Swollen, engorged breasts can be very uncomfortable, and might make it tricky for your baby to latch well to nurse. It is very common to experience swollen breasts as your milk is “coming in”, usually about 3-5 days after birth if you are a first-time mom, and about 2-3 days after birth if you have had other babies.
What you can do to help with breast swelling and engorgement:
- Empty your breasts as much as possible.
Nurse at least every two to three hours throughout the day/night in the first few weeks after the baby is born. As long as your baby is latched on and drinking well, let her nurse for as long as she would like.
If your baby will not nurse well, you will need to pump and/or manually express (using hand expression) your breasts at least every two to three hours. During the first week, pumping in addition to nursing may be necessary to help with your engorgement. However, after the first week frequent pumping may cause your body to make too much milk. Check in with a lactation specialist if swollen, engorged breasts are still a problem for you after one week.
- Before nursing or pumping, apply heat to your breasts.
A warm shower, a warm washcloth directly on your breasts, or resting your breasts in a bowl of warm water can help to get the breastmilk flowing.
- Before nursing or pumping, massage your breasts.
Massaging your breasts before nursing or pumping can help with your milk flow. You can massage your breasts either during or after applying heat. To massage your breasts, first lay flat on your back on a comfortable surface like your bed. Lying on your back will allow you to massage all areas of the breasts, particularly the underside of the breasts. Starting with one breast, use your fingers to gently make small circles over your breast, moving from your chest wall toward your nipple, and then around your breast.
- After nursing or pumping, put something cool on your breasts.
You may use cool compresses or cold packs such as ice packs, bags of frozen vegetables or frozen wet towels on your breasts. Place these very cold items in a pillow case to prevent frostbite to your skin. Place them over your breasts for 15-20 minutes, lying flat on your back. These cold items will help to decrease the swelling in your breasts.
- Lie down on your back as much as possible.
Lying down helps to elevate the breasts, for the same reason you would put your legs up if they are swollen. Keeping your breasts elevated will help to move the extra fluid back into your body.
- Take an anti-inflammatory medication.
Talk with your care provider about taking a medicine like ibuprofen to help you if your engorgement is painful.
- Use a technique called “Reverse Pressure Softening”.
Reverse Pressure Softening is a special type of breast massage that makes it easier for your baby to latch on when your breast is hard and full. Reverse Pressure Softening involves using your fingers to push on the breast around the areola (the dark part around the nipple) in order to get rid of the swelling that is around the nipple. The goal is to make the area around your areola softer and more compressible so your baby can latch on deeply to your breast when nursing.
Here are the steps to do Reverse Pressure Softening:
- Lie back in a chair or on a large pillow in bed, making sure you can see what you are doing to the areola region of your breasts. Firmly, but gently use your finger tips to press steadily on the areola, right where it meets your nipple.
- Press inward toward your chest wall for a full minute or longer. If you need to, you may continue to press for 2 to 5 minutes as needed.
- Do not press so hard that it hurts. If it is painful, press softly, but for a longer time.
Here is a good YouTube video that demonstrates Reverse Pressure Softening:
- Wear a well-fitting, supportive bra that is not too tight.
An underwire bra or a small, tight bra can be very uncomfortable, and make the swelling and engorgement of your breasts worse. Find a comfortable bra that is stretchy but still supports your breasts, with no underwire.
