It is normal for your breasts to become full and heavier in the first week after delivery, when your supply increases. If breastfeeding is going well, breast fullness lessens within 24 hours.
When normal fullness is not relieved, your breasts can become engorged, which will cause your breasts to feel hard, swollen, tender and uncomfortably full.
Signs and symptoms
- Breasts become very full, hard, tender and warm to the touch.
- The skin of the breast may be stretched and appear shiny.
- The nipple may increase in size and become flat, making it hard for your baby to latch.
- You may experience a low-grade fever.
Prevention
- Feed your baby within the first hour of birth.
- Breastfeed when your baby shows signs of hunger and for as long as the baby wants.
- Nurse often, 8-12 times or more in 24 hours. Don’t skip feedings, even at night!
- Make sure your baby is latched and positioned correctly. There may be some initial discomfort when a baby first latches, but pain should not continue throughout the feeding. If unsure, ask a lactation professional for assistance.
- Allow your baby to finish the first breast before offering the other breast. The baby may not take the second breast; you can offer it first at the next feeding.
- Avoid pacifiers in the first few weeks.
- Do not give your baby anything other than breast milk, unless indicated by your health care provider.
- If your baby is not nursing well, hand express or use a breast pump to fully drain the breast.
- If weaning your baby from the breast, it is best to do it gradually.
Treatment
- Express milk before the feeding so it is easier for your baby to latch onto your breast.
- You can hand express or use a breast pump.
- Apply warm, moist towels to your breasts a few minutes before nursing to help the milk flow.
- Gently massage the breast during the nursing session to increase milk flow, which encourages your baby to suckle.
For comfort
- Relax in a warm shower and hand express milk.
- Hand express or use a breast pump if breasts still feel full after nursing.
- Cover both breasts with a cold compress between feedings to reduce pain and swelling.
- Avoid tight or poorly fitting bras, as they can lead to plugged ducts or mastitis.
- Ask your health care provider about pain medication.
When to contact a lactation consultant
- Engorgement becomes severe and is not relieved by the above measures within 24 hours.
- Your baby is having trouble latching or you feel pain when nursing.
When to contact your health care provider
- You have symptoms of mastitis.
- Red, painful breasts with a temperature greater than 100.6 F.
- You have any other concerns about your baby.