Breast Fullness Versus Breast Engorgement

WHAT YOU SHOULD KNOW:

Breast fullness happens when your breast milk starts to come in. This is usually 3 to 5 days after you give birth. When your breasts are full with milk, they may look swollen and feel tender. Your breast milk should flow out normally when you breastfeed or pump milk from your breasts. Breast engorgement can also occur if your body makes a large amount of milk that does not get removed. Engorgement can happen if your baby misses a feeding or you change how often you breastfeed your baby. Engorged breasts may be swollen, painful, and shiny. Your baby may have a hard time latching on (attaching) to your breast to feed.

AFTER YOU LEAVE:

Medicines:

• Acetaminophen: This medicine decreases pain. You can buy acetaminophen without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
  
  
• Ibuprofen: This medicine decreases pain and swelling. You can buy ibuprofen without a doctor's order. Ask how much to take and how often to take it. Follow directions. Ibuprofen can cause stomach bleeding and kidney damage if not taken correctly.
  
  
• Take your medicine as directed. Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your primary healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

How breast engorgement affects breastfeeding:

Your milk supply will decrease if the excess breast milk is not removed. Your baby may not be able to latch on correctly to your breast, which can cause damage to your nipples. Engorgement can also lead to mastitis (breast infection) if the milk is not removed.

Factors that increase your risk for breast engorgement:

• 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 baby needs.
  
  
• You stop breastfeeding without slowly weaning your baby.
  
  
• You wear tight-fitting bras or clothes that put pressure on your breasts.

Self-care:

• Breastfeed often: 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.
  
  
• 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 for more information about expressing, collecting, and storing breast milk.
  
  
• 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 your 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.

Prevent breast engorgement:

• Do not wear tight-fitting clothes or underwire bras: These can put extra pressure on your breasts.
  
  
• 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: Let your baby feed from each breast during each feeding. Be sure the first breast is completely emptied before you offer the second breast. Start with a different breast each time. 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.
  
  
• Breastfeed on demand: Breastfeed your baby any time he shows signs that he is hungry, instead of following a schedule.

For more information:

• American Academy of Pediatrics
  141 Northwest Point Boulevard
  Elk Grove Village , IL 60007-1098
  Phone: 1- 847 - 434-4000
  Web Address: http://www.aap.org
  

Contact your primary healthcare provider if:

• You have a fever.
  
  
• Your body aches.
  
  
• You have pain and swelling in one or both breasts that keeps you from breastfeeding.
  
  
• One or both of your breasts are red, very swollen or hard, painful, and they feel warm or hot.
  
  
• Your have breast engorgement that does not get better within 24 hours.
  
  
• You have questions or concerns about your condition or care.

Learn more about Breast Fullness Versus Breast Engorgement (Discharge Care)