Engorgement
Engorgement is when your breasts swell and fill with milk. They may start to feel hard, warm, and tender. This normally happens when your milk comes in a few days after you have your baby. Most of the time it goes away in a day or so. If it is severe, it can last for several days or weeks.
What can I do to keep from becoming engorged?
The main thing you can do to keep from becoming engorged is to drain your breasts of the milk. This can be done by breastfeeding your baby on cue, using your hands, or with a breast pump. To make sure your baby is able to breastfeed properly, you can:
- Start breastfeeding as soon as you can after you have your baby. This gives your baby time to learn before your breasts are full and firm.
- Make sure your baby is able to get their mouth on your nipple the right way. This is called the latch. If your baby has a poor latch, they will not get enough milk or be able to empty your breasts of milk.
- Try to breastfeed your baby at least eight times a day. If you miss a feeding, use your hands or a breast pump to get the milk out.
- Use a breast pump or your hands to empty your breasts if they are too firm for your baby to latch well.
- Unless your doctor tells you to, do not use bottles or pacifiers while your baby is learning to breastfeed.
- Ask for help. UAMS has lactation consultants (breastfeeding experts) that can help you.
If my breasts are engorged, what can I do to ease the pain?
To ease the pain when your breast are swollen, you can:
- Place ice packs on your breast for 10 to 15 minutes at a time, after nursing, every hour as needed.
- Take a hot shower before you feed your baby. The heat will help your milk let down.
- Before breastfeeding use a warm wet rag for no more than five minutes. If you use it too long it can make swelling worse.
- Gently massage and press on your breast if your baby takes a break while eating. This will help your baby get more milk.
- Wear a nursing bra with good support that fits you well. If you feel better without a bra, do not wear one.
- Use a breast pump or your hands to drain your milk.
What can happen if my breasts become severely engorged?
Sometimes engorgement can be serious. If you have severe engorgement:
- Your breast may get sore. If you have severe pain, call your doctor.
- Your breasts may get red.
- You may get an infection and a fever. If you have a fever (temperature over 101 degrees Fahrenheit), call your doctor.
- It can keep you from being able to make milk.
- If it lasts a long time, it may affect your milk supply.
If you decide to stop breastfeeding, do not quit all at once. You will have to do this over time. Ask a lactation consultant for help.
If you have questions, you can ask your doctor or a lactation consultant. To learn more about breastfeeding and engorgement, visit:
Yeast Infection During Breastfeeding
If breastfeeding has been free of pain and the nipples suddenly become sore or painful, it might be a yeast infection.
Caveat: Not all nipple pain and redness around the nipple is yeast, this is just one possible diagnosis to consider.
Risk factor: Mom and baby may have recently been treated with an antibiotic.
Signs of a Yeast Infection
Mom
- Burning or stabbing pain in the breast or nipples
- Red nipples with tiny bumps, blisters, or flaking skin
- A clean cut at the base of the nipple (slight bleeding in the cut may occur.)
- May have a vaginal yeast infection.
Baby
- White patches on the tongue, gums, and inside the cheeks that do not rub off
- A diaper rash with raised, red, sore looking patches that do not heal with regular rash creams
What To Do
Mom
- Apply over the counter Lotrimin cream to the nipples after feedings for two weeks.
- If nursing is too painful, pump the milk and feed to the baby.
- Keep the nipples dry and expose to the light two to three times a day.
- Do not use lanolin, hydrogel, or other creams.
- If no improvement in the pain or rash, see a doctor. A prescription may be needed.
Baby
- Talk with a doctor about treating the baby.
- Mom and baby need to be treated at the same time.
More to Know
Boil breast pump parts, pacifiers, bottle nipples and teethers for 20 minutes once a day.
Keep bras and bra pads clean and dry.
Additional Help
For more help, call UAMS Lactation Services at 501-526-3558
Mastitis During Breastfeeding
Mastitis is a breast infection. It begins suddenly and if not treated, gets worse quickly. Germs may enter through a break in the skin or through the nipple. Once treatment starts, the mother usually feels better in a day or two. The milk will not harm the baby and breastfeeding can continue. The mother usually has:
- Flu-like symptoms — fever of 100.8 degrees Fahrenheit or more, chills, body aches
- A painful, hot, reddened breast
What To Do
- Call the doctor and describe the symptoms.
- Antibiotics may be needed. Take all of the prescription, even after starting to feel better. Most antibiotics are safe to use while breastfeeding.
- Wrap the breast with a wet, very warm towel or cloth; or soak the breast in a basin of very warm water. Repeat several times a day until the redness is gone.
- Take acetaminophen (Tylenol) or ibuprofen (Advil), Motrin) for pain.
- Drink more fluids to replace what’s lost with a fever.
- Keep the breasts soft by continuing to nurse frequently. Add gentle massage to help the breasts empty.
- Get more rest and nap when the baby naps.
Contact a doctor if the symptoms haven’t gone away after finishing the antibiotic.
To Avoid Mastitis
- Don’t allow the breasts to become overly full. Try not to miss or put off a feeding. Talk to a breastfeeding counselor about ways to manage if making more milk than the baby can take.
- Treat sore nipples quickly. See the “Sore Nipples” information sheet.
- Avoid tight bras or clothing that binds.
Additional Help
For more help, call UAMS Lactation Services at 501-526-3558