Breast Engorgement: What You Need to Know

Late into your pregnancy and for the first few days after giving birth, your body starts producing colostrum, or the earliest form of milk. Colostrum is packed with antibodies that will help your newborn develop his or her immune system, says Lisa Sandora MA, CCC-SLP, IBCLC, a lactation consultant at the TriHealth Breastfeeding Care Center . But, feeding your baby this so-called "amazing milk" eight to 12 times daily is beneficial for you, too. It helps prevent engorgement, a painful overfilling of the breasts with milk.

Breast Engorgement: What Can I Expect?

While Lisa says it is normal for your breasts to feel fuller, heavier and tender, "this fullness usually goes away when a baby is breastfeeding often and well," she points out.

Some women develop hard, swollen, painful breasts when the milk first comes in. The nipple and areola may become hard and more flat, making it difficult for your baby to latch on deeply, to remove enough milk. In turn, your nipples become sore from your baby latching only on the nipple.

4 Ways to Treat Breast Engorgement

Tip #1: Breastfeed Frequently

Lisa says to breastfeed often - at least every two to two-and-a-half hours during the day, and three hours at night - until the engorgement subsides. Then, resume breastfeeding your baby on cue eight to 12 times daily.

Tip #2: Decrease Swelling Before Breastfeeding

Before you breastfeed or pump, place cold packs on your breasts for 15 to 20 minutes to reduce swelling. "Use cold packs, alternating for 15 to 20 minutes on and 15 to 20 minutes off, between breastfeeding or pumping sessions, as needed, until the milk begins to flow well," Lisa explains. On the other hand, she warns to not use heat when there is swelling, because it could worsen the swelling.

Ask your doctor about using a non-steroidal, anti-inflammatory medication, such as ibuprofen, to minimize swelling.

Tip #3: Help Baby to Latch on More Easily

Sometimes your nipple and areola become too full for your baby to latch onto the breast due to engorgement. In this case, soften that area by:

• Using reverse pressure softening (a manual technique used to soften the areola)
• Hand expression
• Pumping some milk out for one to two minutes before breastfeeding

For more detailed instructions on these techniques, see pages 17-19 of our Breastfeeding Resource Guide.

If your baby is unable to latch on for a feeding due to fullness, Lisa recommends calling the TriHealth Breastfeeding Help Line (513 862 7867, option 3) to speak with a lactation consultant.

Tip #4: Relieve Fullness After and Between Feedings

If your breasts are still uncomfortably full after breastfeeding, you can express milk to relieve fullness. It's important for you to express enough milk to be comfortable, but not to overdo the pumping, since it will encourage overproduction. You may only need to do this temporarily since the engorgement should decrease over time.

Tip #5: Know When to Call for Help

Call the TriHealth Breastfeeding Help Line (513 862 7867, option 3) to speak with an International Board Certified Lactation Consultant if engorgement is not relieved by these suggestions.

If you develop signs and symptoms of mastitis (see our Breastfeeding Resource Guide ), you should call your obstetrician and the TriHealth Breastfeeding Help Line.