Breast engorgement is when your breasts get too full of milk. This can leave them feeling hard and painful.
You may also have a slight rise in temperature due to the increased blood flow to the breasts.
Engorgement can lead to breastfeeding problems such as blocked or narrowed ducts or mastitis.
Engorgement usually happens in the early days of breastfeeding. If milk is not removed as it is formed, the breast may not be able to store it comfortably. It can take a few days for your supply of breast milk to match your baby's feeding needs.
You may get engorged sooner or more severely if you breastfed before.
You can also get engorged if you:
- delay feeding
- add in formula top-ups
- wear tight clothing or underwired bras
It can also happen later on. For example, when you introduce solid food to your baby (weaning).
Getting help
It is important to recognise and manage engorgement early. Ask your midwife, nurse, public health nurse (PHN) or lactation consultant for help if you think your breasts are engorged.
They can show you how to express a little milk by hand before a feed. This can soften your breast and help your baby to attach. You may notice that removing even a small amount of milk (5mls to 10mls) can ease the feeling of fullness.
They will also help you to attach your baby with a bigger mouthful of breast, avoiding nipple damage.
Encourage your baby to breastfeed at any time by keeping them close to your breasts. They can even feed while they are in a light sleep. This will relieve engorgement while providing the milk your baby needs.
Urgent advice: Contact your PHN, midwife, lactation consultant, GP or ED immediately if:
- your baby is unable to attach to your breast
- your baby is not having enough wet and dirty nappies
- you begin to feel the symptoms of mastitis (fever, chills and painful or swollen breasts)
- you have a rise in temperature that is not going away
Relieving breast fullness
Breastfeed your newborn between 8 and 12 times in each 24 hour period, or more if your baby is looking to feed. Removing milk from the breasts relieves the fullness in the milk ducts.
This feeling of fullness usually goes away after 12 to 48 hours with regular feeds and good management. This is where your baby is well attached and taking plenty of milk from your breast with each feed.
Avoid using a soother which may cause your baby to feed less often.
Reduce the symptoms
Positioning and attachment may be a little difficult if your breasts are uncomfortably full or hard.
There are things you can do to ease the symptoms of full or hard breasts.
Do
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gently hand express some milk before feeding - this can help soften your breast, making it easier for your baby to attach
-
use a cold pack or moist face cloth to reduce swelling and relieve pain - after a feed or in between feeds
-
soften the areola using reverse pressure softening
-
very gently massage your breasts in a circular motion - using the flat of your hand to massage all the way up to your armpit
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if wearing a bra, make sure it is non-padded, non-wired, fits you properly and is not too tight
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take paracetamol or ibuprofen at the recommended dose (unless there is a medical reason not to) to ease the pain - these are safe to take while you're breastfeeding
-
hand express breast milk for few minutes at least twice a day during the first 2 to 3 days after birth