Breast engorgement

It is quite normal for your breasts to feel firm and swollen in the early days after birth, although it can also happen later on. With both types of engorgement, the most helpful thing you can do is to breastfeed often.

Gem
Mor har brystspænding

What can you do about physiological breast engorgement?

Hvis du får ømme og spændte bryster 2-4 dage efter fødslen, er der typisk tale om fysiologisk brystspænding. Swipe her for at se forslag til at lindre smerten. Eller scroll længere ned for at læse om den anden type brystspænding (mælkebrystspænding).

How can you tell if it’s physiological breast engorgement?

Physiological breast engorgement typically appears 2–4 days after birth, when extra blood and fluid flow to the breasts as they prepare to produce milk. This is completely natural, but it can feel very painful, and the breasts may become so firm that your baby has difficulty latching.

Breast tissue also extends slightly towards the armpit, so the tightness can often be felt under the arm. You may also have a slight fever of up to 38.5°C. Within about a week, the engorgement will usually settle by itself. Until then, there are several ways to relieve the discomfort.

Expressing milk disturbs milk production

Expressing milk is not helpful in this situation. With physiological engorgement, the swelling is caused by extra fluid and blood—not by the milk itself. Hand-expressing may stimulate the breasts to produce more milk and can therefore make the engorgement worse.

Offer the breast often

This helps soften the breasts as your baby removes milk, and—unlike expressing—it does not overstimulate milk production.

Apply firm pressure to the brown area around the nipple

Sometimes gentle, steady pressure toward the chest—known as Reverse Pressure Softening—can help move fluid away from the nipple area.

Place your fingers on the areola close to the nipple and apply steady pressure for about a minute. Then move your fingers to another spot and repeat until the area feels softer.

Apply cool compresses to the breasts between feedings

Applying cool compresses to the breasts for 10–20 minutes between feeds can help ease pain and reduce swelling, allowing the milk to flow more comfortably. A damp cloth placed in a plastic bag and cooled in the fridge works well.

Gentle massage can relieve tension in the breast

Careful massage of the breast can help prevent and reduce breast engorgement. Massage the breast with light, calm strokes away from the nipple. This helps fluid that has built up in the breast move away. As the tension decreases, milk can flow more easily when you breastfeed.

See how to massage in this video.

Gentle movement can reduce tension and pain in the breast

When you have breast engorgement, the breast may feel hard and sore. This can make it difficult for your newborn to latch on properly.

Gentle movement can help. Move the breast carefully in small circles. This can relieve soreness, reduce tension, and make the breast softer.

When the breast becomes softer, your baby can more easily latch onto the nipple. See the video to learn how to do it.

Apply warm compresses to the breasts just before feeding

Some people find that milk flows more easily when the breasts are warmed just before feeding. You can use a warm compress or let warm water run over the breasts. Try and see what feels most helpful for you.

Pain relief medication can reduce pain and swelling

Pain relief such as paracetamol (Pamol, Panodil or Pinex) and ibuprofen can help reduce pain and swelling. Do not use pain relief for more than seven days without medical advice.

Make sure to wear a good, supportive bra

If you use a nursing bra, make sure it offers good support and is not too tight. A tight bra can restrict milk flow.

Take care of yourself and get enough rest and fluids

Take care of yourself and try to get enough rest and fluids. You may need support to take a nap or to drink more.

What can you do about milk engorgement?

Mælkebrystspænding kan komme kort tid efter fødslen, når mælken løber til, eller senere i ammeperioden, hvis mælken hober sig op i brystet. Swipe for at se, hvordan I kan lindre smerter ved mælkebrystspænding.

How can you tell if it’s milk engorgement?

Milk engorgement often occurs when the milk comes in 2–4 days after birth, as milk supply is usually high at the beginning. It may take a couple of weeks before the milk adjusts to your baby’s needs.
Engorgement can also occur later if milk builds up—for example, if your baby suddenly sleeps longer stretches or if you are away and unable to breastfeed as often.

Common symptoms include:

  • Gradual onset rather than sudden
  • The breast feeling firm, swollen and warm, sometimes with pain
  • Red areas or noticeable lumps
  • A slight fever (up to 38.5°C) without flu-like symptoms.

Offer the breast as often and as long as your baby wants

The most effective way to relieve milk engorgement is to keep the milk flowing by breastfeeding. Offer the breast whenever your baby shows signs of wanting to feed, and let them feed for as long as they need. Your milk supply will gradually adjust to your baby’s needs.

Take a break from the dummy

If your baby uses a dummy, they may fall asleep with it even though they might have fed a little more. When milk builds up, the engorgement can worsen or lead to mastitis.
Try taking a break from the dummy and offer the breast instead.

Help your baby get a good latch

Your baby feeds most effectively when they have a deep latch. If the latch is shallow, slide a clean finger into the corner of your baby’s mouth to release it and try again, perhaps in another position. Different holds work differently for each baby. Key points:

  • Your baby should face you directly, chest-to-chest, without turning their head. If they turn away, you can help by expressing a few drops of milk onto the nipple.
  • The nose should line up with the nipple so they can tilt their head slightly back to latch.
  • The mouth should open wide before being brought to the breast.

