Overcoming Breastfeeding Problems

Engorgement means that there is an excessive build up of milk within the breast.

It is normal for the breasts to feel warm, heavy and tender when they first fill with milk around three days after the baby is born. However, if the breasts feel hot, painful, hard and tight, this is not normal and needs to be addressed in order to prevent future problems such as mastitis and reduced milk supply. Engorgement is common in the first week after birth, but can also happen at any time if the milk is not being removed effectively from the breasts.

How can engorgement be prevented?

Engorgement is prevented by making sure that milk is removed efficiently from the breast so it is not allowed to build up excessively. This is done by:

• making sure positioning and attachment are effective – help may be needed to improve this
• feeding frequently so milk is removed
• avoiding infant formula which replaces breastfeeds
• avoiding dummies which may reduce the frequency of breastfeeding.

How can engorgement be treated?

It is important that engorgement is managed quickly and effectively in order to prevent complications such as a reduced milk supply, blocked ducts and mastitis. Enabling the baby to attach effectively can be difficult with an engorged breast. Gently hand expressing some milk at the start of feeds to soften the breast tissue can help to enable the baby to attach and have an effective feed. Following feeds, if the breasts remain full, further expression to soften the breast until comfortable will help avoid milk stasis which can reduce future milk production. Warmth before feeding/expressing can help milk flow more easily.

For more information please see the NHS website.