Breast engorgement (swelling) occurs when the breasts produce more milk than the amount that is being expelled by breast-feeding, pumping, or manual (hand) expression.   The milk overflows from the glands and engorges the breasts.  Breast engorgement is common during the first two to five days after childbirth when breast-feeding begins but can also develop any time the baby’s demand for breast milk decreases or stops or the mother is unable to empty her breasts.  

When breast engorgement occurs, the entire breast, nipple, and areola (pigmented region surrounding the nipple) swell and usually cause discomfort or pain.  The baby may suck from the nipples but will not receive much milk.  However, the baby's sucking will cause the breasts to produce more milk, further overfilling the milk glands and increasing engorgement. 

Other symptoms of breast engorgement include:

• Hard, warm, throbbing, or slightly lumps breasts
• Flattened nipples (difficult for the baby to latch on)
• A slight increase in body temperature (around 100 degrees Fahrenheit or 37.78 degrees Celsius)
• Slightly swollen axillary (underarm) lymph nodes

Breast engorgement can lead to blocked milk ducts or mastitis (breast infection) if milk is not emptied from the breasts. 

Engorgement may occur shortly after childbirth even if a woman does not breast-feeding since the breasts will still produce milk temporary.  Milk production should stop soon if milk is not being emptied.

The best way to prevent breast engorgement is to breast-feed frequently (eight to 12 times in 24 hours), especially during the first few days after childbirth.  Breast engorgement may also be prevented by practicing the following:

• Pump the breasts if any feedings are missed.
• If weaning the baby, do so gradually.

Severe breast engorgement should not last more than 12 to 48 hours.  The treatment of breast engorgement usually focuses on relieving symptoms.  Women who experience breast engorgement may wish to talk to their physician or consult a certified lactation consultant (an individual with medical training in the field of lactation). 

One or more of the following may help alleviate the symptoms of breast engorgement:

• Before breast-feeding, take a warm shower or apply warm moist compresses to your breasts.
• Breast-feed often (every one and a half to three hours) or pump the breasts to stimulate milk production
• Use icy compresses after breast-feeding to decrease swelling.
• Manually express or pump milk from the breasts before breast-feeding to soften the breasts
• Massage the breast with the fingertips in a circular motion down toward the nipple as the baby nurses.
• A technique commonly used by midwives in Australia involves applying cooled cabbage leaves to the breast under the bra to decrease pain and discomfort.
• Ask a physician whether over the counter medications (such as Tylenol) are safe to take to relieve discomfort. 

• Visit the Imaginis.com Breast Health bookstore for additional resources on breast-feeding and engorgement at http://www.imaginis.com/bookstore/breasthealth/nursing.asp
• To learn more about other common problems associated with breast-feeding, please visit http://www.imaginis.com//breasthealth/breastfeeding/problems.asp

Updated: June 29, 2008