Breast Engorgement

What is breast engorgement?

Breast engorgement is when your breasts are painful, swollen and tender because they’re overly full of milk. It occurs most often in the days and weeks after giving birth due to milk production and increased blood supply to your breasts (chest). The increase in blood supply helps your body make breast milk for your baby, but it can cause severe engorgement. Engorged breasts are a temporary problem but can happen as long as you produce milk.

The most common reasons for breast engorgement are:

• You’ve given birth and your milk is “coming in.”
• You’re breastfeeding (chestfeeding) and skip nursing sessions.
• Your baby changes their feeding schedule. For example, they start sleeping through the night.
• You skip pumping sessions or forget to pump when you’re away from your baby.
• You have an oversupply or make more milk than your baby needs.
• You’re weaning your child from breastmilk to another form of milk.

It can be tricky to balance managing your milk supply and preventing engorgement. However, there are ways you can relieve the discomfort and minimize complications from engorged breasts.

When do you start making breastmilk?

The first milk your breasts produce is called colostrum. It’s a highly nutritious first milk that your body begins making in pregnancy. Colostrum transitions to breast milk after three to five days. Engorgement tends to occur during this time because your milk production is ramping up. Your breasts will be fuller, firmer, swollen and tender to the touch. After several days, the pain and discomfort should gradually subside.

When does engorgement start?

The exact timing varies, but the most common time is between three and five days after you give birth. It may start later if you’ve had a cesarean birth (C-section). The degree of swelling and pain you feel can also vary. Some people are severely engorged, while others feel minor side effects of breast engorgement.

How long does it take for engorgement to go away?

There’s no set time for engorgement to subside. The engorgement you feel after giving birth is usually the most severe. Most people stop feeling engorged within 10 days; however, feeling “full” can last several weeks. Breast engorgement can come back as long as you breastfeed, chestfeed or pump breast milk.

What causes breast engorgement?

Your breasts become engorged anytime they’re overly full of milk. It happens the first time within a few days of giving birth and can last several weeks. You can get engorged breasts for as long as you’re making milk.

Reasons your breasts may become overly full are:

• Your milk is transitioning from colostrum to mature breast milk.
• You miss or skip feedings or pumping sessions.
• Your baby sleeps through the night or starts eating solid food.
• You supplement feedings with formula.
• Your baby doesn’t eat as much due to illness.
• Your baby isn’t latching correctly and fully emptying the breast.

What are symptoms of breast engorgement?

No two people will have the same symptoms. People describe their engorged breasts as being:

• Fuller and larger than usual (up to a few cup sizes).
• Swollen.
• Painful.
• Hard and firm.
• Tender and sensitive to touch.
• Lopsided or rocky (hard lumps).

The swelling can also extend up into your armpit and across to your sternum (breast bone). This is because breast tissue extends to these areas. Your nipples may change from being soft and flexible to flat and firm.

Some people also experience a low fever (called milk fever) when they’re engorged. This is typically OK. Call your healthcare provider if your fever increases or lasts several days as it could be a sign of infection.

What does breast engorgement feel like?

Engorged breasts feel like they’re ready to burst. They may feel hard like rocks and so tender that it hurts to walk or change your clothes. Your breasts will feel heavier, and simple things like snuggling your baby may be extremely painful.

What do engorged breasts look like?

Engorged breasts look several sizes bigger than their normal size. Most people will see their veins protruding visibly under the skin of their breasts. The skin of your breasts may appear shiny from being stretched. Your breasts will likely have an uneven shape, and you may see visible lumps or hard spots.

How do you relieve breast engorgement?

Most people can relieve breast engorgement at home within a few days. Some common treatments for engorged breasts are:

• Using a warm compress or taking a hot shower before feedings to soften your breasts and encourage milk flow.
• Massaging your breasts while nursing or pumping.
• Hand expressing or pumping a small amount of milk between feedings to relieve pressure.
• Applying a cold compress or ice pack to your breasts between feedings to help with swelling.
• Taking ibuprofen or acetaminophen for pain.
• Feeding your baby or expressing milk every two to three hours.
• Letting your baby completely drain your breasts.

