Tips to Manage Engorgement

Follow these 12 breastfeeding tips to help manage engorgement.

Breastfeeding or pumping (if baby can’t breastfeed yet)

  • Do this often before your milk comes in. It will reduce your risk of severe engorgement. 

Empty breasts often

  • Let baby breastfeed when you see hunger signs. If baby doesn’t wake often, have baby wake up and feed every two to three hours. 
  • Have baby soften one breast really well before offering the other breast.
  • Don’t limit the time baby is at the breast. 

Use massage while emptying breasts

  • This helps the breasts soften.
  • The more often and completely mom’s breasts are emptied, the sooner the engorgement will go away. 
  • Baby may have trouble latching because of engorgement. If so, use reverse pressure or hand expression. If those don’t work, pump to soften breast enough for baby to latch. 

Cold compresses

  • Use cold compresses between feedings to reduce inflammation.
  • Do it 20 minutes on and 20 minutes off.

Warm compresses

  • Some moms say that using moist, warm compresses right before pumping can help express milk.

Prescribed medicine for inflammation (non-steroid)

  • Many moms leave the hospital with a prescription for medicine, such as ibuprofen. If so, take it as your doctor has prescribed.
  • This can be very helpful for engorgement. Some of the swelling is caused by inflammation.

Pumping to comfort

  • Do this if uncomfortable between feeds.
  • This can help keep mom comfortable between feeds when engorged.
  • Stop pumping to comfort between feeds once engorgement issue goes away. If not, you may have a milk oversupply problem.

Lymphatic massage

  • How to do this:
    • Use a fine - toothed comb to massage the breast.
    • Use very light pressure – like a coin was laid on your skin.
    • Lightly move the comb from the base of your breasts toward the areola.
    • Make sure to cover all areas of the breast.

Lymphatic massage by licensed massage therapist

  • Some moms say this is very helpful when engorged.
  • You should find a therapist trained and certified in lymphatic massage.

Warm showers

  • Do this before pumping.
  • It should work like the lymphatic massage.
  • Just let the water run down the breast.
  • Don’t spray water directly on the breast.

Cluster pumping

  • Do this if baby is not feeding at the breast and you are very engorged and no milk is expressing because of the fullness.
  • How to do it:
    • Pump for five minutes then stop for five minutes.
    • Repeat four times.
    • Do breast massage while pumping. 
    • After that, pump every two to three hours for 15 to 20 minutes until milk begins to release and breasts soften. 
    • Only cluster pump one to two times in a day.
    • Once your breasts begin to soften, pump for two to three minutes past the time the milk is no longer expressing. This makes sure the breast is as empty as possible. 

Green cabbage (see caution below)

  • This can help reduce pain and swelling.
  • How to do this:
    • Slightly break the leaves on cold green cabbage.
    • Put them in your bra.
    • Only do this thee times a day for 20 minutes at a time.
  • Use with caution.
    • Stop right away once engorgement starts going away.
    • Only do this when you have very bad engorgement.
    • If used too long, it could reduce your milk supply.