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Breast fullness is a normal part of early breastfeeding and is a sign that the milk is coming in well. Early, frequent and effective breastfeeding will prevent severe engorgement. Mothers with mild engorgement who are able to breastfeed often and well, do not need to pump or express milk before breastfeeding. If your breasts are very full due to swelling, your baby may have trouble drawing in enough breast tissue for effective, comfortable breastfeeding. It is important to breastfeed, hand express, or pump every few hours if severe engorgement occurs to keep the milk flowing. Engorgement usually subsides within a few days.

If you are engorged, you may want to try to remove some of the milk by hand expression before you breastfeed. This will help your baby latch on to the breast. You can also pump a bit of milk before breastfeeding in order to soften the areolar tissue. Use warm compresses or stand in a shower before expressing milk or breastfeeding to increase comfort and flow. You can cool your breasts with cold compresses in between feedings to decrease swelling. Bags of frozen vegetables make good cold packs because they are flexible and mold well to the breasts. Some mothers place a towel between the bag and their skin for added comfort.

If your breasts are painful, red, tight. or have pink/red streaking, or if you feel ill or have a fever, these may be signs of engorgement or possibly a plugged duct or breast infection (mastitis). See your health care provider you have any of these symptoms.

If Your Breasts are Engorged, You Can:

• Take a warm shower, or apply warm compresses for 2 to 3 minutes before breastfeeding/expressing milk.
• Focus on frequent latching baby onto breast correctly or use a pump if your baby cannot latch on well.
• Make sure that clothing, a tight bra, baby carrier, or seat belt does not constrict your breasts.
• Rest and breastfeed frequently, at least 8 to 12 times in 24 hours. Pump if breastfeeding is not possible.
• Use cool compresses in between feedings.
• Consult your health care provider or breastfeeding specialist if the problem does not resolve or if you have increased pain, fever or red, hot streaks on the breast. You may need medication.