Breast/Chest Engorgement

Important information about breast/chest engorgement:

Breast/chest engorgement is swelling, tightness, and an increase in size of the breasts/chest. It happens most often in the early days of milk production. It is caused by the build-up of fluid, blood, and milk in the breast/chest.  Fullness in the breast/chest can prevent milk drainage and cause painful swelling.It usually occurs in the early days of breast/chestfeeding, between days 3 and 5. But it may occur as late as days 9-10.

• It can occur any time you have gone too long between breast/chestfeeding or pumping.

• Moderate to severe engorgement results in hard, full, tense, warm and tender breasts/chest with throbbing and aching pain.

• History of breast/chest surgery increases the risk of engorgement

• A cesarean birth may delay engorgement by 1-2 days because the milk may come in later.

Instructions to prevent breast/chest engorgement:

Some breast/chest fullness is expected and normal as your milk comes in. However, engorgement can be prevented by emptying your breasts/chest frequently. Poor emptying and unresolved pressure within the breast/chest can damage milk producing cells and reduce your milk production.

Here are a few tips you can use to help prevent breast/chest engorgement:

• More time spent breast/chestfeeding and/or pumping in the first 48 hours will reduce engorgement.

• Let your baby breast/chestfeed on the first side until it is soft before switching to the other side.

• Alternate which side you offer first.

• Breast/chest feed often, every 1-2 hours, to avoid severe breast/chest engorgement.

• Be sure you are wearing a well-fitting supportive bra.

Instructions if your breasts/chest become engorged:

• Use an easy breast/chest massage technique called reverse pressure softening to soften the area around the areola. This will also make it easier for your baby to latch. To do this, use your fingertips and apply gentle firm pressure to your areola for 30 seconds. This will move some of the fluid back into your breast/chest.

• If your baby cannot successfully latch and breast/chestfeed after using this technique, you can try hand expressing for a few minutes. Then try to breast/chestfeed again. A hand or electric pump can be used if hand expression doesn’t work to soften the breast/chest.

• Hot or cold packs applied to the breast/chest may reduce swelling and provide comfort.

• If needed, use pain medicine such as acetaminophen and ibuprofen.

• Herbal remedies have not been shown to be effective to treat engorgement.

Reviewed June 2024 by Lauren Davidheiser, MS, RDN, IBCLC, LDN and Meghan Devine, BSN, RN, IBCLC