Should I pump to relieve engorgement?

Yes, you can pump a little bit of milk to relieve engorgement. Try to pump just enough to feel relief —around 1 to 2 ounces. Remember, producing milk is a supply and demand process. If you pump too much milk, your body will just produce more to make up for it.

How do I stop getting engorged at night?

It’s normal for your breasts to become engorged once your baby starts sleeping longer at night. It may take your milk supply a few days to adapt to your baby’s new pattern. If your breasts are overly filled, it’s OK to remove some milk. You should only remove a little milk – enough to provide some relief so you can get back to sleep.

This can happen anytime your baby goes longer without feedings. If you experience pain or fullness because your baby is going longer stretches between meals, pumping or hand-expressing a little bit of milk is fine.

What do I do for engorgement if I don’t want to breastfeed or chestfeed?

You’ll have engorged breasts even if you choose not to breastfeed or chestfeed. However, milk production will eventually stop. Your body will recognize that you don’t need milk, and your supply will dry up. Don’t pump for relief. This will only prolong the process of ending your milk production. Instead, try some of the following treatments until your pain subsides:

• Take an over-the-counter (OTC) pain reliever for pain and swelling.
• Wear a tight-fitting and supportive bra.
• Apply cold compresses to your breasts several times a day.

What can happen if my breasts get too engorged?

Engorged breasts can make it hard for your baby to feed. Relieving engorgement and softening your breasts and nipples can help with your baby’s latch (the way your baby attaches to your nipple).

Some of the most common feeding issues caused by engorged breasts are:

• Your baby can’t latch to your nipple because it’s too flat and stretched.
• Your nipples become sore and cracked because your baby isn’t latching correctly.
• You feed your baby less because it’s too painful. This can lower your milk supply.
• Overactive let-down or fast milk flow. This can lead to your baby gagging or choking on milk.
• Your baby is unable to empty your breast fully. This can cause clogged milk ducts.

Breast engorgement can also lead to complications like clogged milk ducts and mastitis.

What’s a clogged milk duct?

Milk ducts are a part of breast anatomy that carry milk to the nipples. When one of these ducts gets clogged with milk, you may feel a lump in your breast. Removing the clog as soon as possible can prevent it from becoming infected. To unclog a milk duct, apply heat to the area and gently massage the lump toward your nipple while nursing or pumping.

What’s mastitis?

Mastitis is an infection in your breast tissue. It happens when milk gets trapped in the breast. Bacteria grow in the trapped milk, leading to infection. Your healthcare provider will treat mastitis with antibiotics. You will also be encouraged to gently massage your breast, nurse or pump, and use medication to bring down any fever you may have.

When do I call my doctor?

Contact your healthcare provider, pediatrician or lactation consultant if:

• Your breasts are engorged longer than a few weeks.
• You develop symptoms of mastitis. Signs include a red spot on your breast, a fever, a painful spot on your breast or chills.
• Your baby has a poor latch or issues with breastfeeding/chestfeeding.
• You think you have low milk supply or your baby isn’t eating enough.

Don’t be ashamed to ask for help. Struggling with breastfeeding, chestfeeding or feeding your baby pumped milk is a common struggle. Healthcare providers can help you.

Can you prevent breast engorgement?

No, you can’t prevent breast engorgement. It’s a natural part of childbirth. However, you can manage your symptoms so you’re more comfortable. Remember, it will subside once your milk supply is under control. When your milk comes in and your supply is regulated, you can prevent future breast engorgement by:

• Not skipping feeding or pumping sessions.
• Making sure your baby maintains a good latch on your breast.
• Weaning your baby from breast milk slowly.
• Emptying your breasts at each feeding.

A note from Cleveland Clinic

Engorged breasts are hard, swollen and extremely painful. Some engorgement is unavoidable – like when your milk comes in after giving birth. It’s good to learn how to manage breast engorgement and treat it quickly. Remember, engorged breasts are only temporary, and you can take steps to ease the discomfort by removing some milk, softening your breasts before nursing or using ice packs. Call your healthcare provider if your engorgement lasts longer than a few weeks or if you develop signs of mastitis.