Breast engorgement happens when your breasts become too full up of milk. This causes them to feel tight and painful and hard and can be very uncomfortable for a mum. Engorgement can also affect the nipple, becoming stretched or flat and painful. This can be unsettling for babies as it becomes difficult for them to attach to the breast properly. Breast engorgement happens when the supply and demand of milk are out of sync. Commonly it occurs in the early days when both mother and baby are getting used to each other's needs. But it can also happen later when the baby is older and begins reducing the amount or the frequency of their feeds, for example when transitioning to solids, cow’s milk, or formula milk, or if mum is away from home for longer than usual.
It is a delicate balance between supply and demand when it comes to breastfeeding. Prolonged severe engorgement sends signals to the brain to reduce milk production, whereas removing too much breast milk frequently, sends signals to the brain that more milk is needed. It is therefore advised to continue to feed as usual, but it might be helpful to express a small amount before giving the baby the breast. This will help relieve the pressure and make the breast more comfortable for the baby to latch.
It is important that when you breastfeed you are as relaxed and comfortable as possible. You should wear well-fitted loose breastfeeding bras. Strangely, there is some evidence that cold cabbage placed on the nipples can provide relief after feeding and reduce pain or swelling. Simple painkillers such as paracetamol or ibuprofen can also help relieve the pain. It is really important to reach out for help if you are struggling. You will find support through your health visitor, doctor, or a breastfeeding (lactation) specialist.