Caring for engorgement

Remember, engorgement isn't always caused by too much milk. Tissue swelling may also be present. It is important to treat both the excess of milk and the swelling to help the milk flow. It is easy to damage swollen tissue with aggressive massage, pumping or heat. Be gentle.  Use pain as a guide.

It is important not to let engorgement go untreated. It has been my experience that untreated engorgement results in a number of problems, from breast infections to an under-supply of breastmilk. It is also important not to continue with milk expression beyond the engorgement with the onset of milk production (your milk coming in). Normally no more that the first 5 to 7 days. If engorgement continues or is unmanageable, contact you local lactation consultant for assistance.

Treat only the symptoms you have; when you have them.

In the first few days following the birth of your baby your breast are in a state of beginning full production of milk, and that production is in overdrive. See How the breast makes milk Engorgement as the milk comes in is common even if your baby has been nursing on demand and nursing well. This type of engorgement should lessen within a few days if you keep the milk flowing well.

Engorgement can also occur when you go too long between feedings and happens most often when the baby begins sleeping more or you miss feedings/expressing milk. This type of engorgement should lessen quickly at least within a few hours following a feeding or milk expression session.

• Take a hot bath or shower or place your breasts in a basin of warm water.  Allow milk to leak out.
• baby's dad (or a friend) massage your back, along the spine from the top of your neck to your waist.  
• Warm moist packs to breasts right before feedings.  
• Gently massage breasts.  
• Keep the areola soft by expressing milk before putting the baby to breast.  
• Nurse baby frequently.  
• Apply ice packs or cold compresses to breasts after nursing. See  The Cabbage Cure.  
• Pump gently, or manually express milk to relieve any over-fullness.      
• Don't try to empty the breasts after every feeding as this will increase milk production.    The more you express, the greater your milk supply will become, and an oversupply of milk can be just as bad as too little milk.

Copyright Marie Davis, RN, IBCLC 1999

Revised: Friday, January 27, 2012

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Last Reviewed: Thursday, 21-Apr-2011 0:34 AM

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