Engorgement is different from normal fullness and also different from a breast infection (mastitis), although the symptoms are similar. Nearly all women experience breast fullness during the first 2–3 days after their babies are born. Your breasts feel firm and heavy with fluid, but they should not be painful. Engorged breasts are swollen, hard, and painful, and the skin is red, shiny, and hot. With engorgement, body temperature can increase slightly (to less than 100°F or 37.7°C), but a fever greater than 100°F may be a sign of a breast infection.
There is no medicine you can take for breast engorgement. To reduce the swelling, put cold packs on your breasts—a bag of frozen peas wrapped in a wet washcloth works well. Some women put cold, raw cabbage leaves on the breasts after each feeding to reduce engorgement. Why cabbage leaves work is unclear. There may be a substance in the leaves that reduces swelling, or it may simply be the cool temperature of the leaves. Rinse the leaves in cold water to remove any chemicals. Place the leaves on the breasts with the nipples exposed until the leaves wilt. Apply fresh leaves only until the swelling decreases.
Before breastfeeding, hand express or pump a small amount of milk. This will soften your breasts and make it easier for your baby to latch on well. If your breasts are leaking freely, a warm shower or bath can make milk expression easier. It is important to remember that heat can increase swelling, so do not use heat unless your breasts are leaking freely.
Regular feedings will also help reduce the swelling and keep it from reoccurring. Breastfeed at least 8 times in each 24-hour period. To increase the flow of milk, gently massage the breast in a circular pattern with the flat part of your fingers, while your baby breastfeeds. If your breasts are still full and firm after feeding, hand express or pump to relieve the fullness.
The following tips will help you prevent engorgement:
- Breastfeed as soon as possible after birth.
- Breastfeed at least 8 to 12 times in each 24-hour period. Don’t skip nighttime feedings.
- Breastfeed as long as your baby wishes on the first breast before offering the second breast.
- Offer both breasts at every feeding, but don’t be concerned if your baby is satisfied after only one breast. If necessary, hand express or pump to relieve fullness in the second breast.
- Begin each feeding on the breast offered last during the previous feeding.
- If you delay or miss a feeding, or your baby breastfeeds poorly, hand express or pump to relieve the fullness.
- Avoid giving your baby water or formula supplements. Breastfeeding is based on the principle of supply and demand, and giving other fluids can lead to problems.
