What can I do if my breasts are engorged?

What can I do if my breasts are engorged?

Your breasts will produce more milk on the third or fourth day after you give birth; this is usually known as “milk come-in”. If your baby is not suckling well, your milk will stay and the milk ducts of your breasts may get stuck. If the situation persists, your breast will engorge and become very painful, which will obstruct the milk flow. With an engorged breast your nipple will also become flattened which makes your baby even harder to suckle effectively. Again without proper suckling and milk removal, your breasts will engorge further and results in a vicious cycle. In order to relieve the breast engorgement after your milk “comes-in", you should establish breastfeeding early. Have skin-to-skin contact with the baby and breastfeed your baby straight after birth, thereafter, breastfeed your baby according to his needs. Let the baby be fed on one breast first, if he is satisfied with one side you do not need to feed him on the other. If the other breast is engorged, apply cold compress to relieve the discomfort.

When your breasts are engorged:

  • Do not wear tight or underwire bras, they will impede your milk flow
  • You can take painkiller regularly. Take it 45 minutes before breastfeeding to allow time for it to work. Paracetamol is the common use of drug for breastfeeding mothers
  • After and in between feeds, apply cold compress on your breasts to relieve pain and swelling. You can apply repeatedly, but remember to avoid contacting your areola with the cold compress
  • You can also apply chilled or room temperature raw green cabbage leaves to your breasts, yet avoid the areola. Dispose the leaves after 20 minutes or when the leaves soften. Before application, you can use a bottle to flatten the cabbage leaves
  • Continue breastfeeding, and ensure your baby is suckling well
  • You can stimulate the milk let-down reflex before breastfeeding to enhance milk flow by
    • make skin-to-skin contact with your baby
    • gently massage your breasts and avoid strong pressure or
    • use warm compress on the breasts. However, only apply warm compress to your breasts for 3 minutes or less, prolonged application or overheating will scald the skin and increase swelling
  • You can express small amount of breastmilk by hand so as to soften your areola, your baby can grasp more areola easily and suckle well
  • You can try other nursing positions

If the situation does not improve and you still have questions, please consult Maternal and Child Health Centres or other healthcare professional for advice.