Engorgement is when the entire breast, including the nipple, the areola (the coloured area surrounding the nipple) and the area under the armpits become hard and swollen. The skin is warm to touch and may appear tight and shiny. A low grade fever may also develop.
It's common that this will happen in the first few days when your breasts step up milk production and cause a surge of blood and lymph fluid. It can also happen if you suddenly stop feeding and have too much milk in your breasts.
How to treat it
The best way to treat engorgement is removing adequate milk and encouraging lymphatic removal.
- Your baby will likely be having eight to 12 breastfeeds a day for the first few weeks, so don't be afraid to breastfeed your baby as often as he wants. You might need to wake him up to feed every two or three hours.
- While you will need to avoid prolonged warming in showers or baths (this can increase swelling), it may help to warm your breasts for one or two minutes before feeding. You can do this by immersing your breasts in a bowl or sink of warm water. This should help milk flow.
- Make sure your baby is positioned correctly and attached well to the breast. You may need to hand express a little if your nipple has become too taut.
- Allow him to feed for as long as he needs. If you have an abundant supply of breast milk, which many mothers do in the early weeks, he may be content to feed from one breast only.
- As your baby feeds, use sweeping strokes to massage your breasts from chest wall to nipple and gentle breast compression to increase milk drainage.
- If either breast feels hard after breastfeeding hand express or pump until comfortable.
- Apply cold compresses or cabbage leaves to your breasts between feeds to reduce swelling and relieve pain. Remove the compresses 10 to 15 minutes before the next feed.
- Talk to your healthcare provider about using a mild pain reliever such as paracetamol or ibuprofen.
- Avoid giving your baby bottle feeds.
Although painful, breast engorgement shouldn’t cause more than a temporary inconvenience. You should be able to relieve the symptoms in 12 to 24 hours if you act quickly, but it does have the potential to lead to bigger problems if you don't act, like: