How to Relieve Breast Engorgement

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Breast engorgement is the development of hard, swollen, and painful breasts caused by too much breast milk. 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, as well as at other times, and can be quite uncomfortable, but is relieved by patience and/or removing excess milk.

Overview

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 the blood flow to your breasts along with a surge in your milk supply often results in your breasts getting overly full. If you're breastfeeding, this stage of breast engorgement typically starts to get better within a few days as your nursing habits take hold and your milk production adjusts to meet your baby's needs.

If you aren't planning to breastfeed, you'll still experience breast engorgement. Since your body doesn't know your babycare 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 breast milk for a few weeks until production fully tapers off.

Milk Fever

Breast engorgement during the first week or so of breastfeeding is also called milk fever as it can cause fever and an overall run-down feeling. You should continue to breastfeed with a fever—that's the best way to relieve symptoms. Note that 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.

Causes of Breast Engorgement

Breast engorgement is a common breastfeeding complication, and as noted above, it isn't limited to the first few weeks. For example, if you miss a few feedings or pumping sessions, you may begin to feel that heavy fullness of engorgement. However, the engorgement experienced when the milk first comes in tends to be the most intense, and the majority of new mothers experience it to some degree.

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

Look out for the following situations that can result in breast engorgement:

Schedule Changes

Schedule changes can have a big impact on your milk supply—and can quickly lead to breast engorgement if not managed proficiently. These may be temporary disruptions, new patterns you are adjusting to, or lifestyle changes. (Give yourself some slack: nursing parents are tired and busy, so it's easy for breast engorgement to sneak up on you.)

These factors include changes in your baby's schedule, such as sleeping through the night, going to daycare, or taking longer naps. Your schedule changes, from going back to work to travel, can cause engorgement as well. Sometimes, your baby may not be breastfeeding often enough or you may be breastfeeding a sick baby who's having trouble nursing because of a stuffy nose, ear infection, or other illness. Also, you may pumped too much or not enough when away from your baby.

Overabundant Milk Supply

Sometimes, you may simply have an overabundant supply of breast milk, which is also called hyperlactation. Generally, the amount of breast milk your body 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.

Usually, with consistent feedings, an overabundant milk supply will even out to meet your baby's level of hunger without having too much extra left over.

Excess milk production is often the result of not adequately draining both breasts or other nursing management issues. This condition can happen if you tend to breastfeed more on one side or the other. It can also occur if you pump excessively, which prompts more and more milk. You may also have an overabundance of the hormone prolactin, which is responsible for stimulating milk production.

An overabundant supply can also happen temporarily if your baby is refusing the breast. It can also occur when you have breast implants that block the flow of breast milk from your breasts. In this case, your baby's suckling keeps stimulating more milk but it's not all getting to your baby, so their continued nursing prompts more and more milk to be produced but not removed.

Weaning or Supplementing

Breast engorgement also can happen when you adjust your baby's diet, such as beginning other feeding options like adding first foods, supplementing with formula, or switching to formula or milk. (The American Academy of Pediatrics does not recommend cow's milk for babies until age one).

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. Additionally, when your baby goes through a growth spurt, they may suddenly start nursing much more, which can also stimulate an overproduction of milk that results in engorgement.

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, and 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 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. Avoid giving your baby formula in between breastfeeding sessions as they'll take less breast milk when it's time to nurse.

You can also use a breast pump (or hand express) to remove a small amount of breast milk to relieve any pressure or discomfort that you may feel. However, be careful not to express too much or you could inadvertently encourage your body to continue to make more breast milk than you need.

Make Breastfeeding Easier

Take a warm bath or shower, but avoid direct breast contact with the shower spray as this may be painful on your swollen breasts. Alternatively, apply warm compresses to your breasts just before breastfeeding. The warmth can help with your let-down reflex and get your milk flowing. However, don't put heat on your breasts between feedings since that can make the swelling worse.

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 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, a lactation consultant, or a local La Leche League group if you have any questions or concerns about your breastfeeding positions and/or technique.

If you're weaning, try weaning more slowly, but be sure to drain both breasts. If you gradually wean your baby, you may not experience breast engorgement at all.

Soothe Pain

After each feeding, place a cold compress or cabbage leaves onto your breasts—slipped them under your bra to help them stay in place. These items can provide some relief from the pain and swelling. Talk to your doctor about taking an over the counter pain medication such as Tylenol or Motrin to help ease the pain and inflammation. Wear a snug (but not uncomfortably tight), supportive bra. Get plenty of rest.

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

Engorgement can make nursing challenging for babies. If your breasts are full and hard, your nipples can become flat, making it tough for your baby to latch on (called poor latch). This may cause your breast milk may stay inside your breasts, which slows the production of more breast milk. Then, you can end up with low milk supply. Excessive use of cold compresses and cabbage leaves can also result in reduced milk supply. Some babies may also go on a nursing strike during engorgement.

The pressure from the backup of milk in your breasts can 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, as noted above, you can ease this issue by pumping a bit of milk before each nursing session.)

If your baby doesn't get enough milk, due to poor latch, lowered supply, or nursing refusal, this could result in your baby not getting enough breast milk. However, this is unlikely to happen with an occasional bout of breast engorgement.

If engorgement, low milk supply, or poor latch are continue or you have any other nursing or breast health concerns, seek advise 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.

Aside from the discomfort and breastfeeding challenges, breast engorgement can lead to other breast conditions for the nursing parent including sore nipples, blebs, plugged milk ducts, and mastitis. When it does happen, address engorgement as soon as possible to prevent complications. If left untreated, engorgement can lead to potentially serious issues, including painful blebs, plugged milk ducts, or mastitis. Consulting a lactation consultant can 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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Article 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.
  1. Mangesi L, Dowswell T. Treatments for breast engorgement during lactation. Cochrane Database Syst Rev. 2010;(9):CD006946. doi:10.1002/14651858.CD006946.pub2

  2. American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milkPediatrics. 2012;129(3):e827-e841. doi:10.1542/peds.2011-3552

  3. Berens P, Brodribb W. ABM Clinical Protocol #20: Engorgement, Revised 2016. Breastfeed Med. 2016;11:159-63. doi:10.1089/bfm.2016.29008.pjb

Additional Reading
  • American Academy of Pediatrics. (2011). New Mother’s Guide to Breastfeeding. Bantam Books. New York.

  • Cadwell, Karin, Turner-Maffei, Cynthia, O'Connor, Barbara, Cadwell Blair, Anna, Arnold, Lois D.W., and Blair Elyse M. (2006). Maternal and Infant Assessment for Breastfeeding and Human Lactation A Guide for the Practitioner, Second Edition. Jones and Bartlett Publishers.

  • Lawrence, Ruth A., MD, Lawrence, Robert M., MD. (2011). Breastfeeding A Guide for the Medical Profession, Seventh Edition. Mosby.

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

  • Academy of Breastfeeding Medicine Protocol Committee. (2009). ABM clinical protocol# 20: Engorgement.