Engorged breasts and breastfeeding

engorgement and breastfeeding

When your milk comes in, about two to three days after birth, your breasts may become painful and swollen – this is known as engorgement. For most women, this subsides once they start feeding regularly but, for some, the problem can be persistent or recurring.

How can I tell if my breasts are engorged?

If your breasts are engorged then they’ll feel full, heavy and tender. Your nipples might flatten out as your breasts stretch from swelling, with the areola feeling harder than usual. They may also leak. Engorgement can affect both breasts or just one at a time.

If you notice that your breasts remain full after feeding, it could be that engorgement is also preventing your baby from latching on properly and may eventually affect her ability to gain weight, which is another reason why it’s important to get it sorted out.

Why are my breasts engorged?

Engorgement that occurs in the days after birth is caused by your milk ‘coming in’. This usually happens on day two or three. Up until this point, the milk that your baby is getting from your breasts is colostrum – a thick, yellowish liquid that is your baby’s first food. The engorgement will subside once you begin to feed frequently.

If your breasts become engorged again while breastfeeding, then it could be for another reason:

  • Latching problems. If your baby is having trouble latching on, it means she won’t be emptying your breasts during a feed, which will leave you feeling engorged. Ask your health visitor to check your latch.
  • Expressing milk too often. While pumping milk has many benefits, doing it too often can over-stimulate milk production and leave you with full breasts.
  • A missed feed. This can happen when there’s been a change to your routine such as an event or going on holiday. Your body will be producing milk with the expectation of releasing it. When that release doesn’t happen, either through feeding or expressing, your breasts will become engorged.

I had oversupply so was engorged for months. I didn't want to pump but I was advised to hand-express before feeds so my daughter could latch on.

  • Oversupply. While some mothers are worried about having enough milk, others have the opposite problem, producing more milk than their babies need. Not only will oversupply leave you engorged but you could also end up with leaky breasts. If you do have an oversupply of milk, it’s always worth remembering that you can freeze it or donate to a local milk bank, who will use your breastmilk to feed premature and sick babies.
  • Stopping breastfeeding too quickly. When weaning from the breast you should gradually drop one feed at a time to allow your milk supply to adjust. Dropping too many feeds too quickly, or going ‘cold turkey’ and quitting breastfeeding completely, can cause your breasts to become engorged.
  • Your baby is ill. If she is unwell it may affect her desire to feed. Consequently you can be left with full, heavy breasts.

How do I relieve engorged breasts?

Engorged breasts, left unrelieved, can lead to blocked milk ducts and mastitis, which in turn can affect milk production, so it’s worth getting on top of it as soon as possible.

  • Massage or apply heat to your breasts before feeding. Some mums find it helpful to massage their breasts under a warm shower, working from the outside of the breast near the chest wall towards the nipple, in circular motions. You could also just apply a warm flannel for a few minutes before feeding. The heat and massage action can help milk to flow but avoid applying heat for too long as it can make the swelling worse.
  • Feed frequently. Feeding is the best way to Make sure you are offering your breast to your baby regularly and allowing her to 'drain' the breast rather than leave it half full. relieve engorgement. You should ideally be trying to feed at least every two hours. Empty one breast before moving on to the other. If you wait too long between feeds, it can make your breasts painful and uncomfortable. Frequent feeding also helps to prevent blocked ducts.
  • Hand-express a little milk. While frequently pumping milk can over-stimulate your milk supply, you may find it useful to hand-express a little milk before feeding. This will make it easier for your baby to latch on and hopefully allow her to drain your breast fully.
  • Do breast compressions while you nurse. Using a free hand, cup your breast with your thumb on one side and position the rest of your fingers on the other side near the chest wall, taking care not to disturb your baby’s latch. Gently squeeze. The pressure combined with your baby’s sucking action will help to keep the milk flowing so your breast gets emptied fully.
  • Try cold compresses between feeds. Apply an ice pack or similar to your breasts for 20 minutes at a time to help ease the swelling between feeding times. Mumsnetters also swear by cold cabbage leaves – place one inside each bra cup to help bring down swelling.
  • Invest in a well-fitted bra. Try to avoid underwired bras and tight-fitting clothes as the pressure can make the swelling worse.

More tips from Mumsnetters on how to relieve engorged breasts

“I found that having a hot shower before feeding helped to prompt the let-down and get rid of the excess. It helped with the pain and tight skin, too.”

“What worked for me was to stand under the shower and gently massage my breasts. It's best to massage towards the nipple to encourage milk to flow in the right direction. The warmth, massage and shower action helped to make the milk flow.”

“I had breasts that felt like bowling balls. As tempting as it is, don't express large volumes as your breasts will go into milk production overload if they think your baby is needing over 7oz per feed.”

“As weird as it is, cabbage leaves inside your bra does work, especially if you keep the cabbage in the fridge. But do remember to take them out before leaving the house and not go out with them poking out of a low-cut top, as I once did.”

How can I prevent engorged breasts?

Don’t wait until you are carrying around two leaky watermelons before taking measures. Adopting some good breastfeeding habits now will help to prevent engorgement.

  • Get breastfeeding going properly as soon as you can after your milk comes in to help relieve the initial engorgement.
  • Get your latch checked. Ask your health visitor to observe a feed. If your baby is not latching on properly, you need to know sooner rather than later so you can take action.
  • Avoid skipping feeds. Missing a feed is a sure-fire way to get yourself engorged. If you do miss a feed, express instead and store the milk. If you happen to have a sleepy baby then you’ll need to bite the bullet and wake her so that she doesn’t miss a feed.
  • Don’t wait until your baby is hungry to feed her. Watch out for early feeding cues, such as her moving her head from side to side with an open mouth or sucking her lips or hands. Feeding her while she is still happy will make it easier to get a good latch and help to drain your breast.
  • Feed frequently. Waiting long periods between feeds can lead to engorgement. Once your milk comes in you should be feeding at least eight times in 24 hours. In the first few weeks, you may even be feeding as often as 10-12 times per day. If your baby falls asleep during a feed, gently tickle her feet to keep her awake.
  • Feed from both sides. Drain one breast and then switch sides.
  • Wean from the breast gradually. Drop one feed at a time. If you’re returning to work, start dropping feeds a few weeks in advance to allow your milk supply time to adjust and prevent engorgement.