Frequent (but not excessive) removal of breast milk is the primary treatment for breast engorgement, which means either the infant or a pump must effectively drain milk from the breasts. If breastfeeding, there are some simple techniques to help an infant achieve better feeds from an engorged breast and thus treat the condition. Manual expression of small amounts of milk prior to beginning a feed can soften the breast and help the infant latch onto the nipple more easily. Just remember to keep the amount of expressed milk small because overstimulation will worsen the problem. Reverse pressure softening, pressing into the chest wall with 2 fingers on each side of the nipple, can also help an infant latch on by pushing fluid away from the nipple. If the engorgement is causing a strong let down (ejection of milk), breastfeeding in a reclined position can slow the flow of milk and improve infant feeding.[1][2]
Comfort measures are another important aspect of treating breast engorgement. One of the most common methods of reducing pain from engorgement is the use of cold compresses for 15 to 20 minutes between feedings. The compress can be an ice pack, a bag of frozen vegetables, cabbage leaves, or an herbal compress.[3] Heat, applied via a warm shower or warm pack, is sometimes used to facilitate milk removal; however, heat should be limited to only a few minutes immediately prior to a feeding because heat increases blood flow and can worsen breast swelling. Breast massage, acupuncture, and ultrasound therapies have also been used to treat breast engorgement, but there is limited evidence on their efficacy. Of the three methods, gentle massage is the most promising for symptom relief.[1] Additionally, wearing a well-fitting bra that is supportive but not overly tight can reduce discomfort.