Breast Swelling and Engorgement: Managing Discomfort Postpartum

Breast swelling and engorgement are common challenges new mothers face in the early postpartum period. While some swelling is expected as milk production increases, excessive engorgement can cause discomfort, pain, and difficulty with breastfeeding. If not managed properly, this can lead to blocked ducts and Mastitis.

Fortunately, physiotherapy techniques like Manual Lymphatic Drainage (MLD), massage, therapeutic ultrasound, and proper positioning, along with guidance from a lactation consultant, will help reduce swelling and improve breastfeeding comfort.

Why Does Breast Swelling Occur After Birth?

Breast swelling is caused by a combination of increased blood flow, lymphatic congestion, and milk production. Common causes include:

• Milk Coming In – In the first few days after birth, the transition from Colostrum to mature milk can cause temporary swelling.

  
  

• Fluid Retention – Postpartum hormonal shifts and Intravenous Fluids (IV) fluids from labor can contribute to fluid buildup in breast tissue.

  
  

• Poor Milk Drainage – Infrequent or ineffective breastfeeding can lead to engorgement, where milk builds up and causes excessive pressure.

  
  

• Blocked Ducts & Mastitis – If milk is not fully drained, ducts can become clogged, leading to localised swelling and inflammation. If untreated, this can develop into Mastitis - an infection that may cause breast pain, redness, fever, and flu-like symptoms.

Swelling and engorgement usually peaks 3-5 days postpartum but can persist if not managed properly.

How can Physiotherapy Helps Reduce Breast Swelling, Blocked Ducts & Mastitis Risk?

Physiotherapy techniques can provide relief from breast swelling and help prevent complications like blocked ducts and Mastitis.

• Manual Lymphatic Drainage (MLD) – MLD is a gentle hands-on technique that stimulates the lymphatic system to reduce fluid congestion in swollen breast tissue. Light strokes around the breast, armpits, and neck area can encourage natural drainage.

  
  

• Therapeutic Breast Massage – Gentle massage techniques, such as reverse pressure softening, help move fluid away from the nipple, making latching easier and promoting better milk flow.

  
  

• Therapeutic Ultrasound for Blocked Ducts – Low-intensity ultrasound therapy helps break down hardened milk clogs by increasing blood flow, reducing inflammation, and softening the blockage for easier milk drainage. This non-invasive and painless technique is highly effective in treating blocked ducts and preventing mastitis.

  
  

• Cold Therapy – Applying cold compresses after feeding help reduce inflammation and pain.

  
  

• Optimal Breastfeeding Positions – Ensuring a good latch and experimenting with different nursing positions (such as the laid-back position or football hold) can improve milk drainage and reduce engorgement.

  
  

• Postural Adjustments & Movement – Avoiding hunched shoulders while feeding and practicing gentle shoulder exercises can promote better circulation and lymphatic drainage.

Mastitis: Signs, Prevention & When to Seek Help?

Mastitis occurs when a blocked duct becomes inflamed or infected, leading to:

• Pain, swelling, and redness in one area of the breast

  
  

• Fever, chills, and flu-like symptoms

  
  

• A burning sensation during or after breastfeeding

To prevent Mastitis:

•  Breastfeed frequently and ensure a deep latch

  
  

•  Massage any firm or tender areas to encourage drainage

  
  

•  Use MLD and therapeutic ultrasound if experiencing persistent blockages

  
  

•  Consult a lactation consultant for help with positioning, latch issues, and effective milk drainage

If Mastitis symptoms develop, early intervention is key. Please seek medical treatment if symptoms persist beyond 24 hours, as antibiotics may be needed for infection.

Conclusion

Breast swelling, engorgement, and blocked ducts can be uncomfortable, but MLD, therapeutic ultrasound, massage, warm and cold therapy, and proper breastfeeding techniques can help manage symptoms and prevent complications - Mastitis.

If you’re struggling with persistent breast swelling, blocked ducts, or breastfeeding discomfort, book a session with me at PhysioMatters for expert physiotherapy support.

Claire

Senior Physiotherapist