Tips for dealing with engorgement

Engorgement occurs when there is more milk volume occurring on days 2-5, and typically lasts 12-48 hours, longer if not treated appropriately. During this time, breasts may feel larger, heavy, and warm. Sometimes a low grade fever can occur during this time. It can affect each individual differently, ranging from mild to severe, involving both breasts or more on one side, and can extend into the armpit. Some babies may have a hard time latching onto the areola (darker skin around the nipple) and nipple because of the full, tight skin. Here are some tips to help during this period:

  • Feed on demand, let the baby nurse as desired. Aim for at least 10 feedings per 24 hours

  • Allow baby to nurse until a contented state and empty one breast well before moving to the second breast

  • Ensure baby is latched well and watch for signs of good milk removal

    • Hearing swallows (or gulps) after every 1-2 sucks

    • Breasts feel full before and softer after feeding

    • Watch for dark bowel movements in baby to turn loose, yellow, and seedy

    • Urine output should increase to 6-8 wets per 24 hours, typically by day 5

  • If pumping breasts, empty every 2-3 hours, and use techniques to maximize milk removal

    • Use your hands to compress/massage breasts during pumping

    • Ensure the correct flange size is being used

    • Hand expression after finished pumping

  • Use of cold compress on the breasts

  • Use a pain reliever, like Ibuprofen, when necessary

  • If baby is having a hard time latching onto tissue around the nipple because of firmness, use hand expression to soften for a few minutes, and then attempt to latch

  • If breasts still feel full after nursing, try hand expressing some milk until you feel more comfortable; not removing milk to empty

  • Wear a comfortable bra, and try to avoid tight fitting bras

  • Ensure you are drinking plenty of fluids

  • Avoid heat to breasts, as this may increase inflammation and swelling

  • Short periods of applying chilled, green cabbage leaves may help with reducing swelling, but can potentially cause a decrease in milk production

Reach out to a lactation consultant if you are struggling with engorgement and needing some advice during this period of time.

Caitlin Hainley