What to do when your breasts are engorged
When you breastfeed or pump milk for your baby, there may be times when you are producing more milk than your baby is drinking. When this happens, your breasts may become engorged. Read this handout to learn:
• What is engorgement? • What signs to look for • How to prevent it • What to do if it happens • When to get help
What is breast engorgement?
When more breast milk is made than your baby can drink or you can pump, milk begins to collect in the ducts. The blood flow to the breasts increases and the lymph fluid cannot drain properly. The breasts become swollen, firm and tender or painful.
What signs should I look for?
• Your breasts are very firm, tender or painful on both sides.
• The darker skin around the nipple (areola) may be hard and the nipple may be flattened-out.
• The swelling and tenderness may extend up into the armpit area.
• The skin may be tight, shiny and feel warm to the touch.
How can I prevent my breasts from getting engorged?
• Be with your baby as much as possible. It will help you see when your baby is ready to feed.
• Let your baby breastfeed as often as they want (for full term healthy babies).
• If your baby cannot breastfeed for medical reasons, pump your breasts regularly. (every 3 hours)
3 Why are my breasts engorged?
You may become engorged if you miss feeding or pumping for any reason, such as:
• being away from your baby for a number of hours without hand expressing or pumping your milk
• your baby suddenly starts sleeping through the night or going longer between feeds
• your baby refuses the breast
• you wean your baby quickly
What can I do if my breasts are engorged?
Make sure your milk is flowing well:
• latch your baby properly
• watch for signs your baby is feeding effectively
If the your baby is premature, ill or unable to go to the breast:
• use a hospital grade electric breast pump to pump your milk
• completely “empty” the breasts
This will help to prevent your breasts from getting even more engorged. It will also prevent blocked milk ducts. Use the care plan below. This will help the engorgement get better.
4 Care Plan
Follow this care plan if your breasts are engorged. This should help the engorgement get better within 24 to 48 hours.
1. Before breastfeeding or using the breast pump
• Take medicine for pain and swelling , such as Ibuprofen (Motrin® or Advil®). This can ease the pain and swelling. Talk to your pharmacist before taking this medicine.
• For comfort, apply warm compresses to your breasts before breastfeeding or pumping. This can help the release or letdown of the milk.
• Gently massage your breasts. Work with your hand, gently massage in small circles, starting at the upper side of the breast and working up or down toward the nipple. This will start the milk flowing, soften the breasts for feeding your baby and relieve the fullness and discomfort. It will make the nipple softer and longer, much easier for your baby to latch on to.
2. During breastfeeding /pumping
Remove your bra while breastfeeding or pumping. This will help to drain all areas of the breast.
5 If you are breastfeeding:
• Feed your baby at least every 2 to 3 hours.
• Let your baby nurse until your baby has enough and your breast feels softer.
• Make sure your baby latches well. Watch for signs of effective feeding (sucks and swallows).
• Change nursing positions during the feeding to help drain all parts of the breast.
• Use gentle massage during the feeding. This will help to drain the breast.
If you are only pumping for your baby:
• You should pump your breasts as often as you would be breastfeeding. This is about every 3 hours day and night.
3. After breastfeeding or using the breast pump
• Your breasts should feel softer after breastfeeding or using the breast pump. If your breasts still feel full and uncomfortable after your baby has breast fed, express your breasts by hand or with the breast pump.
• Apply cold compresses to your breasts between feeding or pumping sessions for about 15 to 20 minutes each hour. This will reduce swelling and make the breasts feel more comfortable.
• Wear a nursing bra that supports your breasts, without being too tight.
6 Why is it important to prevent and treat engorgement?
If engorgement is not relieved it can cause problems:
• It may be more difficult for your baby to latch onto your breast. This may lead to sore and/or cracked nipples.
• Milk ducts can become blocked. This may lead to a breast infection called mastitis.
• Your milk supply can decrease.
When should I get help?
Try the tips above for 48 hours. After this time, call your doctor or health care provider if you still:
• feel tired, achy or have other flu-like symptoms
• have a tender, red, swollen or warm area in a breast
• have red, cracked, bruised or bleeding nipples.
• have symptoms of engorgement
• have chills or a fever, a temperature greater than 38.4 C or 101 F
7 St. Michael’s cares about your health. For reliable health information, visit our Patient and Family Learning Centre or find us online at www.stmichaelshospital.com/learn
This information is not intended as a substitute for professional medical care. Ask your healthcare provider about this information if you have questions.
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72653 Rev. Nov.21 2017 V1