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Breast Engorgement

Overview

What is breast engorgement, and what causes it?

Breast engorgement means your breasts are painfully overfull of milk. This usually occurs when a mother makes more milk than her baby uses. Your breasts may become firm and swollen, which can make it hard for your baby to breastfeed. Engorged breasts can be treated at home.

Engorgement may happen:

  • When your milk first comes in, during the first few days after birth.
  • When you have a regular breastfeeding routine but can't nurse or pump as much as usual.
  • If you suddenly stop breastfeeding.
  • When your baby suddenly starts breastfeeding less than usual. This may happen when your baby is starting or increasing solid foods or when your baby is ill and has a poor appetite.

Once you are five months pregnant, your breasts will start to make colostrum, which is a yellowish liquid that contains everything your baby needs right after birth. About 2 to 5 days after your baby is born, you will notice an increase in the amount of breast milk you will be making. Your breasts may feel warm and heavy. This early breast fullness is from the milk you make and extra blood and fluids in your breasts. Your body uses the extra fluids to make more breast milk for your baby.

This normal breast fullness will probably go away in a few days as you breastfeed and your body adjusts to your baby's needs. Your breasts may become painfully engorged if you aren't breastfeeding your baby often or if the feedings are not removing enough breast milk.

If you have any concerns or questions, you can work with a lactation consultant. This is someone who helps mothers learn to breastfeed.

What are common symptoms of breast engorgement?

Engorged breasts:

  • Are swollen, firm, and painful. If severely engorged, they are very swollen, hard, shiny, warm, and slightly lumpy to the touch.
  • May have flattened-out nipples. The dark area around the nipple, called the areola, may be very hard. This makes it difficult for your baby to latch on.
  • Can cause a slight fever of around 38°C (100.4°F).
  • Can cause slightly swollen and tender lymph nodes in your armpits.

If engorgement is severe, your breasts get very swollen and painful. Severe engorgement can make it hard for your baby to latch on to the breast properly. As a result:

  • Your baby may not get enough milk.
  • Your breasts may not empty completely.
  • Your nipples may become sore and cracked. This may cause you to breastfeed less, and that makes the engorgement worse.

Severe engorgement can lead to blocked milk ducts which can lead to a breast infection, called mastitis. Mastitis may need to be treated with antibiotics.

How is breast engorgement treated?

If engorgement is making it hard to breastfeed, use the following steps. They can relieve your symptoms and keep your milk flowing.

  • Soften your breasts before feedings. You can apply a warm compress for a couple of minutes before you breastfeed. Or you can use your hands or use a pump to let out (express) a small amount of milk from both breasts.
  • Try to breastfeed more often. Pump your breasts if your baby won't breastfeed. At each feed, take care to remove enough breast milk from your breasts to make you feel comfortable. Over expressing can cause more breast milk to be made.
  • Take ibuprofen (such as Advil or Motrin) to reduce pain and swelling. Ibuprofen is safe for breastfeeding moms when taken as directed. But it's a good idea to check with your doctor before you take any kind of medicine while breastfeeding.
  • If your breasts still feel uncomfortable after nursing, try a cold compress to reduce swelling. You can use a frozen wet towel, a cold pack, or a bag of frozen vegetables. Apply it to your breasts for 15 minutes at a time every hour as needed. To prevent damage to your skin, place a thin cloth between your breast and the cold pack.

If you are not breastfeeding, use one or more of these steps to relieve discomfort:

  • Do not pump or remove a lot of milk from your breasts. If your breasts are very painful, it's okay to remove just a little bit to make you more comfortable.
  • Apply a cold pack to your breasts for 15 minutes at a time every hour as needed. To prevent damage to your skin, place a thin cloth between your breast and the cold pack.
  • Take ibuprofen (such as Advil or Motrin) in addition to using non-medicine treatments. Be safe with ibuprofen. Read and follow all instructions on the label.
  • Wear a bra that fits well and provides good support.

Your breasts will be engorged for several days if you don't or can't breastfeed after your baby is born. This will gradually go away if your breasts are not stimulated to make milk. At present, there is no approved medicine to "dry up" your milk supply and prevent engorgement.

How can you prevent breast engorgement?

You may be able to prevent engorgement if you keep milk moving out of your breasts and take care not to let your breasts become overfilled.

  • Breastfeed whenever you notice signs that your baby is hungry, such as eagerly sucking on fingers or rooting.
  • Make sure that your baby is latching on and feeding well. If your breasts are hard and overfilled, let out (express) enough to soften your nipples before putting your baby to the breast.
  • Allow baby to finish on the first breast first, before switching to the other breast. You can tell that it's time to switch sides when the following things happen:
    • Your baby lets go of the breast and turns their head to the side.
    • Your baby's sucking slows down a lot or stops for a few minutes.
    • You can no longer hear your baby swallowing on a regular basis.

References

Other Works Consulted

  • American Academy of Pediatrics (2009). Feeding your baby: Breast and bottle. In SP Shelov et al., eds., Caring For Your Baby And Young Child: Birth to Age 5, 5th ed., chap. 4, pp. 91–93. New York: Bantam.
  • Cunningham FG, et al. (2010). The puerperium. In Williams Obstetrics, 23rd ed., pp. 646–660. New York: McGraw-Hill.

Credits

Adaptation Date: 7/29/2020

Adapted By: Alberta Health Services

Adaptation Reviewed By: Alberta Health Services

Adapted with permission from copyrighted materials from Healthwise, Incorporated (Healthwise). This information does not replace the advice of a doctor. Healthwise disclaims any warranty and is not responsible or liable for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.