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YOUR GUIDE TO BREAST ENGORGEMENT REMEDIES
New moms often ask me how to tell if your milk is coming in. I tell them that, while the early signs can be subtle, there should be a point when you look in the mirror and say, “Whose breasts are these because mine have never looked like this before.”
That’s my way of saying that when your milk comes in, you should expect some drama. That drama is called breast engorgement.
Getting engorged breasts when your milk comes in is common. Approximately two-thirds of new moms report moderate amounts of breast engorgement when their milk comes in (Source).
WHAT IS BREAST ENGORGEMENT?
There are two kinds of breast engorgement. The short definition is hard, tender breasts.
When the milk first comes in, the definition of breast engorgement is swelling that occurs in the breast tissue.
When you first start to make milk, there is an increase in blood and fluid to the breast tissue that surrounds the milk-producing glands. This results in swollen breasts and is called primary engorgement.
Because a woman’s breasts can triple in size, moms often think their breasts are full of milk. The truth is that at first, there is more swelling than milk. As the swelling goes down, the milk volume significantly starts to increase.
When your milk comes in, a certain amount of engorgement is normal, and even reassuring. I consider it a red flag if a mom doesn’t have any breast engorgement. It could signal the possibility of issues with her milk supply.
The other type of engorgement is when your breasts get very full of milk. This also results in hard, tender breasts. This is called secondary engorgement.
Secondary engorgement happens when you go a longer than typical stretch between breastfeeding or pumping your breasts. You will get immediate relief from the engorgement when you feed your baby or use a breast pump.
Secondary engorgement usually happens when your baby starts sleeping a longer stretch at night. If he continues to sleep long stretches, then your body will learn to stop producing so much milk during the night time hours.
You can also get engorged from a clogged duct or mastitis.
SIGNS OF BREAST ENGORGEMENT
The early signs of engorgement can be subtle and easy to miss.
- Breasts feel warm
- Breast tenderness
- Breasts feel fuller
- Breasts look larger
When I see a mom in the hospital, I ask her if it feels like her milk is coming in. Many times, when I describe the signs to look for, she will say no, but her partner will disagree and say, “They are getting much larger.”
I always advise a mom to get that second opinion if they think that things are not changing.
WHEN DOES MY MILK COME IN?
Most moms start producing milk within 48 to 72 hours after birth. You can begin to experience engorgement as soon as your breasts start making mature milk.
The transition from making colostrum to making mature milk is a process.
When you first start producing milk, it is called transitional milk. Your milk is not considered “mature” until about two weeks. This is precisely the way it is supposed to be.
Colostrum is a special, early milk. You make exactly what your baby needs when he needs it. All of the milk you make is valuable and important for your baby.
If you are not feeling any changes in your breasts by the fifth day, you should contact a lactation consultant.
I recommend a mom start pumping if she has reached the fourth day and has not noticed any signs that her milk is coming in.
Noticing that what you are producing “looks” like milk is not enough. When your baby is breastfeeding you should hear swallowing every one or two times that your baby sucks for at least ten minutes.
HOW LONG DOES ENGORGEMENT LAST WHEN MILK COMES IN?
Typically breast engorgement lasts 24 to 48 hours. Some moms have experienced engorged breasts for up to two weeks. This is not common. But that is little consolation to those moms who do experience prolonged engorgement.
Severe and prolonged breast engorgement seems to happen more often in women who received large amounts of intravenous fluids when they were in labor (Source).
REMEDIES FOR ENGORGED BREASTS
If you are in discomfort you want to know how to relieve pain from breast engorgement.
The good news is that you can get breast engorgement relief. There are a variety of home remedies for breast engorgement.
The most important thing is to keep the milk moving. This sends the message to your breasts to make a lot of milk. Frequent feeding is one of the best ways to relieve breast engorgement.
Feed according to your baby’s hunger cues. Holding your baby and having frequent skin to skin sessions will result in your baby wanting to breastfeed often.
Pumping To Relieve Engorged Breasts
Sometimes your milk production will exceed your baby’s needs. If your baby breastfeeds and you still feel very full, use a breast pump to pump off enough milk to soften your breasts.
It is best not to pump too often unless your lactation consultant has advised you to. You want to let your baby tell your breasts how much to make. It’s that supply and demand thing.
Doing a lot of pumping can result in an oversupply of breast milk.
If pumping until your breasts are softer does not give you enough relief from your engorgement, you might try pumping until your breasts are thoroughly drained. Try to do this only once or twice, so you don’t cause an oversupply problem.
If you are unsure about how often you should be pumping, contact a lactation consultant.
Ice For Breast Engorgement
Ice can help decrease the swelling that occurs with breast engorgement. Applying ice packs is one of the best remedies for engorged breasts.
- Apply ice for no more than twenty minutes.
- You can apply ice every 1-2 hours, as needed
- If using ice cubes or crushed ice, wrap it in a cloth before putting it on your breasts.
- Bags of frozen peas work well as ice packs.
- Lansinoh TheraPearl Breast Therapy Packs are specifically designed for breastfeeding moms.
Heat can feel good on engorged breasts. However, it just invites more fluid into the tissue. It can make breast engorgement worse and make it last longer.
