What is Breast Engorgement and What Causes It?
What is Breast Engorgement

What is Breast Engorgement and What Causes It?

If your breasts feel tender, firmer, heavier, and larger, they're probably engorged. Learn why engorgement happens and what you can do about it.

Medically reviewed by a board-certified pediatrician

Picture it: You're cradling your newborn, recovering from childbirth, and before you know it, your breasts are growing larger and they’re rock-hard. They may appear shiny, and your nipples may be flat. They may feel tender or downright painful. You're probably wondering, "Wait, why do my boobs hurt?" The simple answer is breast engorgement. Within three to five days after you've given birth, your breasts will begin to produce mature milk[1]. This process (also referred to as "milk coming in") typically creates the swelling, heaviness, and tenderness associated with breast engorgement.

What is breast engorgement?

Breast engorgement is one of a few common breastfeeding issues. Although your baby is ready to breastfeed from the moment they're born, your breasts don't actually make milk right away. Instead, breasts produce colostrum: a golden-colored, high-protein, concentrated fluid filled with nutrients and antibodies[2]. As your baby drinks colostrum, your breasts interpret that action as a sign to start making milk. A few days after delivery, your breasts will swell, become firmer, and possibly become tender—a process that may be uncomfortable or even painful.

Even after you've been breastfeeding for a while, you may experience breast engorgement if you haven't fed your baby or pumped in a few hours. In either case, the good news is that it's typically easy to address.

How to treat breast engorgement

The fastest, easiest way to address breast engorgement is to regularly breastfeed your baby, which prevents milk from accumulating in your breasts. Regular feeding not only keeps your newborn happy and full, it also helps your breasts "learn" how much milk to produce. During the day, your newborn should eat every two to three hours; overnight, go no longer than four hours without a feed[3]. As your body aligns with your baby's eating patterns, you should experience less engorgement.

Can breast engorgement happen even if I'm not breastfeeding?

The answer is yes. If you are not breastfeeding your baby, you may still experience breast engorgement, since your body's hormones are primed to make milk. You may wonder if you should pump to relieve engorgement, but that will only prompt your body to make more milk. Instead, avoid expressing any milk; within a week or so, your breasts will stop being engorged[4].

Do home remedies work for breast engorgement?

Some women swear by home remedies such as placing chilled cabbage leaves on the breasts to cool and soothe. At least one study has found that doing so might reduce pain[5], but doctors don't uniformly agree whether cabbage leaves (and other treatments such as acupuncture and herbal remedies) are effective[6]. 

Do I need to call a doctor about breast engorgement?

Most of the time, breast engorgement resolves on its own. But if your breasts feel especially tender or warm, develop red spots, or you develop a fever or chills, this could be a sign of lactation mastitis—a common and treatable condition common among breastfeeding moms. In this case, you should contact your doctor and look into some home treatments for mastitis.

Breastfeeding is a natural, wonderful way to feed your baby—and breast engorgement is part of the process. When you know what to expect (and how to deal!) you'll be well on your way to a more comfortable and enjoyable experience.

Find out how to avoid common breastfeeding issues so you and your baby can feel good during feedings.

[1] https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/02/breastfeeding-challenges

[2] https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Colostrum-Your-Babys-First-Meal.aspx

[3] https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/How-Often-to-Breastfeed.aspx

[4] https://www.uofmhealth.org/health-library/hw133953

[5] https://pubmed.ncbi.nlm.nih.gov/27820535/

[6] https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/02/breastfeeding-challenges