Woman breastfeeding

Maybe your breastmilk has just come in. Or your little one dropped a feeding. Or you’ve been away from your baby longer than usual…and your breasts feel incredibly full, hard, and just plain uncomfortable. This temporary condition is known as engorgement and it can lead to bigger problems than discomfort. Here’s what to know about engorgement, including tips on how to treat it and find relief. 

What Is Engorgement? 

Engorgement happens as your milk comes in, causing them to become uncomfortably full. While it’s normal for your breasts to feel full as your body regulates your milk supply, excessive engorgement can be painful and lead to bigger problems like clogged ducts or mastitis.

What are the Signs of Engorgement? 

If you’re experiencing engorgement, chances are you’ll know. Your breasts will feel hard (sometimes the whole way out to your armpit area) warm, and tender. At times engorgement can even lead to a low-grade fever. 

When your breasts are very engorged, the fullness and firmness can also make it difficult for your little one to latch and begin breastfeeding. 

How Can I Prevent Engorgement?

While it may not be possible to avoid engorgement entirely during your breastfeeding journey, there are a few tips that can help you prevent engorgement from happening very often: 

  • Breastfeed frequently: It’s important to nurse your baby at least 8-12 times in 24 hours in baby’s first few months of life to establish and regulate your milk supply. Stick to a consistent breastfeeding or pumping schedule whenever possible, and drop feedings or wean gradually when you’re ready.
  • Check baby’s latch: If your little one isn’t latching or sucking correctly, the amount of milk being removed from your breasts may not be sufficient to prevent engorgement. If you’re unsure if baby’s latch is correct or you don’t think your little one is nursing efficiently, contact a lactation specialist for an evaluation. 
  • Don’t limit baby’s time breastfeeding: While there’s no magic number in regard to how many minutes baby should breastfeed, younger babies typically nurse for 15 -20 minutes or so per breast. Follow baby’s lead, and let your little one nurse until they finish feeding on each breast. After they unlatch at one breast, offer the other breast to see if baby is still hungry. This helps ensure that they’re getting the amount of milk they need, and that your body understands how much breastmilk it needs to create to satisfy your baby.
  • Give yourself a massage: Gently massage your breasts during or between feedings or while pumping to encourage breastmilk to move through and out of the breast. The amount of pressure should be as light as petting a kitten or stroking your baby’s face.  

How Do I Get Rid of Engorgement? 

There are things you can do to help relieve the pressure in your breasts and help your engorgement subside. Try the following: 

  • Breastfeed: This is the best way to begin to take care of engorgement. Since breastfeeding is supply and demand based, your breasts will start to regulate your milk production and only make the amount that your baby needs. Always start breastfeeding from the most engorged breast first to encourage plenty of milk to drain from the breast. Once you’re no longer engorged, alternate which breast you offer baby first at each feeding.
    • If baby is having trouble latching or breastfeeding, try a technique called “reverse pressure softening":
      • Sit or lie on your back, and ask your support person for help if needed.
      • Place the pads of your fingers and thumbs of one hand in a circle around your areola, touching the sides of your nipple (but not covering it).
      • Push gently yet firmly straight inward towards your chest wall without spreading your fingers across your skin, and hold the pressure for one to three minutes continuously. 
      • You’ll know that you’re ready to feed your baby or pump when you can hand express easily, and the areola is soft. Depending on how engorged you are, you may need to repeat the process.  Seeing indents from where you have pushed in is normal.   
      • You can also use both hands on one breast, placing the sides of your fingers or thumbs on opposite sides of the areola. Apply pressure inward, and rotate your hands a quarter turn occasionally to soften all areas of the areola. 
  • Use cold compresses or ice packs: After feeding, a cool compress on your breasts such as a damp washcloth or a cold breast-pad can help further reduce any swelling and ease your discomfort. Another trick? Although there isn’t a lot of scientific research to support it, many women find relief by wearing a clean, cool cabbage leaf in their bra for 20 minutes between feedings (up to three times a day).

We know that engorgement can be a pain—literally! Give these tips a try in order to find some relief while your body regulates your milk supply. If you have any concerns that your engorgement has led to mastitis, it’s important to contact your provider. Hang in there, mama!

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