Engorgement
Hi, Mamas! Let’s talk about engorgement and what we can do about it when it occurs.
Breast engorgement is something many of us experience at different times throughout our breastfeeding journey— and it’s not fun! Engorgement is when the breasts swell due to an increase of fluids and blood flow to the breasts. It brings on swelling, tightness, heaviness, and increased size of one or both of the breasts. It can cause a lot of discomfort and can even become painful if not remedied.
Having engorged breasts is common, and there are so many potential contributing factors. Let’s talk about what we can do to try and prevent engorgement, as well as what we can do if it happens to us!
Let’s get started!
WHAT IS engorgement?
Engorgement is caused by an excess of fluid in the breasts (blood flow, lymph flow, milk, and fluids). Think of it as a “traffic jam” in the breast— lots of “congestion” because there’s too many fluids in one small space. Most moms find that this often occurs in the early days of breastfeeding as milk starts “coming in” and there is more milk present than what baby is actually consuming.
But really, it can happen at any point during your breastfeeding journey! Have you ever had baby sleep through a night feed and you wake up desperate for baby to feed and relieve the discomfort?! Yeah, that’s the feeling of engorgement. It’s totally common (though painful) and definitely able to be remedied!
Engorged breasts may feel a bit swollen, hard, full, and tender. It’s not uncommon to have throbbing pains extending as far back as your armpits (this is where the “tail of Spence” extends). Other symptoms may include stretched skin, itching, flushed feeling, flattened nipples, and even a rise in your body temperature. When your breasts are engorged, it may also be difficult for baby to latch, which can worsen the issue.
why IS IT HAPPENING?
There are several things that can contribute to engorgement, but here are a few common factors:
Missed feedings/pumping sessions
Mature milk “coming in”
Infrequent or decreased feeds/pumps
Oversupply
Weaning
Baby sleeping through the night
A TIP FOR IDENTIFYING severity
If you’re not really sure if you have or have had engorgement, try this:
Touch your lips - this is how a non-engorged breast feels.
Touch the tip of your nose - this is how a mildly engorged breast feels.
Touch your forehead - this is how a severely engorged breast feels.
WHAT CAN I DO?
In the early days, you may think that your engorged breasts are just full of milk, but remember— that is not the only thing happening. The engorgement present is also an increase in blood flow and extra lymph fluids in the breast tissue. This “full” sensation may pass if baby is feeding well & frequently, but if not, there are some things you can do to treat engorgement at home:
Breastfeed often
(see below if engorgement is causing issues latching)— removing some of the “congestion” (ie milk)
ENSURE BABY HAS A GOOD LATCH
For efficient milk removal
If unable to have baby latch at the moment, express milk regularly via hand expression, hand pump, or electric!
drink plenty of fluids
proper hydration is so important!
add warmth as needed
Directly before feedings to help with milk flow/letdown
Warm washcloth or warm shower directly before feed
Try not to use heat/warmth between feedings as it can worsen edema by increasing blood flow to the breasts
Cold compress
Between feedings
Reduces swelling and pain/ anti inflammation
Check out my reel on when to use hot or cold!
Gently massage breasts— helps encourage milk flow!
Before feedings
Chest to armpit, dangle and move the breasts around as well
Hand express or pump to remove a little milk before a feeding
Remove just enough to find relief + soften the breast to help baby latch
Removing too much milk (ie pumping on top of a good nursing session) may encourage more milk production
Try reverse-pressure softening around the nipple/areola to help when latching baby
Push away some of that congestion for temporary breast softening so baby can latch and begin pulling some of the fluid (milk) out, themselves. You can see how to do this here.
If feeling engorged after pumping:
Please ensure that your flange size is correct and your valves have been replaced recently - both of these help with pump suction and breast emptying so that milk is not left in the breast post-pumping (which can actually lead to an overall decrease in supply if not done consistently).
If in between feeding you’re still feeling engorged, it’s okay to remove a little milk with a hand pump, hand expressing, or an electric pump. Do this just enough to soften the breast + get relief! Just enough to say, “Ahh, I can breathe.” Removing milk to “empty” the breast puts in orders for more milk, which can encourage more milk production that you’re not actually needing, furthering the cycle of engorgement. It’s a catch 22!
Engorgement can feel like an endless cycle, but milk supply should begin to regulate and meet baby’s demand with frequent and effective milk removal. It can take a few days or weeks for initial engorgement to subside. Keep an eye on pain/lumps in the breast, as engorgement does increase the risk for clogged ducts/mastitis. I have two reels and a blog on that here:
Reel: Clogged Duct Remedies
Engorgement is a very uncomfortable feeling, and not knowing how to manage it can make it worse. I hope these tips and preventative measures help you navigate it and know how to manage it properly when the time comes!
You’ve got this, Mamas!
Xoxo,
Kar
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