How To Clear Engorged Breast

What is breast engorgement?

Breast engorgement means that your breasts are overfilled with milk. Engorgement is natural, but at certain levels it becomes a problem and can even lead to serious health concerns.

Between the second and fifth day after giving birth, your breasts will become larger, heavier, and tender as they begin producing greater quantities of milk. Some of the fullness is due to extra blood and lymph fluids in the breast tissue. This fullness usually eases within the first two weeks after delivery, and your breasts should feel softer, even when your milk supply is plentiful.

If your breasts feel uncomfortably full, swollen, warm, throbbing, or painful, they are probably engorged. Your nipples may become flattened and, if the swelling is severe, your breasts may be so full that the skin looks shiny. The swelling may extend all the way to your armpit, and the lymph nodes in your armpits may be tender and swollen. You may even run a low fever.

Engorgement can make it difficult for your baby to breastfeed effectively. A hard areola (the circular area around your nipple) makes it hard for your baby to latch on deeply, which can lead to painful nipples and a low milk supply. (Milk production is a matter of supply and demand.)

If engorgement isn't treated, it can lead to clogged ducts and infection, and it can even permanently harm breast tissue.

What causes breasts to become engorged?

Your breasts may become engorged if you're not able to nurse your baby frequently or thoroughly enough to empty your breasts in the first few days after birth. But some women become engorged no matter how well and often their baby breastfeeds.

Sometimes engorgement happens because the breasts are swollen from the IV fluids given during labor or a cesarean section. This engorgement will subside when the fluid leaves the body through urine and sweat, but it can take a while. (It's not unusual to have some IV fluid retention eight or nine days after delivery.)

You may also become engorged if your milk ducts are obstructed. This can happen if you've had breast augmentation and the implants take up so much room that there's not enough space left inside the breast for the increased blood, lymph, and milk.

Engorgement can also happen if you've been breastfeeding for a while and suddenly stop or if your baby suddenly nurses less than usual (because she's sick or starting solid foods, for example).

Learn how to prevent engorgement while weaning your baby.

How can I prevent breast engorgement?

Getting breastfeeding off to a good start can help prevent breast engorgement. Here are some things you can do to reduce your chances of becoming engorged:

Breastfeed within one hour after birth if possible. (Your labor and delivery team can help you with this.)
Nurse frequently – about eight to 12 times a day. Look for your baby's feeding cues instead of following the clock. Don't put your newborn on a feeding schedule or wait until he's crying from hunger to feed him.
Snuggle up with your baby skin-to-skin to encourage her to breastfeed. Wake your baby if more than three hours go by from the start of one feeding session to the start of the next.
Make sure your baby has a good latch so that she can fully drain the breast. Your lactation consultant can help with this, too.
Let your baby finish nursing on one breast before switching to the other. This will typically take between 10 and 20 minutes.
Track your baby's feedings by recording the time and duration of every nursing session. Your healthcare team will look at how your baby feeds throughout the day. If her feeding sessions tend to be short, or if she skips a feeding, they might suggest hand expressing or pumping to remove the milk.
Avoid introducing a bottle in the first month unless your baby's doctor feels there is a medical reason for it. The muscles used to suck on a bottle or pacifier are different than those used to breastfeed, and your baby may develop nipple confusion (difficulty with nursing after she's learned how to get milk from a bottle).
If your doctor or lactation consultant has advised you to supplement with a bottle, use pumped milk instead of formula. If you do supplement with formula, make sure you hand express or pump each time the formula is given, so you don't become engorged and so you can continue to build and establish your breast milk supply.

cartoon image of woman breastfeeding

Find solutions to a variety of breastfeeding challenges, including nipple pain, low milk supply, and more.

How do I relieve my engorged breasts?

Try these tips to ease engorgement and make breastfeeding more comfortable for you and your baby:

Express a little milk. If your breasts are uncomfortably full and your baby isn't ready to eat yet, try hand expressing some milk for relief. (It may be easier to manually express milk in the shower.) Many women find it uncomfortable or painful to express milk. This is an unfortunate side effect of the milk ducts being overly full, but your breasts are likely to be less tender once some of the milk is removed.

Nurse frequently. Try to go no more than two to three hours between feedings.

Apply heat. Just before nursing, place a warm compress on your breasts for a few minutes to get the milk flowing. You could also take a quick warm shower.

Don't apply heat for more than three minutes, since too much warmth can increase swelling and make it harder for the milk to come out.

Soften your breasts to help with latching. If your baby is having a hard time latching on, hand express or pump just enough milk to make your areola compressible.

Massage your breasts. While your baby is nursing, gently massage the breast she's on. This encourages the milk to flow and will help relieve some of the tightness and discomfort.

Pump sparingly. If you're breastfeeding at least every two to three hours and it's going well, avoid pumping milk except when it's needed to relieve engorgement. Pump on a low setting just long enough to soften the breast so that you're not putting in an extra "order" to make more milk. Excessive or habitual pumping can lead to overproduction of milk and prolonged engorgement.

Use a cold pack. To soothe the pain and help relieve swelling, apply cold packs to your breasts for about 10 minutes before or after nursing. You can use crushed ice in a plastic bag or a bag of frozen peas or corn, covered with a thin cloth.

Some moms find similar relief by placing raw, cold cabbage leaves inside their bra. Replace the leaves when they're wilted, about every couple of hours.

Wear a supportive bra. Many women find a good nursing bra to be helpful. You may even want to wear one at night. Be sure it fits well and has no underwire. Underwire can cause constriction and clogged ducts.

Take an over-the-counter pain reliever. Anti-inflammatory medicines such as ibuprofen can help relieve discomfort or pain. (Ibuprofen is safe to take while nursing.)

If these measures don't seem to work and your engorgement has gone unrelieved for a while, let your doctor or lactation consultant know. She may recommend that you work with a specialist who has experience treating breast engorgement in nursing mothers with acupuncture, ultrasound, lymphatic breast drainage, or Gua-Sha therapy (a skin-scraping therapy).

If you have flu-like symptoms or a fever that climbs to 101 degrees Fahrenheit or higher, call your doctor. You may have a breast infection.

How long does breast engorgement last?

Fortunately, engorgement passes pretty quickly for most women. You can expect it to ease up in 24 to 48 hours if you're nursing well or pumping at least every two to three hours. In some cases, though, engorgement can take up to two weeks to go away.

Once the engorgement passes, your breasts will be softer, although still full of milk.

If you're not breastfeeding, you may still need to pump to relieve the pressure on your breasts and lower your risk of a breast infection. Talk with your doctor or midwife about ways to reduce your risk.

Can I still nurse if my breasts are engorged?

Yes, you can and should nurse. If possible, breastfeed your baby in the first hour after he's born, and nurse often from that point on.

Will engorgement affect my baby?

Engorgement can make it harder for a baby to latch on. Talk to your baby's doctor if you're concerned she's not getting enough milk. And, again, reach out to your doctor or a lactation consultant if you need help dealing with engorgement.

Learn more:

Video: How to use a breast pump

How to express milk by hand

Visual guide to getting a good latch

Tips from breastfeeding veterans

Breastfeeding Problem Solver