Breast engorgement

What is breast engorgement?

Breast engorgement is when your breast tissue overfills with milk, blood and other fluids.

When your baby is born, your breasts are given a signal to start full milk production. Your milk usually comes in 1 to 4 days after your baby is born. Breast engorgement is quite normal in the first few days after your baby is born.

Breast engorgement can also happen at any time when you are breastfeeding, especially when your baby’s sleeping or feeding patterns change and they feed less.

If your breasts continue to feel overfull beyond the first 4 to 6 weeks, you may have an oversupply of breastmilk.

What are the symptoms of breast engorgement?

Engorgement can make your breasts feel very full, hard, swollen and painful.

Engorgement happens in both breasts at once.

Your nipples can become stretched or flat and tight. This can make it difficult for your baby to attach to the breast.

What causes breast engorgement?

Breast engorgement can happen if:

• your baby is not attaching and feeding well
• your breasts aren’t drained well during a feed
• your baby misses a feed or is feeding infrequently
• you are making more milk than your baby needs

Engorgement is usually temporary — eventually your body will adjust and make only as much milk as your baby needs.

How can breast engorgement be prevented?

To reduce the chance of breast engorgement, try the following.

• Feed your baby often and on demand (not by the clock) from birth. Your baby will need 8 to 12 feeds per day once your milk comes in on day 3 to 4. It helps to sleep in the same room as your baby to help keep up the feeds.
• Don’t limit your baby’s time at the breast. Let them feed for as long as they want.
• Wake your baby for a feed if your breasts become full and uncomfortable (especially at night).
• Ensure your baby is positioned correctly and attached well. Hand express a little, if needed, to help your baby attach.
• Avoid giving your baby any fluids other than breastmilk.
• Avoid using a dummy until your milk production settles down.

How can I relieve breast engorgement?

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

The best thing to do is to empty the breast, either by letting your baby feed 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 uncomfortable between feeds.

The following tips might also help.

• Take off your bra completely before breastfeeding.
• Apply a warm washer to the breast, or have a warm shower before a feed, for comfort and to help the milk flow.
• 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 cool pack from the fridge, or a chilled washed cabbage leaf over the breast to reduce inflammation.
• Express milk after a feed, either by hand or with a breast pump, if your breasts still feel full.

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

Complications of breast engorgement

If breast engorgement continues, it could lead to a blocked milk duct or mastitis.

Resources and support

For advice and support with breast engorgement:

• Read more at Australian Breastfeeding Association or call their helpline on 1800 686 268.
• Ask your midwife or child health nurse, or your doctor.
• Visit the Lactation Consultants Australia and New Zealand’s website to find a lactation consultant.