Engorgement in the early days

It is quite normal for breasts to become larger and feel heavy, warmer and uncomfortable when your milk 'comes in', usually about 2 to 6 days after our baby is born.

This usually doesn't affect milk flow or the ability of your baby to attach to your breast.  

However, in some cases, a mum’s breasts can become very hard, swollen and tender and her nipples become flattened and taut. This is called engorgement. It can be painful for you and make it difficult for your baby to attach to the breast.  

Engorgement can occur in any part of the breast, even under the armpit.  

It can help if you: 

• Feed your baby often from birth. 

• Allow your baby to feed for as long and as often as they want to.  

• Start each feed on alternate breasts, to ensure your breasts are drained equally.  

• Wake your baby for a feed if your breasts become full and uncomfortable (especially during the night). 

• Ensure your baby is positioned and attached correctly, to maximise the amount of milk they are getting. 

Feeding your baby as often as possible is one of the best ways of dealing with engorgement. 

Here are some other things you can try: 

• Take your bra off completely before beginning to breastfeed. 

• Gently massage your breasts or apply something warm before feeds to help your milk flow. 

• 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 about taking anti-inflammatory medication or pain relief if needed. 

Your baby may have difficulty attaching if your breast is swollen and your nipple is flatter than usual. In this case it is helpful to soften the area around your nipple.  

• Try expressing some milk by hand or with a pump.  

• Use a simple technique called ‘reverse pressure softening’.  

What is reverse pressure softening?

The idea of reverse pressure softening is to push back the fluid that has built up behind and around your nipple and relieve the pressure. The breast tissue then becomes softer, allowing your baby to more easily attach. There are a few different ways you can reverse the pressure.    

Read the following descriptions and watch the video below to see the technique in action.