What is engorgement?
Engorgement is caused by a build-up of milk, blood and other fluids in the breast tissue. You may find that your breasts become larger and feel heavy, warmer and uncomfortable when your milk ‘comes in’, usually about 2–6 days after your baby is born. This is normal. It does not affect milk flow or the ability of your baby to attach to your breast.
However, in some cases, a mother’s breasts can become very hard, swollen and tender and her nipples become flattened and taut. It can be painful for the mother and make it difficult for a baby to attach to the breast.
How can I prevent engorgement?
- Feed your baby often from birth.
- Don’t limit baby’s time at the breast.
- Wake your baby for a feed if your breasts become full and uncomfortable (especially at night time).
- Ensure your baby is positioned and attached correctly, to maximise the amount of milk she is getting.
How can I relieve engorgement?
- Take your bra off completely before beginning to breastfeed.
- Use warmth before feeds to help trigger your let-down reflex.
- If your baby has trouble attaching to your breast, use ‘reverse pressure softening’ (see below) to soften the breast tissue under your areola or express some milk (by hand or with a pump).
- Feed your baby frequently.
- Massage the breast gently while you are feeding.
- If necessary, express for comfort after feeds.
- Use cold packs or chilled, washed, cabbage leaves after a feed to reduce inflammation.
- Ask your medical adviser or hospital staff about taking anti-inflammatory medication or pain relief if needed.
‘Reverse pressure softening’: The aim is to push fluid in the tissue under the nipple and areola further back into the breast, to relieve the pressure. To do this, apply pressure with two or three fingers of each hand placed flat at the sides of and close to your nipple, and hold for 1–3 minutes. Or use all fingertips of one hand around the nipple and push in, holding for 1–3 minutes, until the tissue softens. More information on reverse pressure softening, including diagrams showing how to do it, can be found here.
For severe engorgement:
A small percentage of mothers experience severe engorgement around the time their 'milk comes in'. In these situations, it is important to ensure that the baby is attaching well and feeding effectively, and that the length and frequency of feeds are being determined by the baby's needs. In addition, mothers who experience severe engorgement often find it helpful to use a breast pump to completely express out the milk from their breasts.
Engorgement in the armpit:
A small percentage of mothers have extra breast tissue in the axilla (armpit). This extra breast tissue is called accessory (or supernumerary) breast tissue and is not connected to the main ductal network of the breast. Accessory breast tissue is different to the breast tissue that normally extends into the armpit (called the Tail of Spence). The Tail of Spence or accessory breast tissue can become engorged just like any other breast tissue can. Management for engorgement, regardless of what breast tissue it occurs in, is the same.
Contact the Breastfeeding Helpline or email counselling for further information and support.
The information on this website does not replace the advice of your health care provider.
© Australian Breastfeeding Association October 2014