Breast fullness & breast engorgement
Kikītanga me pangoro ā-ū
When you are breastfeeding/chestfeeding, it is normal for your breasts to feel full. This is especially so in the early days when your body still has not learned how much milk your pēpi (baby) needs.
Nearly all breasts feel full when their milk comes in, around 3 to 5 days after the birth. This is normal and should ease quickly. If your pēpi is feeding well and often, your body will adjust your supply to the amount of milk your pēpi needs.
Engorgement happens when your breasts are too full and the areas around your nipples (areolas) become so firm that your pēpi finds it hard to latch. Engorgement can be very distressing and painful.
If your pēpi is feeding well and is effectively removing milk, your breasts are less likely to become engorged.
Symptoms of breast engorgement
If your breasts are becoming engorged:
- they may feel hard, and the skin may look stretched or shiny
- they may feel warm and tender to touch
- they may throb
- the areas around your nipples may be full and hard, making it hard for your pēpi to latch on
- you may feel painful lumps in your breasts.
Preventing breast engorgement
- Make sure your pēpi is latching at your breast correctly and is effectively removing milk. Ask your midwife to check your technique, seek help from a breastfeeding/chestfeeding group or consider seeing a lactation consultant.
- Feed your pēpi when they are hungry by following their cues or signs. Nuzzling, hand-sucking or mouthing (when they open their mouth and turn their head) are all signs they want to feed. Crying is usually the last cue for feeding.
- If your breasts are feeling full and uncomfortable, it is okay to wake your pēpi up to feed. If they are too sleepy to feed, you can try expressing a small amount of milk by hand. Ask your midwife or other support person for help.
- Avoid giving your pēpi formula top-ups, as they might not remove enough milk when they next breastfeed/chestfeed.
- Do not use a breast pump unless you have spoken to your midwife, lactation consultant or other health professional about it. This may cause you to make too much milk. Using a breast pump without a good reason can cause problems such as damaged nipples and mastitis.
Self-care for breast fullness or engorgement
If you notice any signs your breasts are becoming engorged, try these techniques to ease the discomfort:
- express some milk after a feed if you are still feeling full and uncomfortable. Even removing a small amount may help
- apply cold compresses to your breasts after feeding or expressing to decrease the inflammation in your breasts.
If your pēpi struggles to latch because your breasts are too full, try hand expressing a small amount of milk first. This should make the nipple area soft enough for your pēpi to latch.
You can also try a technique called reverse pressure softening to remove fluid from around your nipple area. This involves using your fingers to apply firm pressure on either side of the areola (the coloured skin around the nipple) pressing toward your chest wall for 1 to 3 minutes just before feeding. This Australian video shows the technique.
It is safe to use ibuprofen (for example, Nurofen) or paracetamol while you are breastfeeding/chestfeeding. This may help reduce your discomfort and pain.
If you continue to have difficulty with engorgement or your pēpi is not feeding well after trying these strategies, contact your midwife, lactation consultant or other health professional for more advice and help.
Written by HealthInfo clinical advisers. Last reviewed October 2024.
Sources
The information in this section comes from the following sources, some of which may be clinically complex or not available to the general public
KidsHealth, Breastfeeding, retrieved April 2017.
Mitchell KB, Johnson HM, Rodriguez JM, et al. Academy of Breastfeeding Medicine Clinical Protocol #36: The mastitis spectrum, revised 2022. Breastfeeding Medicine 2022;17(5):360-376. Retrieved March 2024.
Patient, Breast-feeding, retrieved April 2017.
Image and embedded video sources
Image of a couple in a café with a baby from Shutterstock (image ID 675390874). November 2017.
Image of a woman breastfeeding (blue background) from Shutterstock (image ID 1097296811). December 2021.
Image of a woman breastfeeding (light-grey background) from Shutterstock (image ID 1936970110). December 2021.
Image of a woman breastfeeding while lying down from Shutterstock (image ID 99091466). December 2021.
Image of a woman breastfeeding while talking to someone from Shutterstock (image ID 1371144848). December 2021.
Image of a woman breastfeeding while sitting in a grey chair from Shutterstock (image ID 2041543973). December 2021.
Image of a woman breastfeeding with an older woman looking on provided by the New Zealand Breastfeeding Alliance. December 2021.
Image of a woman looking at medicine in a pharmacy from Shutterstock (image ID 42597397). November 2017.
Image of a woman using a breast pump from Shutterstock (image ID 276890279). June 2015.
Image of breast milk in a fridge from Shutterstock (image ID 1477336601). December 2021.
Mastitis illustration from Shutterstock (image ID 2288593849). May 20924.
Page reference: 45600
Review key: HIBRF-24381