Engorgement sucks! Here’s what to do about it

About four days after the birth of my third baby, I woke up to see what looked like a tumor poking out the side of my left boob. What the….? It didn’t hurt unless I touched it, and then OH.MY.WORD. I knew then that I was dying. I just knew I’d developed the world’s most aggressive cancer and it was gonna kill me quick. (Oh come on, tell me you never over-react?!) My hubs, aka the voice of reason, wisely suggested that I call the breastfeeding hotline. Thank God for them, let me just say that. After finally convincing me that I wasn’t actually dying, the kind hotline lady told me that the “tumor” was merely engorgement.

What is engorgement?

Now, maybe you read that description and knew exactly what was wrong with me. I didn’t. See, having breastfed twice before, I thought I knew it all. I’d seen my share of engorgement, full breasts, mother nature’s boob job, whatever you want to call it. I’d never seen this. It looked like I’d grown a third breast right on top of my left one! As I would find out when I started researching, this type of breast swelling isn’t all that uncommon when milk first starts coming in.

Engorgement is simply the painful overfilling of milk in your breasts. That’s it. Sounds so simple. Hurts so bad! Depending on how engorged you are, you may experience the following symptoms:

• Breast pain ranging from mildly uncomfortable to extremely painful.
• Very, very firm breasts.
• Breasts feel unusually lumpy.
• Slight fever around 100.4°F or 38°C.
• Flat or sunken nipples.

Is it dangerous?

It actually can be dangerous, but not a get-to-the-emergency-room-now kind of dangerous. If your breasts swell too much, your baby will have a hard time latching on and getting enough milk.

Severe engorgement can also lead to mastitis or clogged ducts. Especially if it happens a lot. So if you start to feel overly full, either feed your baby or express some milk!

Now obviously, I survived my “near-death” breastfeeding experience. 🙂 But it helped me realize that just because I think I know all about something, doesn’t mean I actually do. See, engorgement doesn’t happen in just one way.

• Those boobies might get enormous and look like twin volleyballs perched on your chest.
• One boob might grow big enough to look like it’s about to eat the other.
• You might get a milk “tumor” in only one spot on only one breast.
• Or your breasts may look like overfilled balloons about to pop.

And just like symptoms, the treatment may not be what you expect either. You’re thinking cabbage leaves, aren’t you? We’ll get to that.

What causes engorgement?

While an overabundance of milk can seem like a good thing, it’s actually a sign that there’s a problem. Not a massive problem, but an issue that needs your attention nonetheless.

The two most common causes of engorgement are a new milk supply trying to get established and feedings that are inconsistent.

A new supply for a new baby

When your milk first comes in, your body isn’t sure how much it should be making. That happens to almost everyone postpartum. Since your mammaries are beginning milk production for a new little life, they seem to give their most abundant effort to see what you’ll actually use.

For the first few weeks, don’t try to put your baby on a breastfeeding schedule or store up a milk stash for the apocalypse. The best way to get a healthy supply from the very beginning is to feed your baby whenever she acts hungry, and for as long as she’s interested in nursing. Then burp her and offer the other breast. Check out my section on breastfeeding basics to learn more about getting a successful start.

Inconsistent breastfeeding or pumping

If you’re not in the first four to six weeks postpartum and you’re experiencing engorgement, it’s probably being caused by inconsistent milk removal.

That could mean that you’ve waited too long between feedings. Or that your baby is taking in less milk than she was recently getting.

With milk supply, consistency is key. That may seem challenging if you feed on demand, but it actually works better. You see, when babies are fed on demand, they naturally put themselves into a bit of a routine. Then as they approach a growth spurt, they start to breastfeeding more frequently.

It’s their amazing way of increasing your milk supply to support their growing body! Pretty cool, huh?

How long does it last?

If you leave it alone and you’re not breastfeeding, the pain and swelling will go away in about 3 days or so. Keeping just enough removed to ease the pain or taking ibuprofen (like Advil) will help immensely.

If you’re breastfeeding, you’ll be all better just as soon as you can feed your baby! Or any baby who’s willing to take a drink, for that matter. Try to keep more consistent feedings to prevent engorgement from coming back. If you have to miss a feeding, pump and store your milk.

