Breast engorgement is a painful condition that occurs when milk builds up in the breast. It can lead to pain, warmth, and tenderness in the breasts, alongside fever. It may be difficult for a baby to latch onto an engorged breast.
Engorgement often happens in the first few days after birth, when colostrum changes into milk. It may also occur if there are changes in feeding frequency or pumping, such as skipping regular feedings.
Engorgement can lead to other problems, including clogged ducts and a breast infection called mastitis. Milk production may also decrease because the body takes engorgement as a sign that it does not need to make more milk.
This article explains why breasts become engorged. It also looks at how to prevent this from happening and how to relieve the symptoms if it does occur.
Breast engorgement means that one or both breasts are too full of milk. It is common among people who are newly breastfeeding or chestfeeding and often occurs in the first week after giving birth, when milk fills the breast.
The initial breast fullness following birth should subside after a few days of regular nursing, as the body becomes attuned to the baby’s needs.
If a baby does not feed as much as they need to, engorgement can occur. It may also occur when a baby takes less milk than usual and a person is unable to pump or hand express to reduce the amount of milk in the breast.
In some cases, the body produces more milk than the baby needs, which is called oversupply. This can also lead to breast engorgement.
Engorged breasts can be painful, swollen, and firm. The nipples may flatten, and the areolae may be very firm. This can make it difficult for the baby to latch.
Severely engorged breasts may be hard, shiny, warm, and lumpy.
Engorged breasts can cause a slight fever and swelling of the lymph nodes in the armpit.
Many people who breastfeed or chestfeed experience engorgement at some time. People can often relieve the pain and fullness of engorged breasts by:
- feeding little and often, particularly for newborns, who can feed 8–12 times in 24 hours
- feeding from the engorged breast first
- encouraging milk flow during feeding by massaging the breast from the chest wall to the nipple
- applying a warm washcloth to the breast or taking a warm shower before feeding
- trying to hand express or pump a little milk out of the breast before feeding to reduce the swelling, if the baby is not latching
- applying a cold pack between feeds to provide relief from discomfort
- taking acetaminophen or ibuprofen to relieve pain and discomfort
- wearing a properly fitted, supportive bra
The best way to prevent engorgement is to stick with regular feedings. The Centers for Disease Control and Prevention (CDC) suggest that, on average, babies who exclusively drink breast milk feed
More tips for preventing engorgement include:
- feeding during the night so that the breasts do not become engorged by the morning
- ensuring that the baby latches well so that they can remove milk efficiently from the breast
- alternating which breast the baby feeds from first
- pumping every few hours to remove some milk and maintain milk supply, if nursing is not possible
- avoiding using pacifiers or artificial nipples on bottles until nursing is established to help regulate milk supply
If a person wishes to stop nursing, it is best to do so gradually over several weeks. Stopping suddenly can lead to engorgement and be distressing for the baby.
Below, we answer some common questions about breast engorgement.
How long does breast engorgement take to go away?
Breast engorgement can subside as soon as a person expresses milk from the breast — either through nursing or pumping out the milk. Most engorgement subsides within 12–24 hours.
If a person wishes to stop nursing, they can gradually reduce the amount of milk they express each day, which will cue the body to produce less of it. It can take anywhere from a few weeks to a few months to stop completely.
How should I sleep with engorged breasts?
Engorged breasts can make sleeping difficult. A person may wish to try expressing some milk before going to bed to make the breasts less painful. Placing cold compresses on the engorged breasts before going to bed may also ease swelling and relieve discomfort.
People may find the following beneficial:
- sleeping in a slightly reclined position on elevated pillows to take some pressure off the breasts
- avoiding sleeping on the stomach
- wearing a supportive nighttime nursing bra
Should I wake my baby to feed if my breasts are engorged?
If a person has engorged breasts, they can wake the baby and allow them to feed until they are full. If the breasts remain engorged, a person can express milk by hand or with a pump until they feel more comfortable.
A person should seek medical advice if they:
- have discoloration or swelling of the breasts
- have developed a fever
- are experiencing increasing pain
- have engorgement that has not diminished in 2–3 days
Engorgement is a painful condition that can come on rapidly after giving birth. The breasts may swell, harden, and hurt.
For most people, engorgement will clear up within a few days as the body adjusts to the dietary needs of the baby. In the meantime, pumping and hand expressing milk can help ease pain and soften the breasts.
Cold and warm compresses, massage, and over-the-counter pain relievers can also alleviate discomfort.
Breast engorgement happens when the breasts become too full of milk. This can cause them to feel swollen, hard, and painful. Engorgement is common in the first weeks after birth. It can also happen if a baby feeds less than usual or if the body produces more milk than the baby needs.
The nipples may become firm and flat, making it difficult for the baby to latch and feed.
The best way to ease engorgement is to feed the baby, express milk by hand, or use a breast pump. A person who wishes to stop nursing should gradually reduce the number of milk feeds a baby has or the amount they express.