Breastfeeding A to Z

Are You Experiencing Breast Engorgement?

Information is listed by baby’s age

WEEK 1

Roughly 2-6 days after your delivery, your body will begin to produce milk in greater amounts. You may experience engorgement or breast fullness; this can make the breast feel tender and warm to the touch. The breast will seem very full before a feeding, but softer after you finish feeding.

Several things are happening at the same time to cause this fullness. There is an increased blood supply to the breast, there is swelling in the breast tissue and the more the baby eats the more breastmilk is present. Plus, by the third or fourth day, the mother’s milk supply makes a dramatic increase. This is all trying to fit in the same place—your breast. Engorgement is best prevented by nursing frequently to avoid having it become a problem in the first place.

If the baby eats often enough, engorgement will not be a big deal. For some it is only a mild discomfort, but for others it can make the breast feel like a bowling ball with a temperature!

If the breast becomes too firm, the baby has great difficulty latching on and staying there. This is because the nipple keeps slipping out of their mouth. In this situation the skin is so firm, it has no give left, and this is when breastfeeding can start to break the skin. In this situation, all you need to do is make the areola, the dark area just behind the nipple, a little softer. This way the baby can get latched on more comfortably for you and stay latched on. The skin will have some flexibility or give to it and will not breakdown as easily. You can attempt to avoid things getting to this point by nursing frequently.  For techniques to help resolve engorgement see breast engorgement in Breastfeeding A-Z section.

 

WEEK 2

Most engorgement is resolved by the time the baby is two weeks old.  You feel a difference in breast fullness before a feeding and after, but not the swelling and discomfort you may have experienced during the first week.

Often women think this is because there is something wrong with their milk supply.  Nothing is wrong with your milk supply, it just feels different.  It feels different because the swelling that you initially experienced is decreasing.

You may experience engorgement if your baby goes a longer stretch of time without eating.  This is normal–a reminder if you will–find your baby and feed them!

If you notice a lump or bump under the skin of the breast, you may have a plugged duct.  Check the link for ways to resolve it.

If you have a temperature, a reddened area on the breast or streaks radiating from the nipple, flu-like symptoms or a bad headache, you may have a breast infection, also called mastitis.  If this is happening, you need to be seen by your healthcare provider today.

 

WEEK 3

Most engorgement at three weeks is due to your baby going a longer stretch of time without eating.  If you are both sleeping, you may have the experience of waking up before your baby does due to the fullness in your breast.  When you feed your baby, the fullness goes away.

You may experience milk leaking/let down when you hear your baby cry or another baby cries.  Some gentle pressure from your hand on the breast can stop the leaking.  Wearing nursing pads can also help.  Be sure to change nursing pads as soon as they are damp to prevent nipple soreness or developing thrush (a form of yeast infection).

 

WEEK 5-6

Breast engorgement should have resolved completely by now and you and your baby are more in sync with each other.  Your body is producing the amount of milk your baby needs and you will notice that you don’t have pain, soreness or excessive fullness associated with feeding your baby.  You will feel firmer when you start a feeding and softer when you finish, but there won’t be the marked fullness you felt in the first couple of weeks after delivery.

You may experience some breast engorgement or fullness if your baby does start to have a longer stretch of sleep.  In this case feeding your baby resolves the fullness an it doesn’t cause any further problems.

Often at this point, mothers wonder if something has happened to their milk supply because it feels so different from those early days.  As long as your baby is gaining weight, nothing is wrong with your milk supply it just feels different.  There is more of a rhythm in feeding your baby now.

 

2 MONTHS

Most engorgement is gone by this time.  Some women however, become concerned about their milk supply, because they don’t notice the big change in their breasts like they did in the early weeks.  By 2 months, the breast swelling in the tissue has gone away and the volume of milk has adjusted to baby’s needs.  Your breast may feel more full when you start a feeding and softer when you finish it, but not the big differences you noticed in the first few weeks.  This is normal.  Nothing has happened to your milk supply.  It just “feels” different.

You may also notice that one breast seems larger than the other one.  The left breast tends to be larger than the right. (1)  We don’t tend to come as a matched set and breastfeeding makes it more noticeable.  You may also notice that your baby sometimes prefer one breast over the other because it produces more.  This is true.  You have a smart baby; they know which one is easier to get milk from.  Continue to start each feeding on the side you ended on the previous feeding.  This helps give both sides more equal stimulation.  Whichever side baby starts on usually gets a more vigorous workout, because baby is hungrier.

If you do experience engorgement it is often because baby has slept longer or gone for a longer period of time without eating.  Usually breastfeeding will take care of the fullness.  If it is hard to get baby to latch on because of how full the breast is, try to express some milk by hand or with a pump or lean into a basin full of warm water–usually warmth and gravity will cause a letdown of milk and enough will leak out that the breast will be soft enough for baby to latch on.

  1. Black, RF, Jarman, L, Simpson, JB, Lactation Specialist Self-Study Series Module 2: The Process of Breastfeeding, Sudbury, MA, Jones & Bartlett Publishing International, 1998, p 18.

 

3 MONTHS

When your baby is 3 months of age, usually breastfeeding has become very efficient.  Babies are skilled at latching on, your let-down has become prompt after baby begins eating and breastfeeding times have shortened because your baby has become a more experienced eater.  You may notice the breast is firmer when you start, softer when you finish.  Most feedings the baby will take both sides, some still like one side per feeding.

You may notice when the breasts are full that they are not the same size.  We typically do not come as a matched set and the left side is often bigger than the right. (1–see 2 Months reference)  It may not have been something you noticed before, but because you are producing milk it has become more obvious.

If you notice a lump, bump or have pain in the breast, or nipple soreness, check the following information about possible causes and what to do.  Care Plan For Thrush, Plugged Duct, Breast Infection also called Mastitis.