Mother breastfeeding babyA few days after your baby’s birth, your milk production increases or comes in. It is normal to feel some breast fullness, but engorgement, which can happen during the first week after birth, goes beyond normal fullness. When a mother is engorged, her breasts become full, firm, hard, hot, and sometimes painful.

Some think breast engorgement is caused by too much milk. But it is really caused by fluid build-up in the breast. If the milk is not drained often and well, extra blood, lymph, and other fluids build-up in the breast, too. Lots of IV fluids during labor can also be a factor.

TO PREVENT ENGORGEMENT:

  • From birth, breastfeed at least 8-12 times a day. If the baby is not feeding well, use a multi-user, hospital-grade breast pump to drain the breasts this often. 
  • Be sure when breastfeeding that your baby latches on deeply. This feels better for you and helps your baby drain the breast more fully. 
  • Avoid bottles and pacifiers. Keep your baby at the breast for all sucking.

TO TREAT BREAST ENGORGEMENT: 

  • Discuss with your healthcare provider taking ibuprofen to relieve swelling. 
  • If needed, express some milk before feeding to make it easier for your baby to latch deeply. 
  • Apply warmth right before feeding to aid milk flow. 
  • Breastfeed at least every 1.5-2 hours during the day and at least every 2-3 hours at night until engorgement is gone.
  • Use breast massage or compression during feedings to more fully drain your breasts. 
  • Let warm water run over your breasts in the shower. Leaking relieves pressure. 
  • If your breasts still feel full after feedings, pump to drain your breasts fully. 
  • Express milk to comfort between feedings. 
  • Apply cold—gel ice packs or bags of frozen peas, wrapped in cloth—after feedings for 10-15 minutes to reduce swelling.

Try applying green cabbage leaves to your breasts between feedings to help reduce pain and swelling. To do this, put a chilled cabbage leaf in your bra for 15-30 minutes two to three times per day. Avoid cabbage if you are allergic to it or if you develop a skin rash.

Be sure to treat breast engorgement before it gets painful. Severe pressure and swelling can cause breast damage. If these methods do not provide relief, seek help right away from a board-certified lactation consultant or other knowledgeable healthcare provider.

This is general information and does not replace the advice of your healthcare provider. If you have a problem you cannot solve quickly, seek help right away. Every baby is different. If in doubt, contact your physician or other healthcare provider.

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Sore Nipples and Engorgement