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The Basics of Breast Engorgement

Breast engorgement is the term used to describe the swelling in your breasts that most often occurs when milk starts increasing in volume around 3-5 days postpartum. The pain associated with breast engorgement can range from mild to extreme, but there is no need to be alarmed, as this is a relatively common symptom many women experience after having a newborn. Other signs of breast engorgement include redness, flat areolas and firmness in the breast. In order to prevent engorgement during your breastfeeding journey, here’s what you need to know.

Causes of Engorgement

The most common causes of engorgement are infrequent and/or delayed feedings. When the breasts become overfull, swelling and hardness occur; this is engorgement. Another common cause of engorgement is improper latch. When a baby is not latched on correctly, milk cannot be effectively removed, causing fullness, discomfort and a backup of milk. During your hospital visit, a lactation consultant should evaluate your baby’s latch. Sometimes just a few adjustments can make all the difference in getting milk efficiently transferred to the baby.

While it may seem like engorgement only occurs during the early weeks, it can happen any time. Supplementation without proper milk removal, skipped or missed feedings, and any time a baby starts sleeping longer stretches at night can all lead to engorgement.

How to Prevent Breast Engorgement

In order to prevent engorgement, you’ll want to breastfeeding often. In the early days this means breastfeeding every 2-3 hours, or 8-10 times per 24 hours. Feeding frequently helps prevent breast fullness from becoming painful engorgement. If your baby is extra sleepy, don’t be afraid to wake him up to feed every 2-3 hours. Frequent feeds help establish your milk supply and help your baby gain weight.

If your baby is unable to latch, or if breastfeeding is not possible, you’ll want to begin pumping with a hospital-grade pump to establish and maintain your milk supply.

How to Treat Breast Engorgement

Engorgement should be treated as soon as possible. If treated right away, symptoms should resolve within 24-28 hours. However, if treatment for engorgement is delayed, recovery can take several weeks. To help alleviate engorgement, the following steps can be taken:

  • Before a feeding: Use the Lactation Massager to help soften the breasts by massing toward the nipple. This will help you express a few drops of milk, which will soften your areola. Sometimes just a few drops can make all the difference in getting your baby to latch on deeply.
  • During a feedings: Allow your baby to finish one side before switching to the other. If your baby pauses during a feed, gently massage the breast toward the nipple to assist with milk flow.
  • After a feeding: Apply cold compresses to your breasts to help reduce swelling and relieve pain. If your baby does not soften both breasts, hand express or use a breast pump until you feel some relief.

If engorgement is not resolved, or if symptoms worsen, contact an International Board Certified Lactation Consultant (ilca.org) or your doctor.