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Breast engorgement is the painful overfilling of the breasts with milk. This is
usually caused by an imbalance between milk supply and infant demand. This
condition is a common reason that mothers stop breast-feeding sooner than they
Engorgement can happen:
As you get close to your due date, your breasts make colostrum. Colostrum is a yellowish liquid that contains important nutrients and antibodies that a baby needs right after birth. About 2 to 5 days after your baby is born, your breasts start making milk for your baby. When your milk comes in, your breasts will most
likely feel warm and heavy. Some women feel only slight swelling. Others feel
Early breast fullness is completely
normal. It occurs as your milk supply develops and while your newborn has an
irregular breast-feeding routine. The normal fullness is caused by the milk you
make and extra blood and fluids in your breasts. Your body uses the extra
fluids to make more breast milk for your baby.
If you don't
breast-feed after your baby is born, you will have several days of mild to
moderate breast engorgement. This gradually goes away when the breasts are not
stimulated to make more milk.
Overfilled breasts can easily become
very swollen and painful, leading to severe engorgement.
Common causes of severe engorgement are:
Severe engorgement can make it difficult for your baby
to latch on to the breast properly and feed well. This can make the problem
worse. As a result:
Without treatment, severe engorgement can lead to blocked
milk ducts and breast infection, which is called
prevent breast engorgement by closely managing the milk your breasts make and
keeping milk moving out of your breasts. During your body's first week or two
of adjusting to breast-feeding, take care not to let your breasts become
If you have any concerns or questions, this is a good
time to work with a
lactation consultant, someone who helps mothers learn
engorgement is diagnosed based on symptoms alone. No exams or tests are needed.
A few days
after your milk comes in, your milk supply should adjust to your baby's needs.
You can expect relief from the first normal engorgement within 12 to 24 hours
(or in 1 to 5 days if you are not breast-feeding). Your symptoms should
disappear within a few days. If not, or if your breasts do not soften after a
feeding, start home treatment right away.
To reduce pain and
swelling, take ibuprofen (such as Advil or Motrin), apply ice or cold
compresses, and wear a supportive nursing bra that is not too tight. Before you take any kind of medicine, ask your doctor if it is safe for you to use it while you are breast-feeding.
To soften your breasts before feedings, apply heat, massage gently, and
use your hands or use a pump to let out (express) a small amount of milk from
If your baby can't feed well or at all (such as
during an illness), be sure to gently pump enough to empty each breast. You can
store or freeze the breast milk for later use.
If your breasts
still feel uncomfortable after nursing, apply cool compresses.
you are not breast-feeding, avoid stimulating the nipples or warming the
breasts. Instead, apply cold packs, use medicine for pain and
inflammation, and wear a supportive bra that fits
Learning about breast engorgement:
breast engorgement happen when the breasts produce and
fill with milk but little milk is removed from them. Milk overfills and
engorges the breasts.
If your breasts are engorged, you may notice
If you are
breast-feeding and don't relieve breast engorgement, you are likely to develop
one or both of the following:
Call your doctor now if you
Call your doctor today if you
Call your doctor if you have cracked and bleeding nipples
after trying home treatment for 24 hours.
Blocked Milk Ducts and Breast-Feeding. And for more information, see the topic
Mastitis While Breast-Feeding.
No exams or tests are needed to
breast engorgement. If your doctor suspects a breast
infection (mastitis), you will be treated with antibiotics.
For more information, see the topic
Mastitis While Breast-Feeding.
Breast engorgement is a common problem after birth and during breast-feeding.
You can prevent and treat it at home. You do not need to visit your doctor
unless you have symptoms of an infection (mastitis),
which may require antibiotic treatment.
If you are not going to
breast-feed, there currently is no safe medicine available for "drying up" your
breasts and preventing breast engorgement.
You can use self-care
measures to help prevent or relieve breast engorgement.
For more information on self-care measures to help prevent
or relieve the discomfort of breast engorgement, see Home Treatment.
If you are planning to breast-feed, do the following to
Discuss any breast-feeding
problems or concerns with your doctor or a breast-feeding specialist (lactation consultant).
If you need to breast-feed but breast engorgement is preventing you from
doing so, use these steps to keep your milk flow going and relieve your pain
If you are bottle-feeding formula and you experience breast engorgement after childbirth, use one or more of
the following measures to help relieve discomfort:
This American Academy of Pediatrics website has information for parents about childhood issues, from before the child is born to young adulthood. You'll find information on child growth and development, immunizations, safety, health issues, behavior, and much more.
The website FamilyDoctor.org is sponsored by the American Academy of Family Physicians. It offers information on adult and child health conditions and healthy living. There are topics on medicines, doctor visits, physical and mental health issues, parenting, and more.
La Leche League International (LLLI) offers information and
encouragement—mainly through personal help—to all mothers who want to
breast-feed their babies. It also offers support and information about
breast-feeding babies with various disabilities, such as cleft lip or cleft
palate. Call for information about a chapter in your area.
The Office on Women's Health is a service of the U.S. Department of Health and Human Services. It provides women's health information to a variety of
audiences, including consumers, health professionals, and researchers.
Lawrence RM, Lawrence RA (2009). The breast and physiology of lactation. In RK Creasy et al., eds., Creasy and Resnik's Maternal-Fetal Medicine, 6th ed., pp. 125–142. Philadelphia: Saunders Elsevier.
Other Works Consulted
American Academy of Pediatrics (2009). Feeding your baby: Breast and bottle. In SP Shelov et al., eds., Caring For Your Baby And Young Child: Birth to Age 5, 5th ed., pp. 80–124. New York: Bantam.
Cunningham FG, et al. (2010). The puerperium. In Williams Obstetrics, 23rd ed., pp. 646–660. New York: McGraw-Hill.
April 30, 2013
Sarah Marshall, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology
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