How to make it stop

If you’re engorged, then you’re probably desperate. Believe me, I understand! There are a few ways to make it stop. Any of these will ease that uncomfortable swelling:

Rule #1: More out = more in

The first rule of milk supply is that the more milk you remove from your breasts, the more they will make in return. More out = More in.

And it doesn’t matter how that milk comes out of your boobs. It could be nursing, pumping, massaging in the shower, or squeezing to see if you can hit a target across the room. It doesn’t matter! More milk out always equals more milk in.

So if you want your ladies to stop making quite so much milk, then you’re gonna have to stop removing so much.

Don’t feed the beast

The first time your breasts overfill, it may seem like a gift from the milk gods. You rush to the breast pump and whoosh out every last drop, grateful for the supply that came out of nowhere.

That’s a good idea – if you want to be engorged again. Taking all that milk out is just feeding the engorgement beast. It’ll return with a vengeance.

Remember rule #1. More out equals more in. If you have too much milk and you take it all out, your intuitive mammary glands are going to assume they gave you just the right amount. And they’ll happily give you a refill right back to the painful level!

I know how badly you want to make these achy rocks on your chest feel like boobs again. I get it. And it’s absolutely okay to express a little bit. But not all of it! Not even most.

…but feed the little monster

Don’t stop breastfeeding because of this! If you plan to continue providing breastmilk for your baby, then you have to keep feedings consistent. Not only is that good for your baby for obvious reasons, but it’s also vital in maintaining a healthy milk supply.

By “healthy milk supply,” I mean an adequate amount of milk for your baby’s needs without being painfully overfull!

Express just enough to get relief

When your breasts are too full and you start removing the excess, it’s going to be tempting to keep going. See rule #1 above.

Only take out enough to make you comfortable again.

Heat is your friend

Any kind of heat will bring relief to you. But the best method is a nice hot shower. You’ll probably begin leaking as soon as the water hits you. That’s fine. Go ahead and give your breasts a nice, comforting massage to help them drop some of the load.

And don’t avoid the painful spots! That’s where you need to massage most. Zero in right there.

Ice is helpful too

Ice packs are just lovely! They really do a good job of numbing the pain.

I like to put a thin towel over my skin and then place the ice packs on the towel, and my bra over the ice packs to hold them in place. It’s even nicer if your ice pack comes in a breast-friendly shape like the Lansinoh TheraPearl packs.

Leave it on for 30 minutes, longer if you can stand it. The longer you wear the ice, the longer you have relief.

Cabbage leaves to the rescue!

I would never ask you to eat cabbage. I like people who visit this website. I’m convinced that the ONLY reason God created cabbage was to help women with miserably painful breasts.

It sounds like a wives’ tale, I know. But it works. IT WORKS!!!

Go get a head of cabbage, refrigerate until it’s nice and cold, then tear off a complete leaf. It’s the perfect shape for an engorged breast. Coincidence? I think not!

Next, wash the cabbage leaf and use a blunt kitchen tool to gently smash the veins in the leaf. Then line your bra cup with the cold cabbage and sigh in relief. You’re welcome.

Whenever your leaf starts feeling wilted, grab a new one and repeat the process.

Peppermint is awesome

Peppermint is excellent for easing those overfull breasts! But please please please be careful with it if you’re not weaning! If you plan to keep breastfeeding, I’d recommend staying away from peppermint. But if you must, then start with peppermint candies or only use peppermint essential oil once a day.

To use the essential oil, apply a light coat of carrier oil (any kind will work, I prefer coconut oil) and then place 1 drop of peppermint essential oil on the top of your breast and rub it all around, avoiding the areola and nipple.

I usually notice that I have less swelling within 3 or 4 hours of the first application.

Conclusion

Engorgement sucks! Nobody has time to spend in pain from swollen breasts. And although it’s more uncomfortable than dangerous, it’s important to fix the problem as soon as it starts. Of course, now that you know what causes your breasts to fill up so painfully, you’ll be able to avoid it in the future.

For now, get enough milk out to feel some relief. Or go ahead and feed your baby if she’s around. You can use the heat of a hot shower or the cold of an ice pack to ease the pain. Two other wonderful options for reducing engorgement are cabbage leaves and peppermint – and these are definitely a more discrete option when you’re in public!

What’s helped ease engorgement for you in the past? Please comment and share the ideas!