Breastfeeding

Breast engorgement is one of the many physical changes your body goes through after giving birth. It affects lots of parents, and although it's common, it can be painful, so moms understandably want to know how to overcome it so they can feed their baby comfortably.

We've written this guide to explain why breast engorgement happens and to help you learn how to relieve the uncomfortable symptoms that come with it, whether you're breastfeeding or not.

What is breast engorgement?

Your breasts can swell and become inflamed and painful if they get too full of milk. This is known as breast engorgement - a painful condition that's caused by increased milk supply and blood flow.

If your boobs are engorged, they may feel painful, hard, and tight. Breast milk may leak from your nipples, and your baby may find it difficult to latch on if they're breastfeeding.

Other symptoms of breast engorgement include your boobs feeling warm to the touch and your nipples becoming painful, flat, or hard. Some people also experience a mild fever below 100°F that usually settles within 24 hours.

Why do my breasts feel full?

The pregnancy hormones estrogen and progesterone drop when your placenta is delivered after your baby is born. From then on, prolactin (the hormone that tells your boobs to make breast milk) kicks in. This can sometimes lead to an overproduction of breast milk which causes breast engorgement.

Around three or four days after birth, blood flows to your breasts as they go through different stages of producing milk, including colostrum to making transitional, and then mature milk. This is your breast milk coming in and can cause your boobs to feel very full and swollen, otherwise known as breast engorgement.

How long does engorgement last?

The worst breast engorgement usually happens soon after birth and it can take a few days for your breast milk supply to match your baby's needs.

If you're breastfeeding or expressing milk from your breasts, the uncomfortable symptoms should ease within two to three days, but they can reoccur for as long as you're breastfeeding or pumping. If you're not breastfeeding your baby or using a breast pump to express and giving them formula in a bottle instead, the symptoms of breast engorgement should pass within a few days.

What if I have breast engorgement but I'm not breastfeeding?

Even if you're not breastfeeding, your breasts may still go through to process of producing breast milk for a couple of days after birth, and therefore, engorgement can happen. It typically gets better within several days, and after a couple of weeks, your body will stop making breast milk altogether if you're not pumping or directly breastfeeding. 

The following points may help relieve the discomfort caused by post-birth engorgement if you're not breastfeeding and want to stop your breast milk supply:

• Put cool packs on your boobs to help soothe them.
• Wear a comfortable, supportive bra.
• Avoid nipple stimulation or expressing a lot of milk. You can hand express a small amount to provide some relief, but not enough to trigger the production of more breast milk.
• Take the recommended dose of pain relief medication like acetaminophen or ibuprofen.

What to do if your breasts are too engorged for your newborn to latch

Breast engorgement can mean that your boobs become overly full very fast. While having lots of breast milk may sound like a good thing when you have a hungry baby to feed, it can make it difficult for them to latch on.

To help soften your nipples so they can latch comfortably you can try:  

• Pumping regularly, either by hand or with a pump before feeds to relieve some engorgement.
• Massaging your breasts in gentle, circular motions while your baby feeds to help get your breast milk flowing.
• A massage technique that softens the nipple and therefore helps the baby latch that's known as Reverse Pressure Softening.

What are the risks of breast engorgement?

Overly full breasts may not sound particularly risky, but they can lead to uncomfortable clogged ducts and a painful condition known as mastitis.

If the breast changes shape and the milk ducts become narrow, engorgement can sometimes mean that breast milk can't flow at all.

Your boobs may leak if they're overly full, which isn't a health risk, but it can be inconvenient and cause discomfort.

If you've followed the tips above but are still struggling to relieve the symptoms of breast engorgement yourself, don't hesitate to ask your midwife, health visitor or Lactation Consultant for advice and support.

How to help engorged breasts when stopping breastfeeding

Engorgement can happen whenever you decide to stop breastfeeding, so it's best to slowly wean your baby off breastfeeding to avoid an oversupply of breast milk. Expressing a little between feeds and spacing them out, using ice packs regularly on your breasts, and avoiding hot showers can also help to relieve engorgement when you choose to stop breastfeeding.

Sources

• Postpartum Breast Care When You Don't Plan to Breastfeed: Care Instructions (alberta.ca)
• Breast Engorgement: Causes, Complications & Treatment (clevelandclinic.org)
• Breast Engorgement: Causes and Tips for Relief (healthline.com)
• Help! My Breasts Are Engorged and My Baby Won't Latch (naturalbeginningsonline.com)
• Engorgement Relief When Milk Won't Flow - Breastfeeding Support
• Engorgement - La Leche League International (llli.org)