Breastfeeding: How to Treat Breast Engorgement

What is breast engorgement?

Breast engorgement is a common condition that many new mothers face during their breastfeeding journey. It's characterised by the swelling and discomfort of the breasts, often accompanied by a feeling of extreme ‘fullness’ and pain. While it can be unsettling, it's important to remember that engorgement can be treated and overcome, usually quite quickly. Understanding how to notice it, and how to manage it, can make this phase of breastfeeding less daunting, and make the likelihood of contracting mastitis much lower.

In this blog post, we'll delve into the causes of breast engorgement, its symptoms, and most importantly, some practical tips to relieve discomfort and ensure a smoother breastfeeding experience for both you and your baby.

Your breast milk journey

Colostrum milk

The first milk your breasts produce is called colostrum. Your body will start to make it as early as 12-16 weeks into your pregnancy, but it’s likely you won’t know it’s there until after birth. It can be thick and sticky in texture, and is usually yellow, clear, or white. The benefits of colostrum are countless – it’s known as ‘liquid gold’ for a reason! Although it’s produced in small quantities, it’s extremely concentrated, and is packed full of nourishment for your newborn. It provides immediate protection and immunity support to your baby within a few hours of birth. 

Days 1-3 postpartum

The saying ‘your milk coming in’ can be confusing because it can give the impression that as soon as your baby arrives, your breasts will suddenly fill up with milk. However, this often isn’t the case and it can make you question your milk supply, or assume you’ll never produce enough to feed your baby. The reality is that your breasts will slowly start to make more and more milk over the first week following birth, until your milk supply is fully established.

This doesn’t mean you shouldn’t try to feed your baby immediately after birth. It’s important to give your breasts the message that your baby has been born and milk production should begin. If this is an immediate success, brilliant! But if not, hold fast – patience is key. If you’re struggling with feeding, there’s no shame in asking for support, so make sure you’re consulting your midwife or feeding expert and not suffering in silence. You could also try hand-expressing your colostrum to feed your baby by spoon or syringe. Remember, there are always options - and help is never far away.

Days 3-5 postpartum

On day 3 or 4 post-birth, your colostrum will start to change into transition milk. This is simply a mixture of colostrum and mature milk (the breast milk you may be more familiar with). By day 5, your mature milk will have ‘come in’, and it’s more important than ever to take good care of yourself. It’s around this time that you could experience engorgement, so be sure to keep checking in with yourself and your body.

How can I tell if my breasts are engorged?

Signs of breast engorgement include a significant increase in breast size, and they may feel hard and tight to the touch. You may have trouble breastfeeding or expressing milk, or your baby may struggle to latch. The skin of your breasts might also appear stretched and shiny due to the increased fluid and milk in the breast tissue.

What causes breast engorgement?

There are a number of factors that contribute to breast engorgement, including missed feeds (which happen all too easily when you’re welcoming an influx of visitors.) and feeding your baby against a schedule. Mothers following any kind of fixed feeding routine are more likely to suffer from low milk production, engorgement, and mastitis. It’s important to let your baby dictate when they need to feed and throw any pre-planned rhythm out the window. Learn to recognise your little one’s feeding cues, such as lifting their fists to their mouth or turning their head to your breast – otherwise known as rooting. 

Expressing your milk too frequently can also lead to engorgement. Some people advise expressing often to maintain steady milk production, but this is risky business - making more milk than your baby needs can actually increase your risk of engorgement and mastitis. And if your baby is struggling to latch, this can be a warning sign, too. It’s important to seek one-to-one support if you have any doubt about how well your baby is feeding. 

Breast engorgement treatment

If your breasts do become engorged, the key here is to think ‘cool’. You need to cool your breasts down, as they will likely feel heavy, warm, and sensitive. Between feeds, you could apply ice to your breasts to reduce the swelling. You can use wet, frozen tea towels, frozen peas, or ice-packs. It’s also a good idea to feed frequently, every 1-2 hours during the day, and every 2–3 hours at night. Just before feeding, apply moist warmth to your breasts for up to two minutes to help milk flow. Let your baby finish on the first breast before switching to the second. And of course, there’s nothing like a good massage. It can help to softly massage from your chest wall towards the nipple area in a circular motion, with particular focus on any areas that are painful. 

Remember that engorgement is common, but not normal. Most new mothers experience some engorgement in the first weeks after birth, but that doesn’t mean we should be putting up with the pain! If these remedies don’t do the trick, make sure you get assistance from a medical professional as soon as you can.

A helping hand

This blog was created by Lucy, antenatal educator and birth expert, and founder of butterbean. Winner of the Loved by Parents award 2023 for best innovative maternity product, butterbean is a trusted hub of empowering resources for new and expecting parents. Providing holistic care that’s tailored to your unique journey, butterbean offers a comprehensive hypnobirthing course, a midwife-monitored helpline, personalised pregnancy yoga sessions, and detailed feeding guidance. It’s inclusive of all journey stages and accessible on demand to suit your schedule. Put simply, butterbean is Lucy’s gift to you - from one Mum to another. To take a closer look, head to the butterbean website, or drop Lucy a follow on Instagram for regular top-notch content on pregnancy, birth, and beyond.

Find out more by visiting www.butterbean.uk