Common Concerns While Breastfeeding - Help! I’m Engorged!

Welcome to our blog series…. Common Concerns While Breastfeeding.  These aren’t the complicated, ‘come-to-my-house-immediately’ phone calls I receive.  Rather, these are the questions that come from clients and friends in the middle of the night, by text or by email, that don’t necessarily warrant a lactation consultation.  They can often be easily resolved with a few simple tricks.  So, I would like to share those tricks with you!

Check Out My Cleavage!

I remember the first time I knew my milk had ‘come in.’ It was 4am.  My son was 4 days old.  And I woke up to my breasts looking like I had visited the local plastic surgeon a few hours prior.  I immediately woke up my husband and announced with pride, “Take a look at this cleavage!”  Even without a bra I had cleavage!  It was amazing!

Several hours later, those taut, perky breasts had become quite sore and I was searching for any remedy to help soften their powerful fullness.  I knew that they weren’t engorged, but I also didn’t want to get to that point of challenging return.


What is engorgement?

Flickr - All rights reserved by BreesmanWhile breast fullness between days 2-5 postpartum is normal, your breasts should still be somewhat pliable.  Think of a full balloon.  While a balloon is taut, you can also squeeze it and shape it.  This is how your breasts should feel as your body transitions from making colostrum to your ‘fuller milk.’ 

Engorgement is much more severe.  When your breasts are engorged, they can feel heavy, tender, and/or painful.  Sometimes engorged breasts will look tight and shiny, as if the skin is being stretched beyond its elasticity.  Engorged breasts can become so congested that it is difficult to even remove the milk. Engorgement is most common those first few days postpartum or as your baby gets older and begins to sleep for more consecutive hours at night.


What causes engorgement?

Engorgement is caused by milk stasis (milk not moving out of the breast.) There are many reasons that a mom might become engorged.

  • Several birth interventions, which may result in lots of IV fluids in the hospital
  • Poor latch where the baby is not removing milk efficiently – definitely see a lactation consultant for this issue
  • Subsequent children - I was a lot more 'full' with baby #2, than with baby #1.  Your body has a memory and your milk often comes in more quickly and forecefully with each subsequent baby
  • Your little one slept longer at night than usual
  • Skipped feedings
  • Inflammation
  • Low immunity (caused by lack of sleep, stress as a new mom, stress of going back to work, etc. – Can you imagine that????)


How can I reduce my breast fullness or engorgement?

  • Breastfeed frequently and effectively from both breasts.  In those first few weeks, your baby should be breastfeeding 8 or more times in 24 hours, actively sucking for about 30-40 minutes per feeding session
  • If your baby cannot latch because your breasts are so engorged:
    • Use Reverse Pressure Softening’, which pushes the excess fluid away from your nipple, helping your baby latch more easily. 
    • Hand express or pump on a low setting before latching your baby, to help your breasts to become more pliable and easier to latch onto.
  • To reduce inflammation, treat your breasts as you would a swollen ankle – ice packs/frozen peas in between feeding sessions to help reduce the swelling.  
  • Use warm compresses right before breastfeeding.  The warmth will help to open your blood vessels and hopefully help your milk to begin dripping, thereby making it easier for your baby to latch on. 
  • Take a warm shower and lean forward.  The gravity and warmth should help reduce inflammation.  Use very gentle massage only, as deep massage can cause more inflammation.
  • Take care of yourself and your immune system – rest, drink lots of water, eat immunity-supporting foods
  • Eat cucumber and watermelon to reduce all-over body swelling (like your hands and feet)
  • If your baby isn't latching well or removing milk efficiently, you may find it helpful to pump for about 10-15 minutes after breastfeeding to remove the backed-up milk in your breast.
  • Ask your doctor/holistic practitioner for recommendations for inflammation-reducing medication, herbs, and homeopathy.

As always, here are a few resource that I love and trust.  Check them out for more detailed information.

Breastfeeding Basics – Engorgement

Kelly mom – Engorgement


If you missed our previous Common Concerns articles, please visit:

Common Concerns While Breastfeeding – What is That Knot in My Breast?

Common Concerns While Breastfeeding – Sore Nipple Therapy for the Breastfeeding Mom