How to handle postpartum breast engorgement

For new mothers, engorged breasts can be a painful problem. As the breasts overfill with milk, they can feel heavy, hard, warm and ready to burst. As well as being uncomfortable, engorgement can lead to other breastfeeding problems if not treated. Let’s learn more about how breasts become engorged and what you can do to give yourself some relief.
 

What is breast engorgement?

Breast engorgement is the overfilling of the breasts with milk. This can happen when the milk isn’t being removed well from the breasts through breastfeeding, pumping or expressing by hand. Engorgement usually occurs during the early days of breastfeeding, but it can also happen if a mother cannot nurse or pump as much as usual or suddenly stops breastfeeding. A mother who doesn’t begin breastfeeding after childbirth will have several days of mild to moderate breast engorgement. This will gradually go away when the breasts aren’t simulated to produce more milk.
 

Common symptoms of breast engorgement

Symptoms of engorged breasts include:

• Swollen, firm and painful breasts. If the breasts are severely engorged, they are very swollen, hard, shiny, warm and slightly lumpy to the touch.
• Flattened nipples. The dark area around the nipple, the areola, may be very firm. This makes it hard for your baby to latch on.
• A slight fever.
• Slightly swollen and tender lymph nodes in your armpits.
   

Can you prevent breast engorgement?

As a breastfeeding mother, you may be able to prevent engorgement by keeping milk moving out of your breasts and taking care to not let them become overfilled. Here are a few ways to do that:

• Breastfeed whenever you notice signs that your baby is hungry such as eagerly sucking on fingers or rooting. During the first few days and weeks, your baby will breastfeed at least 8 times in a 24-hour period.
• Make sure that your baby is latching on and feeding well. If your breasts are hard and overfilled, let out just enough to soften your nipples before putting your baby to the breast.
• Empty your breasts with each feeding. Empty one breast completely before you switch to the other side. You can tell that it's time to switch sides when both of the following things happen:
  • Your baby's sucking slows down a lot or stops.
  • You can no longer hear your baby swallowing.
     

How to care for yourself when your breasts are engorged?

If engorgement is making you uncomfortable or breastfeeding difficult, try a few of the following steps to relieve your symptoms and help keep milk flowing.

• Soften your breasts before feeding. Apply a warm compress for a couple of minutes before you breastfeed or use your hands or use a pump to express a small amount of milk from both breasts.
• Breastfeed more often. If baby won’t breastfeed, try pumping your breasts, taking care to empty them each time.
• Take ibuprofen. Advil or Motrin can help reduce the pain and swelling and are safe for breastfeeding moms when taken as directed. However, it’s always a good idea to check with your provider before taking any medicine while breastfeeding.
• Cold compress. If you are still uncomfortable after nursing, try a cold compress to reduce swelling. Take a frozen wet towel, a cold pack or a bag of frozen vegetables and 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, you can use one or more of these steps to help relieve discomfort:

• Try not to pump. It’s okay to remove just a little milk to make yourself more comfortable, but don’t pump or remove large amounts so you don’t encourage more production.
• Use a cold compress. 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. In addition to non-medicine treatments, you can take ibuprofen (such as Advil or Motrin) to help with pain and swelling. Be sure to read and follow all instructions on the label.
• Wear a supportive bra. Having a bra that is supportive and fits well will help with discomfort.
   

When to call a doctor

If your breasts are engorged and you notice symptoms of a breast infection, call your doctor or seek medical care right away.

Signs of infection include:

• Increased pain, swelling, redness or warmth around a breast
• Red streaks extending from the breast
• Pus draining from a breast
• A fever

Watch closely for changes in your health and be sure to contact your doctor if you do not get better as expected.

If you need help finding an OB/GYN or family doctor, our Access Center can help. Call 877-PPG-TODAY or 877-774-8632 for assistance.
 

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Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.