Engorgement and Mastitis

When your milk comes in on day 3-5 postnatally, there’s a good chance you’ll experience some engorgement. This is normal and should settle after a few days


  1. If you’re in pain and your breasts are engorged, paracetamol and Ibuprofen help to relieve swelling and ease pain. Always check first with your GP, pharmacist or Midwife before taking any medications.
  2. If your breasts are rock solid and your baby is struggling to latch, place warm compresses onto the breast, massage gently and then hand express until the tightness and fullness has reduced.
  3. If the engorgement is severe, try getting in a hot shower or bath and hand expressing in there.
  4. Once the breasts are softer and more comfy, latch baby using a good technique and feed until your breast is drained. Your baby may only want one breast per feed so remember which one to feed from next time.

There’s a number of reasons you could end up with blocked ducts. A blocked duct is caused by the breast not being emptied during a feed. Stagnant milk sits in the duct causing a blockage. The breasts may become lumpy, sore and engorged.

The causes could be due to:

  • Baby not draining the breast fully.
  • Swapping breasts too quickly during a feed.
  • Taking baby off the breast too soon before the feed’s finished.
  • Missing a breastfeed or having long gaps between feeds.
  • Over supply, when there’s more milk than the baby needs so the breasts never fully empty.
  • A shallow latch, caused by poor positioning or attachment, tongue tie or a fast milk flow.
  • Tight clothing, obstructing the milk ducts during a feed.


Mastitis is inflammation of the breast. When a duct becomes blocked, breastmilk can leak into the breast tissue causing inflammation. If left the Mastitis may develop into an infection which can develop very rapidly and should be resolved as quickly as possible to prevent a breast abscess.

* Please note you are at further risk of infection if your nipples are cracked.

Signs of infected Mastitis:

  1. Fever, including a temperature of 38 degrees +, aches, chills, tiredness and tearfulness.
  2. An area on the breast that’s hard and lumpy, frequently accompanied by engorgement of the whole breast.
  3. The lumps on the breast are red, swollen, hot and extremely tender and painful to touch.
  4. Baby may refuse the infected breast as the milk can taste salty and the milk flow can be slow.
  5. Generally only one breast is affected.
  6. Sometimes there’s a bleb on the nipple. This is a small, painful white spot which can appear when ducts become blocked.


  1. To bring down temperature and inflammation take Ibuprofen and Paracetamol. Check with your GP, Pharmacist or Midwife before taking any medications.
  2. Use a warm compress on the breast and begin massaging the lumps out towards the nipple, preferably while your baby is breastfeeding.
  3. If it’s too painful or baby won’t latch, get in a hot bath or shower and try to hand express the lumps out. If possible breast-feed baby immediately after.
  4. Following the feed, put cold compresses onto your breasts and lie down, massaging outwards towards the chest wall. This helps reduce the swelling.
  5. If your symptoms persist make an appointment with your GP immediately as you may need a course of antibiotics.
  6. If your temperature spikes over 38 degrees and you feel really unwell, it’s advisable to go into hospital, taking your baby with you. If you’re unsure then call your hospitals maternity help number and speak to someone who can advise you.
  7. For more information read the NHS page on Mastitis:


After you have been treated it is advisable to seek support with positioning and attachment. Get a Midwife to check your latch or get breastfeeding support from a specialist to prevent reoccurrence.