Breast Engorgement

Medically Reviewed by Traci C. Johnson, MD on September 07, 2022
3 min read

Breast engorgement means that your breasts are filled with too much milk. It can make them feel swollen, warm, and tender. It’s normal before you start breastfeeding and can mild or more intense.

After you deliver a baby, your body is still hard at work. Two of its new missions: helping you heal and getting food to your newborn.

In the hours and days following labor, circulation to your breasts increases. At first, they produce a thick, yellowish fluid called colostrum. It's full of protein and everything your baby needs to build a strong digestive system and stay healthy.

Three to 4 days after labor, your body makes milk all the time and stores it in your breast tissue. The first time your milk comes in, your breasts can become engorged, or filled with too much milk.

If your breasts are engorged, they may feel:

  • Warm
  • Heavy
  • Tender and painful
  • Swollen, which may extend to the armpit
  • Hard
  • Trouble for your baby to latch onto

You may also have lumps or flattened nipples.

  • There’s a chance that engorgement could block milk ducts and lead to a breast infection if it’s severe.

Your breasts may naturally become engorged soon after you give birth as your milk comes in. It can also happen if you aren’t able to breastfeed or pump often enough. 

Breastfeeding has many benefits for mother and baby alike. But it isn’t always easy. It may take your body a while to get used to it. And for some women, it might not work out. A lactation consultant or your doctor can help you get started.   

Engorgement can be painful and can cause trouble with your little one latching on. You may not want to breastfeed or pump. But that's the only way to make it go away.

Sometimes engorgement can make your breasts feel hard to the touch. That's all the milk backed up in the breast tissue. If you're breastfeeding, this can make it tough for your baby to latch on or create a painful and improper latch. Pump or manually express milk first, then try again.

You can also try to reduce the hardness in your breasts by massaging them, taking a warm shower, or applying a warm compress to your breasts before feeding. If that doesn't work, don't keep trying. The warmth may increase the swelling instead and prevent the milk from flowing.

Once you get some milk out, the engorgement should go away. Then your baby will be able to latch and transfer the rest of the milk, emptying the breast.

Once your body understands how much milk your baby needs and gets into a rhythm, engorgement shouldn't be an issue. If you still feel that tightness and pain, try these tips and talk to your doctor. If you have fever, discharge from the nipple, or body aches, you should also talk with your doctor. You could also check in with a lactation consultant.

You can also do these:

  • Switch to a bra with more support.
  • Take over-the-counter pain medication (consult with your baby's doctor beforehand).
  • Try ice packs to reduce swelling.
  • Try reverse pressure softening, where you gently press on the area around your nipple for about a minute to try to shift some of the engorged fluid away from that area.

The key is to not let your breasts get overly full with milk.

Feed your baby whenever they are hungry. Breastfeed or pump often or as close to every 2-3 hours to set a routine. Pump if you skip a feeding, have given a bottle, or if your baby doesn't take enough milk or empty the breast enough.

It can help to use a warm compress or take a warm shower before you breastfeed or express your milk.

Make sure you stay hydrated and eat a healthy diet, too.

Your body takes its cues from you. If milk isn't leaving your body, it will stop making more. If your breasts are engorged when your milk comes in and you are planning to formula feed, wear a tighter sports bra and curb any kind of stimulation to the breast. After some days, the engorgement will steadily decline.