Engorgement is unfortunately a common experience
(common does not mean normal!)

Breasts become overly full - engorged - from either too much milk or too much bodily fluid (or both!). Engorgement is most common in the first few days after birth, but it can also happen later in your lactation journey if your milk is backed up for any reason.

Engorgement is exacerbated by:

IV fluids during labor (if your ankles are swollen after birth, your breasts are too!)
Less effective milk “removal” due to breastfeeding or pumping issues
Scheduled or missed feedings/pumping that lead to longer intervals than your breasts can comfortably hold.

Any of this can lead to reduced/inefficient milk removal, and cause the milk to get “stuck” - leading to pain, inflammation and possibly plugged ducts and mastitis.

Engorgement is aided by:

Breast Stretches (also called “breast gymnastics”) and Therapeutic Breast Massage - these videos also show hand expression - more on that below.
- A few more on breast gymnastics in Instagram - One, Two
- A colleague and me doing breast gymnastics as the “Breast-y Pokey”
Lymphatic drainage - Video and Instagram Post
Reverse Pressure Softening - softens the areola to help a baby latch, or for pump flanges to fit better.
Cabbage Leaves and/or CaboCreme
More Engorgement Tips From KellyMom
For professional therapeutic breast massage - in NJ I highly recommend Rena' Ambrose of Mend Lymphatic Massage and Wellness Services. If you are in another area, check with your local IBCLC!
Effective pumping (including correct flange sizing which is almost definitely smaller than you think!)
And - for sure - Hand Expression - NEXT!

Hand Expression is literally a “handy” skill!

To express/collect colostrum before baby is born.
After the baby is born - colostrum is sticky and tends to get stuck on pump parts. This makes hand expression a great way to get milk and stimulate your supply if the baby is not nursing well or needs extra milk. Hand express into a spoon or small cup and you’ll have enough to fill your newborn’s tiny tummy!
Great add-on to pumping for some extra milk/stimulation.
Great way to relieve a plugged duct or milk bleb
If you have lost power or are without your pump

Great videos to help