HERBAL REMEDIES FOR BREAST ENGORGEMENT
Moms looking for natural remedies for breast engorgement may look to herbal remedies
- Hollyhock compresses have been used to relieve engorgement (Source). Work with an experienced herbalist if you want to try this remedy for breast engorgement.
- I do not recommend Sage tea for breast engorgement. Sage can decrease milk supply.
CABBAGE LEAVES FOR BREAST ENGORGEMENT
I have always wondered who the first person was to look at a head of cabbage and think putting the leaves on engorged breasts would be a way to relieve painful breast engorgement.
It’s a good thing they did for moms who want to know how to relieve pain from breast engorgement.
Using chilled cabbage leaves is a treatment that has been scientifically studied and is effective at decreasing engorgement (Source).
- Use green cabbage that has been chilled in the refrigerator.
- The green version seems to work better than red
- Green won’t stain your clothes.
- Chilled leaves are soothing
- Chilling seems to make the treatment more effective.
- To minimizes the risk of bacteria that can be found on fresh produce, thoroughly rinse the leaves.
- Crush the leaves so they will be easier to mold to the breast.
- Cover the breast with the leaves, leaving the nipple exposed.
- Leave the leaves on for 20-30 minutes. At that point, they will be wilted.
- You can wear a bra or tank top to hold the leaves in place.
- You can repeat the treatment with fresh leaves.
- After one hour of continuous application, take a break for a couple of hours.
- Decreased milk supply has been reported with more extended periods of continuous use.
COMPLICATIONS OF BREAST ENGORGEMENT
Losing Your Milk
One of the most serious complications of severe breast engorgement can occur when there is no relief from the hardness. The pressure on the milk-producing glands can destroy them. They will stop making milk. If this happens, it can be extremely difficult to reverse.
It is essential to keep the milk moving to prevent this from happening.
Fever from breast engorgement
- Some women will get a slightly elevated temperature when they get engorged.
- Any significant fever should be reported to your health care provider as it could indicate an infection.
- Any fever that is accompanied by body aches or flu-like symptoms should be reported to your doctor. Mastitis is not common when the milk first comes in. It is possible, though.
I cannot count the number of times I have gotten calls from frantic mamas who tell me their baby was latching fine until they got engorged.
It is so worrisome when your baby won’t latch.
If your baby suddenly has difficulty latching while you are engorged, it will most likely be a temporary problem.
- Keep your baby close to you, so you are aware of his early feeding cues. This may result in more frequent feeding. Your breasts won’t have as much time to get hard between feeds.
- Pumping a little bit before latching can help soften the areola.
- If you use a pump and are not getting much milk, then it is probably swelling that is causing your breasts to be hard.
- Stop pumping if you don’t get any milk within five minutes.
REVERSE PRESSURE SOFTENING
A technique called Reverse Pressure Softening can help soften your areola (Source). That will make it easier for your baby to latch.
MEDICINE FOR BREAST ENGORGEMENT
- You should check with your health care provider before taking medicine for breast engorgement.
- Ibuprofen can decrease pain and swelling.
Sudafed for breast engorgement
Pseudoephedrine is a decongestant intended for stuffy noses. It can decrease milk supply. Some mothers have used it for an oversupply of breast milk.
I do not recommend sudafed for engorgement when the milk comes in.
It is normal for a mom’s supply to exceed her baby’s needs initially. After two or three weeks, the milk supply will start to better match what your baby needs.
Even when a mom has an obvious oversupply, I don’t recommend doing anything to decrease it before 4-6 weeks.
At 4-6 weeks a mom’s milk supply should be established. If she does something to decrease her milk supply she can usually reverse it fairly easily after it has been established.
PREVENTING BREAST ENGORGEMENT
Prevention of breast engorgement is possible to a certain extent.
- Feed your baby frequently.
- Start using ice packs as soon as your breasts start feeling firm. Don’t wait until you are in discomfort.
ENGORGEMENT NOT BREASTFEEDING
Engorgement is the process your body will go through to stop milk production if you are not going to be breastfeeding
Remedies for breast engorgement when not breastfeeding:
HOW TO RELIEVE SORE BREASTS WHEN STOPPING BREASTFEEDING
The amount of engorgement a mom will experience when she weans will depend on two things.
- How often she was breastfeeding when she starts the weaning
- How quickly she weans
- Gradual weaning will mean less engorgement.
- Cold turkey weaning will mean more engorgement.
All of the recommendations previously listed can be used.
How long does engorgement last when weaning?
The duration of engorgement will depend on how long weaning takes. Cold turkey weaning from a full milk supply can result in up to a week of breast engorgement pain.
FINAL THOUGHTS ON BREAST ENGORGEMENT REMEDIES
Breastfeeding can be hard. Getting engorged breasts is definitely one of those times.
Don’t get discouraged, mama.
- Breast engorgement is common
- It can be reassuring when your milk comes is.
- There are many effective remedies for engorged breasts.
- It is temporary.
Andrea Tran RN, MA, IBCLC
Andrea has been working with new families as an RN for over 35 years and a Lactation Consultant for over 25 years.
She has her MA in Health and Wellness with a focus in Lactation.