Breast Engorgement: Causes, Symptoms, and Ways to Relieve an Oversupply of Breast Milk

Breast milk is an ideal food for infants. It’s safe, clean, and has antibodies that protect babies from many common childhood illnesses. Breast milk provides all the energy and nutrients that an infant needs for the first months of life and continues to provide over half of their nutritional needs during the first year. 

Breastfeeding may seem like an easy, natural way to feed your infant. But challenges are common. One example is breast engorgement, which happens when you make too much breast milk. 

Having too much breast milk seems like a good problem for most new mothers. But too much of a good thing can be challenging, or even painful, in some cases. Let’s look at how to alleviate breast engorgement and what to do if you think you have an oversupply of breast milk.

What is breast engorgement or an oversupply of breast milk?

Breast engorgement happens when the breasts become too full of milk. Temporary engorgement is common in the first few days after giving birth, as your milk supply comes in. This will typically go away once you start to breastfeed more often. 

If it doesn’t go away, you may develop an oversupply of breast milk, which means your body makes more milk than your baby needs. This can cause your breasts to stay engorged. 

Engorged breasts are an underreported and often misunderstood problem. They can make it harder for your infant to latch, which may lead to fussiness or even early weaning. For mothers, overly full breasts can feel frustrating and may cause discomfort or pain while nursing. 

What are the signs and symptoms of breast milk overproduction?

One of the most common signs that your breasts are producing too much milk is breast pain and swelling. The pain may even be severe enough to disrupt your sleep. Along with painful, swollen breasts, you may also notice other changes in how your breasts look or feel. 

These symptoms include breasts that:

• Never seem to empty or feel soft after a feeding

• Refill very quickly after feeding

• Are painful with knife-like cramping or shooting pains

• Leak frequently between feedings, or excessive leakage from the side where the baby isn’t feeding

• Have a heavy milk “let-down reflex” (milk flow from the breast when stimulated)

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Because milk may come out forcefully when you have engorged breasts, your baby may have some trouble feeding. As a result, you may notice your baby:

• Arching their back or stiffening while nursing

• Choking, coughing, or gasping during the initial milk let-down

• Gulping quickly or taking multiple breaks while nursing

• Clamping down hard on the nipple to try to slow the milk flow

• Fussing, crying, or acting restless while trying to nurse

• Spitting up often

How to alleviate engorged breasts

Breast engorgement can be uncomfortable, but fortunately there are several ways to get quick relief. The fastest way to alleviate breast pain from engorgement is by encouraging milk flow. This immediately relieves the pressure. There are several ways to get relief, even if your child is not ready to breastfeed.

1. Frequent nursing or pumping

Block feeding is a common strategy for managing engorged breasts. This is where you offer the same breast for feedings within a certain time block. This helps lower milk volume to a comfortable level. Although it requires patience, you should feel less discomfort within 24 to 48 hours. 

Here’s how to try block feeding:

• Offer a feeding on the same side for a set period of time (like 2 to 3 hours). If your baby wants to feed again within that time block, offer the same side. They can nurse as often and for as long as they like, but only on that one side. 

• Let the other breast stay full. If it becomes uncomfortably full, express or pump just enough milk to be comfortable until the next feeding block. 

• Gradually increase the feeding intervals to 4 or 6 hours. 

• If there’s no improvement in your comfort level in 2 days, return to your former feeding schedule and talk to a healthcare professional or lactation consultant.

2. Feed on demand

Feeding your baby “on demand” means breastfeeding them whenever they appear hungry, instead of following a specific schedule. It’s best to feed on demand to help your body regulate the amount of milk it makes and limit overproduction. 

It can be helpful to base your feeding schedule on your infant’s hunger cues, such as:

• Moving their fist to their mouth

• Sucking on their hands or smacking their lips

• Turning their head to search for your breast

• Becoming more alert and active

3. Warm or cold compresses

Warm and cold compresses can both help offer relief when your breasts are engorged. Heat can help you empty your breast more easily, while cold helps reduce swelling and pain:

• Apply a warm compress for 3 to 5 minutes before breastfeeding to help with milk flow. Be careful not to use heat for too long, as it can lead to swelling and more discomfort.

• After feeding, if your breasts still feel sore, place a cold compress or ice pack on the area for 10 to 20 minutes.

4. Hand expression

If your breasts are overfull, gently massage your breasts and hand express milk for a minute before feeding (until your breast feels a bit softer). Hand expressing some milk gives you relief and makes it easier for your baby to latch on.

Hand expression also benefits your baby. It releases the first strong rush of foremilk, which is higher in lactose (sugar). Hindmilk is the milk at the end of a feeding and contains a higher fat content, which satisfies your baby longer.

5. Uphill latching

Feeding “uphill” or using the laid-back breastfeeding position helps to slow the flow of milk and makes it easier for your baby to latch. This position is especially helpful after a surgical delivery (C-section) if you have pain while feeding. 

Latching on is often easier if:

• You’re in a comfortable reclined position on a couch, sofa, or bed, with your back and head supported with a few pillows.

• Place your baby on your chest, belly-to-belly, in line with your body. Their nose should line up with your nipple. 

• Your baby will latch on eventually with very little assistance.

What causes breast engorgement?

Breast engorgement happens when your body makes an oversupply of breast milk. If enough breast milk isn’t removed through feeding or pumping, it can build up in your breast. 

The most common reasons for breast engorgement include:

• An increase in the hormone prolactin: This hormone stimulates glands in your breast to produce milk. Too much prolactin can lead to oversupply.

• Frequent nipple stimulation: This can lead to increased milk production.

• Over-pumping: Pumping too much tells your body to keep making milk to keep up with the demand.

• A strong let-down reflex: This happens when your milk releases with force, causing your baby to have a hard time keeping up with the flow. They may eat less, leaving more milk behind and causing fullness.

• Normal response: Some people simply produce more milk than others, and this can be normal for their bodies.

A healthcare professional can help you figure out what’s causing your symptoms and how best to relieve them.

When should you seek help for breast engorgement?

Overproduction of breast milk can be uncomfortable. You should see a healthcare professional if you have any of the following symptoms:

• Severe breast pain

• Redness or warmth in your breast

• Flu-like symptoms (like fever, body aches, or fatigue)

These may be signs of clogged milk ducts or an infection of the breast tissue (mastitis), which sometimes requires antibiotics.

Breast engorgement can also cause issues for your baby. Talk with your baby’s healthcare team if you’re noticing:

• Slow weight gain

• Difficulty latching

• Explosive stools

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Written by:

Kevin Connelly, DO

Kevin Connelly, DO, is a pediatric emergency medicine physician who believes health and tech can improve a person’s health. He's been a writer and medical consultant for Amazon, universities, startups, and national healthcare groups.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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