Breast engorgement

Breast engorgement is a problem that is common in the early days and weeks of breastfeeding. Once your baby is born, your breasts are given a signal to start full milk production. Blood flows to your breasts, and your milk usually comes in 1 to 4 days after the birth. Breast engorgement is when your breasts get full and sore.

Offer a breastfeed day or night if your breasts become full and uncomfortable between feeds.

What is breast engorgement?

Engorgement is when the breast tissue overfills with milk, blood and other fluids. This causes your breasts to feel very full, to become hard and painful and your nipples to appear flattened and tight.

Breast engorgement can be severe. It usually occurs if the baby is not feeding properly, so the milk builds up.

Breast engorgement can also occur at any time you are breastfeeding, especially when your baby’s feeding pattern changes and they feed less.

Engorgement is usually temporary – eventually you will produce just as much milk as your baby needs.

How to prevent breast engorgement

To reduce the chance of breast engorgement, you should feed your baby often and on demand (not by the clock) from birth, with at least 8 to 12 feeds in the first 24 hours. It will help to sleep in the same room as your baby to keep up these feeds. Also, avoid giving your baby any fluids other than breastmilk unless needed for a specific medical reason, and don’t limit your baby’s time at the breast.

How to relieve breast engorgement

If your breasts become engorged, there are things you can do to relieve the discomfort.

The best way to is to empty the breast, either by feeding your baby at the breast, or by expressing your milk. It’s okay to wake your baby and offer a breastfeed day or night if your breasts become full and uncomfortable between feeds.

The following tips might also help:

• Apply a warm washer to the breast, or have a warm shower before a feed, for comfort and to help the milk flow.
• Remove your bra before breastfeeding (and leave it off).
• Hand-express a little milk before feeding your baby, or try ‘reverse pressure softening’ (applying pressure around the nipples to push fluid back into the breasts).
• Gently massage the breast in a downward motion from the chest wall toward the nipple while your baby is feeding.
• Use a cold compress, like a cool gel pack from the fridge, or a chilled washed cabbage leaf over the breast to relieve inflammation.
• Express milk after a feed, either by hand or with a breast pump, if your breasts still feel full.

Sometimes, if the engorgement does not improve, a complete ‘pump out’ with an electric pump may be necessary to relieve the milk pressure that is causing increased blood and fluid within the breast tissue (ask your lactation consultant or doctor for help).

If you are still uncomfortable, ask your doctor for appropriate pain relief.

For help with breast engorgement prevention and treatment, contact a health professional, including your doctor, lactation consultant or breastfeeding counsellor, child health nurse