Breast Engorgement

What is engorgement?

  • Breast engorgement is swelling, tightness, and an increase in size of the breasts.
  • It usually occurs in the early days of breastfeeding, between day 3 and 5, but may occur as late as day 9-10.
  • Moderately severe breast engorgement results in hard, full, tense, warm and tender breasts with throbbing and aching pain.
  • A cesarean birth may delay engorgement by one to two days because the milk may come in later.
  • Breast engorgement is caused by congestion of fluid and blood in the breast. Fullness in the breast from early milk production can prevent drainage of fluids and cause painful swelling.
  • Some women do not ever experience breast engorgement.

Tips to prevent or minimize painful breast engorgement

  • Some degree of breast fullness is expected and normal as your milk comes in.
  • More time spent breastfeeding in the first 48 hours will reduce engorgement.
  • Let the baby breastfeed on the first breast until it is soft before switching to the other breast.
  • Alternate which breast you offer first.
  • Breastfeed often, every 1-2 hours, to avoid severe breast engorgement.
  • Draining the breasts regularly is the best prevention. Poor drainage and unresolved pressure within the breast can damage milk producing cells and reduce your ability to make milk for your baby.

What to do if your breasts become engorged

  • Reverse pressure softening can be performed to soften the area around the areola to make it easier for the baby to latch. Using your fingertips, apply gentle firm pressure to your areola for 30 seconds. This will move some of the fluid back into your breast.
  • If your baby cannot successfully latch and breastfeed, you can relieve breast engorgement by manually expressing milk or pumping, and then trying breastfeeding again.
  • Wear a well-fitting supportive bra.
  • Cold packs applied to the breast may reduce swelling and provide comfort.
  • Take a warm shower and express some milk before you feed the baby, or lean over a bowl of warm water before you feed the baby to help your milk let-down.
  • Take acetaminophen or ibuprofen before breastfeeding to minimize pain.
  • Apply washed, cool cabbage leaves to the breasts for 20 minutes at a time or until the leaves wilt.

Reviewed by Diane L. Spatz, PhD, RN-BC, FAAN on August 01, 2012