Breastmilk oversupply and breast engorgement: getting help

If you’d like some help with breastfeeding, support services are available. 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.

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 might be the problem if your baby has a lot of wet and dirty nappies, and if you’re noticing other issues with or after feeds.

For example, your baby might seem to have a tummy ache or wind, or baby might be crying a lot and fussy, especially after feeds. Often your baby won’t want the second breast.

In some cases, milk seems to flow very quickly, and your baby can’t swallow fast enough to keep up. Your baby might gag or gulp, especially at the start of a feed.

Other symptoms include baby vomiting after a feed or having green and frothy poos.

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

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

• Feed when your baby is hungry rather than to a set schedule. When babies are hungry, they might make sucking noises or open their mouths wide and turn towards your breast.
• Feed from only one breast at each feed. Put your baby back on the same breast if they need a top-up soon after the feed. Use the other breast for the next feed 3-4 hours later.
• 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.
• 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.

Breast engorgement (full, sore breasts)

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

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.

To get some relief from breast engorgement, you could try the following tips:

• Wear a well-fitting, supportive bra. Take your bra off completely before beginning to breastfeed.
• Warm your breasts with a warm cloth for a few minutes before breastfeeding to 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 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 a day or two, especially in the early days of breastfeeding, talk with your midwife, child and family health nurse or lactation consultant. 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.