Engorgement

Breasts that feel heavy, firm, warm and sore are common in the first weeks while your body adjusts to making milk. It usually eases as feeding settles into a rhythm.

What it is

• Breasts get overly full, hard, tight and painful.
• Swelling in the breast tissue plays a big part, along with milk.
• It often starts as milk comes in, around 2 to 4 days after birth.
• Fullness that lasts past the first 1 to 2 weeks may be oversupply. See the oversupply guide.

What helps

• Feed often, whenever your baby wants.
• Soften before latching. If the areola is too firm for your baby to latch, press gently around the nipple with your fingertips (reverse pressure softening), then hand express a little.
• Express only for comfort. Hand express or pump just enough to feel better. Pumping much more than your baby drinks tells your body to make more.
• Cold between feeds eases swelling. Cabbage leaves work no better than cold and can carry bacteria.
• Light, sweeping strokes over the skin (lymphatic drainage) can move fluid out. Skip deep massage.
• A supportive bra that fits well and doesn't dig in.
• Warmth may feel good just before a feed, but heat can add to swelling.
• Pain relief. Ask your doctor or pharmacist which one is safe while breastfeeding.

When to call your doctor

Call your doctor or midwife, or an IBCLC (lactation consultant), if:

• You have a fever, flu-like aches, or a red, hot, painful area. These can be signs of mastitis. See the blocked ducts and mastitis guide.
• Your baby can't latch even after softening, or has fewer pee diapers than usual.
• It's hard to manage on your own.