If your baby cannot latch because of very flat or inverted nipples, a nipple shield may help. Speak with your health visitor or maternity staff first, as nipple shields may affect milk supply.

How to see if your baby has a good latch

A good latch looks like this:

  • your baby’s chin rests against the breast and the nose is clear
  • the mouth is wide open and the lips—especially the lower lip—are turned outward
  • the lower lip takes in more of the areola than the upper lip
  • your baby makes steady sucking and swallowing movements.

Watch the video to see what it looks like if a baby has a good latch.

Try moving the baby a little at the breast

When positioning your baby, make sure they do not have to stretch to reach the nipple. Holding them close, chest-to-chest, often works best—especially in the laid-back position. Sometimes just a small adjustment can make feeding feel much more comfortable. Trying another position may also help. Try different positions and see which feels most comfortable.

Hand-express a small amount of milk

If your baby cannot latch onto a very full breast, hand-expressing a small amount can soften the breast and help them latch.

Avoid expressing too much, as this can stimulate further milk production and worsen the engorgement or increase the risk of mastitis.

 

Try breastfeeding in different positions

Changing positions helps your baby drain different areas of the breast. The area toward which the chin points is usually emptied most effectively.
Position your baby so the chin points toward any firm or tender areas. Feeding in different positions prevents milk from building up.

If you’re still struggling with milk engorgement

If your breasts remain swollen and sore after frequent breastfeeding and ensuring a good latch, you can also try one of these tips:


Try applying cool compresses to the breasts for 10–20 minutes between feedings. Cool compresses can relieve pain and reduce swelling, allowing the milk to flow more freely. For example, use a damp cloth placed in a bag and cooled in the refrigerator.


Some breastfeeding mothers find that milk flows better when the breasts are warmed before feeding. Use a warm compress or take a warm shower. Try and see what works for you.


You can gently mobilize the breasts by moving them in circular motions – first one way, then the other, and finally up and down. Continue for about 5 minutes and repeat if needed. Because the breasts are sore, mobilizing may feel uncomfortable at first, but for most people, the discomfort will decrease or disappear after a short time.


Careful massage of the breast can help prevent and reduce breast engorgement. Massage the breast with light, calm strokes away from the nipple. This helps fluid that has built up in the breast move away. As the tension decreases, milk can flow more easily when you breastfeed.

See how to massage in this video


Pain relief such as paracetamol (Pamol, Panodil, or Pinex) and ibuprofen can relieve pain and reduce swelling. Do not take pain relief medication for more than 7 days.

Ask your health visitor for advice

Your health visitor can offer further advice and support with managing engorgement.You can also read more about where to get help

Read more about where to get help

Watch videos on how to relieve engorgement

engorged breast
Mor har brystspænding

Good to do

  • Feed often and check your baby’s latch; this helps milk flow and reduces discomfort.
  • Remember that there are two types of breast engorgement, and the advice is slightly different for each.
  • Ask your health visitor if you need more support.

Related content

Who can you contact?

Oplever I små eller store udfordringer med amningen? Hold jer ikke tilbage, hvis I har brug for at få råd og vejledning af en professionel. Swipe for at se, hvem I kan kontakte, og hvornår.

Who can you contact at the maternity ward?

You can contact the maternity-ward staff both during pregnancy and after birth.

Before birth, your midwife is the person to speak with about the early time with your baby and your thoughts about feeding – whether breastfeeding or bottle-feeding. If you have had previous breastfeeding problems, you can create a plan together.

Most maternity wards also offer antenatal classes, and your midwife can inform you about these.

After giving birth, you can receive help with breastfeeding from staff on the delivery or maternity ward while you are admitted.

All parents can also contact a breastfeeding hotline at their maternity ward within the first week after birth if they need help or guidance.

You can contact your municipal health-visitor service

The health-visitor service is available to all pregnant and new parents in Denmark. After birth, you will be offered free home visits with support and guidance to help you get a good start with your baby.
Depending on your municipality and your stage in the process, different services and contact options may be available.

Some municipalities offer prenatal visits from a health visitor, where you can discuss breastfeeding, bottle-feeding, and preparing for life as a new family. Check your municipality’s website to see whether this is available where you live.

If you have special needs, you can contact the service to ask whether prenatal visits are offered to you.

Your health visitor will contact you and offer the first home visit. You can always call your municipal health visitor service for advice or guidance.

You can contact your GP if needed

Always speak with your doctor if you are pregnant or breastfeeding and need medical treatment. In most cases, there is a medication that is safe to use during pregnancy and breastfeeding.

Contact the on-call doctor or call 112 in an emergency

For sudden illness or worsening symptoms that cannot wait until your GP is available, or for minor injuries, you can contact the on-call doctor – or call 1813 if you live in the Capital Region.

In emergencies, if something is life-threatening or dangerous, call 112.

Contact volunteer breastfeeding counsellors

You can also contact volunteer breastfeeding counsellors if you need advice or guidance. Denmark has two support organisations: Forældre & Fødsel and Ammenet. The volunteers are mothers who have breastfed themselves, and both organisations provide guidance based on the recommendations of the Danish Health Authority.

Get help from Forældre og Fødsel

Get help from Ammenet