lactation, Fourth Edition. Jones and Bartlett Learning. 2014.