Breast Engorgement: Causes, Symptoms, Treatment

Breast engorgement is when the breasts are swollen, stiff, and painful due to excessive milk production; especially when your baby is not able to consume as much milk as you are able to produce. You may suffer from this condition in the first few days after delivery. This can make it challenging for you to breastfeed your child.

However, your breasts eventually stop producing milk if you don’t use it or nurse your baby with produced breast milk. Engorged breasts can be treated at home.

Symptoms of Breast Engorgement

Symptoms of breast engorgement are as follows: 

• Tender and swollen lymph nodes in your armpits
• Fever
• Flattened nipples, dark discoloration around the nipples, firm areola
• Swollen, painful, and firm breasts

When your breasts are severely engorged, you may also experience hard, shiny, warm, and lumpy breasts.

Causes of Breast Engorgement

After childbirth, your breasts produce milk that needs to be emptied regularly. When you don’t nurse your child, the breast milk builds up in your breasts. It can cause heaviness in your breasts. Also, they can get firm and swollen.

Your breasts may not produce enough milk for the first three to five days after delivery. You may experience engorgement for the first time in the first or second week after childbirth. 

Certain conditions or situations may cause the symptoms related to breast engorgement such as:

• Difficulty with latching and sucking
• Creating an overabundance of milk for the baby’s appetite
• Weaning too quickly
• Feeding formula milk between nursing sessions, which keeps the baby full, not wanting the breast milk later
• Skipping a pumping session
• Not emptying breasts even if you don’t plan to breastfeed
• Nursing a baby that’s ill
• Missing a feeding

Complications

If your breasts cause severe pain and are very swollen, it might be a sign of severe breast engorgement.

Severe breast engorgement can further make it difficult for your baby to correctly latch on to the breast. This may result in:

• Baby’s hunger not being satiated
• Breasts not being emptied completely
• Sore and cracked nipples

Cracked and sore nipples can make you breastfeed less, worsening the engorgement. 

Severe engorgement may lead to milk duct blockages or worse, mastitis – a breast infection. You might need antibiotics to treat mastitis.

Diagnosis

Ensure you visit your doctor when you suffer from severe breast engorgement. 

Commonly, there are no tests to confirm this condition but your doctor or pediatrician may do a physical examination. Checking your breasts will help your doctor to understand if your breasts just have the symptoms of engorgement or you also have mastitis. If your doctor detects mastitis, he/she will prescribe you medications to treat this breast infection.

Breast engorgement can be treated with pain relievers and home remedies. 

Your doctor, lactation consultant, or midwife may give the following advice on how to manage engorgement:

• Breastfeed your baby on their demand and feed until they have had it enough. Allow your baby to finish the first breast before starting on the other.
• Let your baby use the more painful breast first. Rather than offering milk from both breasts, try using one side for each feed. Offer the other breast if your baby is still hungry.
• Take a warm water shower for 5 minutes before feeding. This will soothe your body and may help ease milk flow during breastfeeding. 
• If not warm shower, you can apply a warm compress or water bag to your breast before milking.
• Although it is not a good idea to nurse excess milk by hand, before you feed your baby, you can try nursing a little in the shower. This can make it easier for your baby to latch on correctly.
• Before breastfeeding, take off your bra. After done breastfeeding, apply a cold pack to relieve symptoms of engorgement.
• Ensure you avoid giving any other fluids to your baby.
• If in case your breasts are very painful, consult your doctor and ask for any medication or remedy.

Ensure you are not using any medication to treat pain without your doctor’s advice, as it can mix with your breast milk and be passed on to your baby.

If you have mastitis, your doctor will prescribe antibiotics or pain relievers. These drugs are usually safe. Ensure you continue breastfeeding even if you have mastitis. It is believed that breastfeeding can help treat mastitis.

Lifestyle Changes

Your breast milk starts getting produced after a few days post-childbirth. The feeding should be adjusted according to your baby’s needs.

You may feel relieved from the first engorgement within a day or two or maximum in 5 days if you are not breastfeeding. The symptoms may disappear within a few days. If the symptoms continue to show up and do not soften breasts after feeding, contact your doctor right away.

To ensure you are breastfeeding your child properly and preventing the symptoms of breast engorgement, you can try the following tips:

• Apply cold or warm compress on your breast.
• Wear a supportive and comfortable nursing bra that is not too tight.
• For easy and comfortable breastfeeding, try applying a warm compress on your breast or massage gently with your hands. You can use a small pump to let out a small amount of breast milk from both breasts to soften your breasts before feedings.
• When your baby can’t feed enough or at all, typically during an illness, ensure to empty your breast milk via pump gently. Use a pump to empty each breast and store the milk for later use.
• Apply a cool pack or compress if your breast feels uncomfortable after feeding.
• Avoid warming your breasts or stimulating your nipples when you are not breastfeeding. Instead, you can use cold packs or use pain-reliever or inflammation-relieving drugs, and wear a supportive bra.

Home remedies

Try these home remedies to treat the symptoms of breast engorgement:

• Aloe vera gel: Fresh aloe vera gel can treat nipple irritation. Also, aloe vera gel can soothe a sore breast.
• Breast milk: It is said that breast milk itself has healing properties that can help treat bleeding or cracked nipples. Try applying your own milk onto your nipples in between feedings.
• Cabbage leaves: Cabbage leaves are widely used to ease engorgement. Apply cold leaves on your breasts for 20 minutes a few times a day. This helps to reduce engorgement when a mother’s first milk comes in.
• Vitamin C: Citrus fruits are a rich source of vitamin C. Eat citrus fruits for faster healing. Vitamin C is an excellent immune booster that can speed up healing and soothe your breasts.
• Coconut oil: Apply coconut oil on your chafed or cracked nipples to heal them properly. Not only does coconut oil helps to heal, but also helps to soothe your cracked or chafed nipples. 

Learn more about breastfeeding here.