Breast engorgement is the painful overfilling of the breasts with milk. This is usually caused by an imbalance between milk supply and infant demand. This condition is a common reason that mothers stop breast-feeding sooner than they had planned.
Engorgement can happen:
As you get close to your due date, your breasts make colostrum. Colostrum is a yellowish liquid that contains important nutrients and antibodies that a baby needs right after birth. About 2 to 5 days after your baby is born, your breasts start making milk for your baby. When your milk comes in, your breasts will most likely feel warm and heavy. Some women feel only slight swelling. Others feel uncomfortably swollen.
Early breast fullness is completely normal. It occurs as your milk supply develops and while your newborn has an irregular breast-feeding routine. The normal fullness is caused by the milk you make and extra blood and fluids in your breasts. Your body uses the extra fluids to make more breast milk for your baby.
If you don't breast-feed after your baby is born, you will have several days of mild to moderate breast engorgement. This gradually goes away when the breasts are not stimulated to make more milk.
Overfilled breasts can easily become very swollen and painful, leading to severe engorgement. Common causes of severe engorgement are:
Severe engorgement can make it difficult for your baby to latch on to the breast properly and feed well. This can make the problem worse. As a result:
Without treatment, severe engorgement can lead to blocked milk ducts and breast infection, which is called mastitis.
You can prevent breast engorgement by closely managing the milk your breasts make and keeping milk moving out of your breasts. During your body's first week or two of adjusting to breast-feeding, take care not to let your breasts become overfilled.
If you have any concerns or questions, this is a good time to work with a lactation consultant, someone who helps mothers learn to breast-feed.
Breast engorgement is diagnosed based on symptoms alone. No exams or tests are needed.
A few days after your milk comes in, your milk supply should adjust to your baby's needs. You can expect relief from the first normal engorgement within 12 to 24 hours (or in 1 to 5 days if you are not breast-feeding). Your symptoms should disappear within a few days. If not, or if your breasts do not soften after a feeding, start home treatment right away.
To reduce pain and swelling, take ibuprofen (such as Advil or Motrin), apply ice or cold compresses, and wear a supportive nursing bra that is not too tight. Before you take any kind of medicine, ask your doctor if it is safe for you to use it while you are breast-feeding.
If your baby can't feed well or at all (such as during an illness), be sure to gently pump enough to empty each breast. You can store or freeze the breast milk for later use.
If your breasts still feel uncomfortable after nursing, apply cool compresses.
If you are not breast-feeding, avoid stimulating the nipples or warming the breasts. Instead, apply cold packs, use medicine for pain and inflammation, and wear a supportive bra that fits well.
Learning about breast engorgement:
Symptoms of breast engorgement happen when the breasts produce and fill with milk but little milk is removed from them. Milk overfills and engorges the breasts.
If your breasts are engorged, you may notice the following:
If you are breast-feeding and don't relieve breast engorgement, you are likely to develop one or both of the following:
Call your doctor now if you have:
Call your doctor today if you have:
Call your doctor if you have cracked and bleeding nipples after trying home treatment for 24 hours.
No exams or tests are needed to diagnose breast engorgement. If your doctor suspects a breast infection (mastitis), you will be treated with antibiotics.
For more information, see the topic Mastitis While Breast-Feeding.
Breast engorgement is a common problem after birth and during breast-feeding. You can prevent and treat it at home. You do not need to visit your doctor unless you have symptoms of an infection (mastitis), which may require antibiotic treatment.
If you are not going to breast-feed, there currently is no safe medicine available for "drying up" your breasts and preventing breast engorgement.
You can use self-care measures to help prevent or relieve breast engorgement.
For more information on self-care measures to help prevent or relieve the discomfort of breast engorgement, see Home Treatment.
If you are planning to breast-feed, do the following to prevent severe breast engorgement.
Discuss any breast-feeding problems or concerns with your doctor or a breast-feeding specialist (lactation consultant).
If you need to breast-feed but breast engorgement is preventing you from doing so, use these steps to keep your milk flow going and relieve your pain and swelling:
If you are bottle-feeding formula and you experience breast engorgement after childbirth, use one or more of the following measures to help relieve discomfort:
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La Leche League International (LLLI) offers information and encouragement—mainly through personal help—to all mothers who want to breast-feed their babies. It also offers support and information about breast-feeding babies with various disabilities, such as cleft lip or cleft palate. Call for information about a chapter in your area.
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- Lawrence RM, Lawrence RA (2009). The breast and physiology of lactation. In RK Creasy et al., eds., Creasy and Resnik's Maternal-Fetal Medicine, 6th ed., pp. 125–142. Philadelphia: Saunders Elsevier.
Other Works Consulted
- American Academy of Pediatrics (2009). Feeding your baby: Breast and bottle. In SP Shelov et al., eds., Caring For Your Baby And Young Child: Birth to Age 5, 5th ed., pp. 80–124. New York: Bantam.
- Cunningham FG, et al. (2010). The puerperium. In Williams Obstetrics, 23rd ed., pp. 646–660. New York: McGraw-Hill.
|Primary Medical Reviewer||Sarah Marshall, MD - Family Medicine|
|Specialist Medical Reviewer||Kirtly Jones, MD - Obstetrics and Gynecology|
|Last Revised||April 30, 2013|
Last Revised: April 30, 2013
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