What is engorgement?

Approximately 2-5 days after the birth of your baby, you may notice that your breasts feel full, heavy, and swollen.  This change in your breasts is known as engorgement and is caused by the swelling of breast tissue as milk production begins and your milk ducts fill.  Although it may feel uncomfortable, it is actually a positive thing as it typically occurs when your breasts first transition from colostrum (link) to milk.  Your breasts can also become engorged if an insufficient amount of milk is removed from them.  This may occur if you miss several nursings (and do not pump) or if your baby is not nursing vigorously enough.  Engorgement may make your breasts very sensitive and painful.  In addition, because of the swelling, the nipple and areola may flatten out, making nursing more difficult for your baby.  Engorgement can be prevented by nursing your baby often (with some experts recommending going less than 3 hours without nursing) and not skipping feedings.

Can I nurse my baby if my breasts are engorged?

You can and should nurse your baby if your breasts are engorged.  However, because of the swelling, the nipple and areola may flatten out, which may make it more difficult for your baby to latch properly.  You can pump or manually express your breast milk to relieve some of the swelling and make it easier for your baby to nurse.

How can I relieve engorgement?

To relieve engorgement, you should nurse frequently and pump or manually express your breast milk.  Massaging your breasts while you are pumping or nursing will also help to get more milk out.  Taking a warm shower may also help relieve some discomfort and faciliate let down before feeding.

How can I prevent engorgement?

To avoid engorgement, nurse your baby frequently.  Some experts recommend not exceeding 3 hours between feedings.  If you miss a feeding, make sure you pump your breast milk.

What if I do not relieve engorgement?

Failing to relieve engorgement may lead to several problems.  You may experience a decrease in your milk supply as the milk producing cells die or swell shut.  If the milk producing cells swell shut, this will also increase the difficulty of removing the milk.  Engorgement that is not relieved may also lead to plugged milk ducts or mastitis, an infection (link).