Breast engorgement and mastitis: causes, symptoms & how to treat it at home

Your mature milk (the white milk that follows colostrum and the clear/white tinged transitional milk) will most likely start ‘coming in’ shortly after you leave the hospital on day 3 or 5, although it happens sooner for some moms.

Initially, your body tends to produce more milk than your baby needs, which can make your breasts feel swollen and painfully overfull (this is also referred to as engorgement). After about six weeks your breasts will naturally adjust to your baby’s feeding requirements. In the meantime, though, it’s essential that you prevent engorgement.

Causes of breast engorgement

There are a number of causes of breast engorgement, including:

• Your body producing more milk than your baby can drink.
• Skipping a feed or allowing more time than usual between feeds so there’s a build up of milk.
• When you suddenly stop breastfeeding.
• Your baby drinking less milk than usual, for example when they start solids.

How to treat and prevent breast engorgement at home

• If your breast is already engorged (it will feel swollen and more firm than usual), it can make it difficult for your baby to latch. Expressing a bit of milk using your hand or a breast pump will help ‘soften’ the breast and make it easier for your little one to latch.
• Apply warm heat before feeding: have a warm shower, massage the breasts with a facecloth.
• Put the baby to your breast (not the other way around!), and make sure they are latched correctly in order to effectively drainage the breast of milk.

ALSO SEE: Our expert paediatrician answers your most asked questions

Common causes of mastitis:

If breast engorgement isn’t treated, or is treated incorrectly, it can lead to inflammation or an infection in a milk duct, called mastitis. Mastitis can also be caused when nipples crack or blister, allowing bacteria to enter via the skin.  

Symptoms of mastitis:

• Fever.
• Chills & typical flu-like symptoms.
• A red or tender wedge-shaped area on the breast (mastitis usually only affects one breast).
• Pain and extreme exhaustion.

How to treat mastitis at home:

Caught in the early stages, mastitis can be treated at home. But if the below treatments aren’t successful, see a doctor who may prescribe an antibiotic. If mastitis isn’t adequately treated, it’s more likely to return.

• Apply a warm compress before feedings.
• Do some gentle breast massage.
• Keep breasts empty by frequent nursing or expressing. Continue to feed, feed, feed! Yes, even on the affected side.
• If your baby doesn’t empty the breast on the affected side, use a breast pump after feedings to drain the remaining milk from the breast.
• Apply ice after feedings for 10-15 minutes for the first day or two.
• Take anti-inflammatories.
• Rest in bed as much as you can.