Breast Engorgement

What is Breast Engorgement

Breast engorgement is the overfilling of your breasts with breast milk. It is usually caused by delaying feedings, which can cause milk to build up.

Breast engorgement can happen at any time while you are breast feeding, and is normal in the first 3–5 days after giving birth. The condition can make your breasts feel heavy, full, hard, tightly stretched, warm, and tender. Breast engorgement should improve within 24–48 hours of feeding your baby or expressing your milk.

Breast swelling, tenderness, and heat caused by accumulation of milk in the postpartum period.

3 Interesting Facts of Breast Engorgement

• Similar to mastitis, breast engorgement causes breast pain, but it is usually without fever or erythema, and both breasts are affected 
• Occurs 3 to 4 days after delivery, whereas mastitis usually begins 2 to 6 weeks after delivery 
• Treat with ice packs, support, and more frequent breastfeeding; if patient does not wish to breastfeed, condition can be treated with bromocriptine or cabergoline

Follow these instructions at home:

When to breastfeed or pump

• Breastfeed when your baby shows signs of hunger. This is called “breastfeeding on demand.”
• Breastfeed or use a breast pump to remove milk from your breasts when you feel the need to reduce the fullness of your breasts.
• If your baby is younger than 1 month, make sure you are breastfeeding every 1–3 hours during the day. You may need to wake up your baby to feed if he or she is asleep at a feeding time.
• Do not allow your baby to sleep longer than 5 hours during the night without a feeding.
• Do not delay feedings.
• If you are returning to work or are away from home for an extended period, try to pump your milk on the same schedule as when your baby would breastfeed.

Before breastfeeding or pumping:

• Increase the circulation in your breasts and help your milk flow. Try either of these methods:
  • Taking a warm shower.
  • Applying warm, water-soaked hand towels to your breasts.
  • Massaging your breasts.
• Pump or hand-express breast milk before breastfeeding to soften your breast, areola, and nipple.

During breastfeeding or pumping:

• Try to relax when it is time to feed your baby. This helps to trigger your “let-down reflex,” which releases milk from your breast.
• Ensure your baby is latched on to your breast and positioned properly while breastfeeding.
• Empty your breasts completely when breastfeeding or pumping.
• Allow your baby to remain at your breast as long as he or she is latched on well and sucking. Your baby will let you know when he or she is done breastfeeding by pulling away from your breast or falling asleep.
• Massage your breasts to help your milk flow.

Managing pain and swelling

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If directed, put ice on your breasts:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.

If you feel pain while breastfeeding, take your baby off your breast and try again.

General instructions

• After breastfeeding or pumping wear a snug bra or tank top for 1–2 days. This will signal your body to slightly decrease how much milk it makes. Once the engorgement passes, make sure you to wear a well-fitted, supportive bra and regular clothes.
• Drink enough fluid to keep your urine clear or pale yellow.
• Avoid introducing bottles or pacifiers to your baby in the early weeks of breastfeeding. Wait to introduce these things until after resolving any breastfeeding challenges.

Contact a health care provider if:

• Engorgement lasts longer than 2 days, even after treatment.
• You have flu-like symptoms, such as a fever, chills, or body aches.
• You have nausea or you vomit.
• Your breasts become red and painful.
• You have a lump in your breast.
• Your nipples continue to crack or start to ooze.
• There is yellow discharge coming from a nipple.
• You have pain while breastfeeding, and it does not go away once you take your baby off your breast and try again.

Get help right away if:

• There is pus or blood in your breast milk.
• You have sudden, severe symptoms.
• You have red streaks near your breast.
• Both breasts appear infected and you cannot breastfeed.

Summary

• Breast engorgement is the overfilling of your breasts with breast milk. It is usually caused by delayed feeding.
• Although it is normal to experience breast engorgement 3–5 days after giving birth, it can happen at any time while breastfeeding.
• Do not delay feedings. Breastfeed on demand to help prevent engorgement.
• Increase the circulation in your breasts and help your milk flow before feeding your baby. You can do this by taking a warm shower, applying warm water-soaked hand towels, or massaging your breasts.