Engorgement may occur when milk supply rapidly increases on or after the third day after birth. IV fluid use during labor may also contribute to engorgement. Your breasts may feel firm and lumpy. There may also be redness and swelling. Frequent breastfeeding reduces the likelihood of developing engorgement but does not always prevent its occurrence.

Cold compresses between feeds may reduce inflammation.  Ibuprofen may also help reduce inflammation and reduce pain.

A baby may have difficulty latching onto a breast when it is engorged, due to firmness in the areola. Reverse pressure softening, developed by K. Jean Cotterman RNC-E, IBCLC, is a technique to move edema out of the areolas in order to soften them for easier latching.

Another highly effective treatment for engorgement, is therapeutic breast massage, which involves gentle stroking of breast tissue toward the direction of the armpit, alternating with gentle hand expression. A small amount of olive oil may be used to reduce friction during massage. This technique is described by Maya Bolman.

Therapeutic Breast Massage in Lactation for the Management of Engorgement, Plugged Ducts, and Mastitis. J Hum Lact. 2016 Feb;32(1):123-31. doi: 10.1177/0890334415619439. Epub 2015 Dec 7. Witt AM1, Bolman M2, Kredit S3, Vanic A2. http://www.ncbi.nlm.nih.gov/pubmed/26644422

The technique is demonstrated in the following video at 2:50.

https://vimeo.com/65196007

If your breasts are engorged and your baby is not latching or is not softening your breasts when feeding, it is very important to remove milk from your breasts. Maintain frequent milk removal 8-10x daily by hand expression or pumping and find expert help for latching. Unrelieved engorgement may reduce milk supply or cause plugged ducts and mastitis.