Breastfeeding Challenges: Breast Engorgement

Your breasts may become engorged (swollen) during the first few days of breastfeeding or when you cut back on nursing. Regular, frequent breastfeeding is the best way to prevent and relieve engorgement.

What is Engorgement? During the three to fve days after • Make sure to let your baby • Hand express milk or pump you give birth, your breasts may fnish breastfeeding on the frst for 2 to 3 minutes to soften the feel full, even uncomfortable. Tis breast before switching to the breast before letting the baby is normal. In fact, it is probably a other side. You will know your latch on. good sign since it usually means baby is fnished when his sucks • Apply a cool compress for 10 that your breast milk is coming become less frequent. to 20 minutes after nursing to in. Most women are much more • Alternate which breast is reduce the swelling and help comfortable by the end of their ofered frst. relieve pain. frst week. • Use diferent nursing positions • Take a pain reliever such as In some cases, however, the (football hold, lying down, cross acetaminophen (Tylenol) or discomfort continues and the cradle hold) to fully empty the ibuprofen (Advil, Motrin). breasts become engorged. You breasts. Avoid aspirin. may have breast engorgement if your breasts are hard, swollen, • Gently massage your breasts in • If your baby doesn’t nurse or and painful, or if your nipples a circular motion after feedings only nurses on one breast, no longer stick out far enough during the frst 4 days after hand express or pump milk for your baby to latch on. If not delivery. from the unused breast just relieved, breast engorgement can • Wear a supportive bra that long enough so your breast lead to plugged ducts or a breast is not too tight. Avoid feels comfortable. Start with infection (mastitis). underwire bras. the unused breast at the next feeding. Prevention Care and Treatment • Fully drain the breasts once or Nursing often is the best way to If your breasts are severely twice a day using an efective prevent engorgement. Try these swollen: breast pump. other prevention tips: • Apply warm moist compresses • Make sure your baby latches to the breasts or take a warm well and empties your breasts. shower 10 to 15 minutes Your breasts should feel softer before nursing. after a feeding and your baby should look relaxed and satisfed.

HEALTH EDUCATION Breastfeeding Challenges: Breast Engorgement

Breastfeeding is a learned skill that takes practice and patience. It may take some time for new moms and newborns to get used to breastfeeding positioning and techniques. You might feel frustrated while you and your baby are learning and adjusting, but know that we are here to help you succeed.

Helping Baby Latch On: Reverse Pressure Softening Other Resources Part of the reason your breasts • Tips of the ring fngers Visit kp.org/mydoctor to: may become engorged is together, below the nipple • View most lab results and check your preventive health reminders due to fuid accumulating in • Tips of the index fngers the soft tissues of the breast. together, above the nipple • Email your doctor (Tis is similar to ankle • Use interactive online tools to • Middle fngers at the sides of swelling you may have had help keep you and your family the nipple during pregnancy.) Using healthy gentle pressure with your Apply steady, frm, but gentle Contact your facility’s Health fngers on the areola can help pressure inward, toward your Education Center or Department to temporarily push away chest wall and count slowly for books, videos, classes, and additional resources. this fuid so that the nipple to 60. (See image below.) You protrudes more. Tis makes may do this while sitting or The American Academy of Pediatrics. healthychildren.org latch-on easier for your baby lying down. If needed, you can and more comfortable for you. move your fngers clockwise a Your health and your ability to breastfeed your baby can be quarter turn around the areola Reverse pressure softening seriously affected by violence helps to soften the areola and repeat. or abuse. If you are hit, hurt or around the base of the nipple. threatened by a partner or spouse, Before feeding your baby or there is help. Call the National pumping, place your fngers Domestic Violence Hotline at around your areola as follows: 1-800-799-7233 or connect to ndvh.org.

Call Kaiser Permanente if: • You have increasing pain in • You have increasing redness in • You have a fever of 101°F one area of the breast. one area of the breast or red (38.5°C) or higher. • Pus is coming out from streaks spreading away from • Breast engorgement is getting the nipple. an area of the breast. in the way of breastfeeding.

This information is not intended to diagnose health problems or to take the place of medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult your doctor. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identifcation only.