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Got Engorgement?

Leana L. Thompson, RN, BSN, IBCLC

How to Recognize and Resolve this Common Breastfeeding Condition

Engorgement is a common twist on the road of breastfeeding. Brief periods of engorged breasts are normal and usually harmless when addressed promptly. To maintain a healthy and productive breastfeeding journey, it’s important to know how to recognize and resolve this condition.

What is Engorgement?

Breast engorgement is swelling, tightness and increase in breast size caused by congestion of fluid and blood in the breast. This engorged state may be uncomfortable and painful. As an International Board Certified Lactation Consultant (IBCLC), I usually describe it to my clients as feeling as if they have bowling balls on their chest. A common cause of engorgement is when early milk production fills breasts for the first time, this fullness can prevent adequate drainage of fluids, which causes painful swelling.

How Can You Tell if You Have Engorgement?

If you are having discomfort or feel like your breasts are extremely full around day three to five of postpartum, you are likely experiencing normal engorgement. Normal engorgement is a sign of your milk transitioning from colostrum to mature breast milk production. It can last 24 to 48 hours in the early postpartum days. Some indicators of engorgement are a low-grade fever and other “flu-like” symptoms; swollen, firm, painful breasts, or flattened nipples. The lymph nodes in your armpit may also be enlarged and tender. When breasts are severely engorged, they are swollen to the point of being hard, shiny, warm and slightly lumpy to the touch.

When Is It Normal to Experience Some Engorgement?

Most breastfeeding parents will experience some sort of normal engorgement a few days after delivering your baby. Also, when you decide to stop breastfeeding or cut down pump sessions, you may experience a temporary period of engorgement while your body adjusts to decreasing your milk supply. If engorgement is happening outside of these anticipated circumstances, I’d strongly recommend seeking the help of an IBCLC.

How Can You Relieve Engorgement?

When noticed early, engorgement can be relieved in any and all of these ways:

  • Take a warm shower and massage the engorged breast(s) to encourage milk let down and help resolve any congestion.
  • Use a warm compress to encourage milk and fluid flow before or during a nursing or pumping session.
  • Do breast compressions and light massaging while nursing.
  • Apply a cold compress after nursing or pumping.
  • Try different feeding positions to help drain milk from all areas of the breast and avoid any clogging.
  • Hand express milk or use a pump to relieve pressure between feeding/pumping sessions.
  • Take ibuprofen to help with pain or inflammation, if approved by your doctor.

If engorgement is more severe or not resolving, connect with a lactation expert.

When Should I Reach out for Help With Engorgement?

If you are experiencing engorgement for more than 48 hours, or if you have a fever for more than 24 hours, then you should reach out to an IBCLC or your healthcare provider. They will discuss what other methods you can try to help relieve engorgement. This is important, because prolonged engorgement can lead to infections like mastitis, which in turn must be treated medically to avoid causing further issues.

How Can I Safely Stop Breastfeeding and Pumping?

The safest way to wean off breastfeeding or pumping is to do it slowly; how slowly depends on is the age of your baby, how big your milk supply is and your stage of lactating. It may be as straight-forward as dropping one feeding/pumping session per week. Weaning when your baby is 3-months-old looks a little different than weaning at 13-months-old. If needed, an IBCLC can help you create a plan to decrease your supply safely and comfortably.

What’s the Takeaway Message on Engorgement?

Engorgement can be normal for a short period of time in your breastfeeding journey, but should be taken care of as soon as possible. An IBCLC can be a great resource to help you create a plan to manage and monitor engorgement symptoms or to prevent engorgement during the weaning process. The breastfeeding path is rarely a straight line of ease and success, but preparing yourself with knowledge of this common condition can help you navigate with confidence.

About the author:

Leana L. Thompson, RN, BSN, IBCLC

Leana is a Registered Nurse, an International Board Certified Lactation Consultant, and a mom of two little girls under age 2. She lives in Gilbert, Arizona, where she owns her own business, LactationNow. She worked as a Mother-Baby RN for nearly a decade in hospitals all across the United States. Leana offers in-home and virtual lactation consultations. LactationNow’s goal is to provide services that give you and your partner the ultimate mother-baby experience before and after you leave the hospital. She covers prenatal breast consults, weaning consults, and everything in between. She also shares pumping and breastfeeding tips and tricks on her social media (@lactationnow) to support families across the globe. Contact Leana at for virtual or in person IBCLC support.

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