HealthInfo Canterbury
Breast fullness & breast engorgement
When you're breastfeeding, it's normal for your breasts to feel full, especially in the early days when your body still hasn't learned how much milk your pēpi (baby) needs.
Nearly all women's breasts feel full when their milk comes in, around three to five days after the birth. This is normal and should ease quickly. If your pēpi is breastfeeding 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 breastfeeding 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 group or consider seeing a lactation consultant.
- Feed your pēpi when they're 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's okay to wake your pēpi up to feed. If they're too sleepy to feed, you can try expressing a small amount of milk by hand. Ask your midwife or other breastfeeding support person for help.
- Avoid giving your pēpi formula top-ups, as they might not remove enough milk when they next breastfeed.
- Don't use a breast pump unless you've spoken to your midwife, lactation consultant or other health professional about it, as it 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're 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 and the areas around your nipples are too firm, 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. (The linked page refers to a 24-hour breastfeeding hotline, but this is a USA number and won't work in New Zealand. See below for who to contact if you need help).
Reverse pressure softening 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 one to three minutes just before feeding. This Australian video shows the technique.
It's safe to use ibuprofen (for example, Nurofen) or paracetamol while you're breastfeeding, and this may help reduce your discomfort and pain.
If you continue to have difficulty with engorgement or your pēpi isn't 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 December 2021.
SourcesReview key: HIBRF-24381
