Dealing with Pain and Engorgement

Especially in the early weeks of breastfeeding, you may experience swelling and tenderness of the breasts. As your milk comes in, your breasts will become engorged and full of milk, and it will take a little while for your body to regulate milk production so this doesn’t happen all the time.

Breastfeeding is supply and demand – the more your baby nurses, the more milk your body produces. In the first weeks, your body needs to figure out how much milk it needs to make in order to meet your baby’s needs. This process usually begins with a lot of milk being produced, but soon the production will settle down to the right level. In the meantime, there are some steps you can take to ease the discomfort.

Relieving Engorgement

The quickest way to relieve engorgement is to let the baby nurse. If baby is sleeping or not hungry, you can express a small amount of milk to take some of the pressure off, but use caution. Expressing too much will tell the body that the baby needs more, setting off higher levels of milk production and making the engorgement worse! The best way to express only a small amount of milk is to do it by hand, avoiding the breast pump. Try taking a warm shower and gently massaging the breasts until the milk lets down. Just the warm water and massage will ease the pain, even if no milk is released. However, if you can get a small amount of milk to come out this way, it will also take off some of the pressure.

Use warm compresses prior to nursing and cold compresses in between feedings to bring down the swelling. Using a cold compress prior to nursing will make it difficult for the milk to let down for baby. A great way to make a cold compress is to put some water in a newborn size diaper and put it in the freezer. Then, simply slip one into each side of your bra for soothing relief. Some women also use cabbage leaves as compresses to relieve engorgement.

Other Sources of Pain

Not all pain during nursing is caused by engorgement. Your nipples may become painful, red and crack or even bleed, especially as they get used to nursing. Lanolin ointments can help to relieve the dryness and cracking. Cold compresses will also help with pain. Make sure to gently clean nipples after nursing and allow them to dry before putting your bra back on to help prevent further problems.

Mastitis, a painful infection of the milk ducts, can occur anytime during breastfeeding, but is most common in the early months. It happens when a milk duct becomes clogged and it is not relieved quickly. Avoid mastitis by making sure to empty the breast completely, nursing baby on both sides equally, and dealing with any sign of a blocked duct quickly. If you notice a tender spot on the breast, a hard area where engorgement is not relieved in spite of nursing, or a general feeling of pain in the breast, you may have a blocked duct. Massage the area gently, apple heat, and allow the baby to nurse regularly to free the blockage. If you notice redness, swelling, or the pain does not go away within a few days, contact your doctor.

Some pain and discomfort during the early stages of breastfeeding is normal, and should resolve within a couple of months. With careful treatment and precautions, you can avoid most breastfeeding pain. However, don’t hesitate to call your doctor if you have continuing problems.

Potential Issues with Breastfeeding and Their Solutions

Breastfeeding is the best way to feed your baby, but that’s not to say that the natural way always feels natural and goes without a hitch. There are problems many mothers face when starting to breastfeed their child and other problems develop down the road as new developmental stages develop.

A Poor Latch

The first problem many mothers face is a poor latch. When a baby doesn’t hold the nipple correctly in his mouth, it can be frustrating for the baby who can’t get the food he’s desperately seeking and exquisitely painful for the mother. A poor latch can result in painful breastfeeding and even extremes such as cracked and bleeding nipples.

A lactation consultant or pediatrician can show you the correct way to latch your baby onto the nipple if you are having trouble. Resolve latching issues as quickly as possible as this issue can spell the end to breastfeeding if both mother and baby are overwhelmed and frustrated. When latching, the baby should open his mouth wide to take in the nipple. Almost the entire nipple enters the mouth with the point of the nipple facing slightly up. If your baby latches incorrectly, break the seal his little mouth creates by slipping a pinky between your breast and his mouth and try again. Keep trying until you get it right, otherwise, you’ll be in serious pain and your baby might not get enough to eat.

Inverted Nipples

If your nipples pull in instead of pointing out, your baby might have a hard time getting latched on. You can help resolve this by using a nipple shield. This gives your nipple the shape the baby needs for a correct latch. As the two of you get more familiar with the process over time, you can remove the shield to see if he’s able to latch effectively without it.


When you don’t feed your baby fast enough, or when your body steps up milk production, your breasts will swell with milk until they are hard and painful. If they get too hard, your baby will have a difficult time latching on, but the only real solution is to have your baby nurse or to pump away the extra milk. If your baby can’t latch onto your engorged breast, express some of the milk using your palm to apply pressure on top of the breast. This might reduce the hardness. Once he starts feeding the pressure should continue to reduce. Pumping with a breast pump can reduce the engorgement as well, plus you get milk to store, which is always a plus.

Chapped Nipples

After a few days you might notice that your nipples are chapped and possibly cracking or bleeding. This might have to do with a poor latch if pressure is distributed wrongly, but if your latch is fine, it is more likely due to combination of conditions that causes chapped lips. Baby’s little mouth leaves your nipples wet and the abrasion on your bra or breast pad irritates and dries out the tender skin until it becomes chapped. When this happen, don’t use petroleum jelly as it isn’t safe for your baby. Instead use a product designed for this situation. Lanolin is a product that creates a heavy duty moisture barrier that is safe for baby. Once the chapping is resolved, you can prevent it by continue to use just a dab of lanolin or by allowing your breasts to air dry before putting on your bra after a feeding.


Mastitis is an infection of the breast tissue that can make you feel sick as if you are having a flu. Redness, heat, swelling and tenderness of the breast are signs of mastitis in a breast. It is normally only in one breast at a time, and you are safe to feed your baby while you have mastitis unless your doctor tells you otherwise. In fact it could be your baby who is causing the infection due to the contact of a foreign body.

Use warm heat on the affected area and have your baby nurse more often. Try to empty the breast completely. If this doesn’t work, see your doctor who will give you antibiotics and prescription. Do not ignore mastitis; it can lead to abbesses in the breast which might require surgery to drain together with very strong antibiotics.