Breast Fullness Versus Breast Engorgement

WHAT YOU SHOULD KNOW:

• Breast fullness is a normal process that happens when your milk starts to come in after you have your baby. When your breasts are full with milk, they may look swollen, and may feel tender. Your breast milk should flow out normally when you breastfeed or pump milk from your breasts.
  
  
• Breast engorgement can occur when you begin to lactate (make breast milk). This happens about 3 to 5 days after giving birth. Your body increases the amount of breast milk it makes. If your body makes excess (too much) milk, it may press on your milk ducts. Milk ducts carry breast milk from the glands (small sacs), where it is made, down to your nipple. A blockage may form, making it hard for you or your baby to remove milk from your breast. With engorgement, your breasts may be swollen and painful. They may also look shiny and feel warm. Symptoms of engorgement may last up to 10 days.

AFTER YOU LEAVE:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not working as expected. Tell him if you are allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs you take. Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Risks for breast engorgement:

Your breasts may become engorged if:

• You do not completely empty your breasts when feeding or pumping.
  
  
• You miss feedings, feed your baby from the breast less often, or rush through feedings.
  
  
• Your body makes more breast milk than your breasts can hold.
  
  
• You stop breastfeeding without slowly weaning your baby.
  
  
• You wear tight-fitting bras or items that put pressure on your breasts.

Treating breast engorgement:

Rest as much as possible if you think your breasts are engorged. The following can help treat breast engorgement:

• Remove excess milk. Breast engorgement may improve when you remove the excess milk in your breasts. You can do this by breastfeeding or expressing milk from your breast.
  
  
  • Breastfeed often. Breastfeeding more often is important when your breasts are engorged. Breastfeed your baby 8 to 12 times each day or any time he shows signs of being hungry. Signs include looking more awake, being more active, and mouthing. Mouthing is when your baby puts his hands in his mouth or acts like he is sucking. You may need to wake your baby to breastfeed more often. Breastfeeding more often also may help prevent engorgement.
    
    
  • Express or pump milk from your breasts. Express or pump out a small amount of milk before you breastfeed. This will help soften your breast and your nipple, and allow your baby to latch on better. Express or pump after you breastfeed if your baby is not emptying your breasts when he feeds. Ask your caregiver for more information about expressing, collecting, and storing breast milk.
  
  
• Decrease swelling and pain.
  
  
  • Apply a cold compress after breastfeeding. The cold may help decrease swelling and pain in your engorged breasts. Put ice in an ice bag or use a package of frozen vegetables. Wrap the bag in a thin towel before putting it on your engorged breasts. You also can use chilled cabbage leaves in place of ice.
    
    
  • Apply warmth to your breasts before breastfeeding. Put a warm, wet cloth on your breasts or take a warm shower. This can help increase milk flow.
    
    
  • Massage your breasts. Breast massage helps empty your engorged breasts and decrease pain. Gently massage your breasts before and during breastfeeding to help increase your milk flow. Gently stroke your breast, starting from the outer areas and working your way toward the nipple. Breast massage may also help prevent breast engorgement if done in the first few days after giving birth.
    
    
  • Take medicine to decrease pain and swelling as directed by your caregiver. Ibuprofen and acetaminophen are common nonprescription medicines that help decrease pain and swelling. Follow your caregiver's advice on how to take them.

Preventing breast engorgement:

• Avoid wearing tight-fitting clothes and underwire bras.
  
  
• Do not rush through a breastfeeding session. Allow your baby to breastfeed for as long as he is able. Do not set a time limit for how long you breastfeed your baby.
  
  
• Empty your breasts completely. During each feeding, let your baby feed from each breast. Be sure the first breast is completely emptied before you offer the second breast. Start with a different breast each time you breastfeed. Use a breast pump to remove and store leftover milk after your baby has finished a feeding. Use it to remove excess milk if you miss a breastfeeding session or any time your breasts feel very full.
  
  
• Eat a healthy diet and drink plenty of liquids, such as water. Ask your caregiver for more information about breastfeeding and your diet.

For more information:

Contact the following:

• The American College of Obstetricians and Gynecologists
  409 12th Street, SW
  Washington , DC 20090
  Phone: 1- 202 - 638-5577
  Web Address: http://www.acog.org
  

CONTACT A CAREGIVER IF:

• You have a fever.
  
  
• Your body feels very achy.
  
  
• One or both of your breasts is very swollen or painful and keeps you from breastfeeding.
  
  
• One or both of your breasts is red, very swollen or hard, painful, and feels warm or hot.
  
  
• Your signs and symptoms are not getting better within 24 hours.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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