Breastmilk oversupply and breast engorgement: getting help

Your midwife, child and family health nurse or GP or the Australian Breastfeeding Association (ABA) can support you with breastfeeding your baby. They can also help you find a lactation consultant if you need one.

An ABA counsellor can also help – phone the National Breastfeeding Helpline on 1800 686 268 or use ABA LiveChat.

This article is about how to manage breastmilk oversupply and breast engorgement. If you’re having other issues with breastfeeding, you could check out our articles on how to increase milk supply, breastfeeding attachment techniques, sore nipples and nipple infections and mastitis and blocked ducts.

Breastmilk oversupply

Breastmilk oversupply is when you make more milk than your baby needs.

It’s normal to have an oversupply of breastmilk in the first few weeks after birth. But it’s good to know that your supply will usually settle down.

Oversupply of breastmilk might be the issue if your baby:

• has a tummy ache or wind
• has a lot of wee
• has green frothy poo
• cries a lot
• gags or coughs because they can’t cope with the flow of your milk.

You might also notice that your breasts seem to fill quickly or feel lumpy and tight after breastfeeding.

If oversupply sounds like the issue, you can try any of the following:

• Look for your baby’s  early hunger cues. Your baby might make sucking noises or open their mouth wide and turn towards your breast. If you offer the breast early, your baby can attach to and drain your breast more easily.
• Feed when you see your baby’s hunger cues, so that you’re feeding to their need. But if your baby is sleeping and oversupply is making you very uncomfortable, you might want to wake your baby to feed.
• Allow your baby to feed from one breast as long as they want. Try to make sure the first breast feels well drained before you offer the other breast.
• Check your position and technique – our illustrated guide to breastfeeding techniques and illustrated guide to breastfeeding positions might help. Your breast drains better if baby is well-attached.
• At the start of a feed, gently lean or lie back in a relaxed position with your back well supported. This will help to slow down your milk flow.
• Express a little bit of milk if your breasts feel uncomfortable. But too much expressing will make more milk, so express just enough to relieve pain or discomfort.
• Use reverse pressure softening to soften the part of the breast that your baby will attach to. This will make it easier for your baby to attach.

If you’re still having trouble speak to your midwife or child and family health nurse, a lactation consultant or an ABA counsellor. They’ll help you find another solution that works for you.

Breast engorgement (full, sore breasts)

Breast engorgement is when your breasts get full and sore because milk and other fluids build up in them.

Breast engorgement is most likely to happen in the first week after birth. But it can also happen at other times, like when babies miss a feed.

Breast engorgement can be quite uncomfortable. It can feel like your breasts are much heavier and warmer than usual, and it can even hurt to breastfeed.

The best way to deal with breast engorgement is watching for your baby’s early hunger cues and feeding your baby more often. Here are other tips to help you get some relief from breast engorgement:

• Wear a well-fitting, supportive bra or crop top, but make sure it’s not too tight. Take your bra off completely before beginning to breastfeed.
• Warm your breasts with a warm (not hot) cloth for a few minutes before breastfeeding. This can help your let-down.
• Hand-express a little milk or try reverse pressure softening before starting the feed. This can help your baby attach more easily. Make sure baby attaches well.
• Massage your breast gently while breastfeeding.
• Vary breastfeeding positions. For example, you could try the cradle hold at one feed and the football hold at the next.
• After breastfeeding, place an ice-pack or a bag of frozen peas wrapped in cloth on your breast to relieve pain and swelling. Some mothers find that it helps to put chilled cabbage leaves over their breasts.

If your breasts are engorged for more than 1-2 days, especially in the early days of breastfeeding, talk with your midwife, child and family health nurse, lactation consultant or an ABA counsellor. They might suggest you try an electric breast pump after one of your breastfeeds to completely drain both breasts and ease the pressure.

It might help to know that milk supply usually adjusts to match your baby’s needs over the first few weeks after birth.