Dealing with breast tenderness caused by a large milk supply

What do I do if my breasts are always full and heavy?

Breast tenderness disappears on its own within a month or two after delivery. It can be more severe and persist for longer if mothers have a large milk supply. If the breasts are so full and uncomfortable that mothers need to do something, they can try breastfeeding whenever the baby is hungry, then massaging the breasts using a bit of cooking oil followed by green cabbage compresses. If mothers are still uncomfortable and feel they need to express milk to relieve the pain, they should express only as much milk as is needed to feel comfortable. Emptying the breast by expressing may increase the milk supply and may make things worse. If mothers have frequent or severe complications from full breasts, they may need to decrease their milk supply.

A) Describing breast tenderness caused by a large milk supply

Mothers who have a large milk supply are prone to overfull, tender breasts as their babies will only take in as much milk as they need and leave the rest behind (Dewey 1986). This is most common in the days and weeks after the baby's birth.

B) Treatment

1) Letting the tenderness pass naturally

If your breasts are tender but the discomfort is manageable, you don’t need to do anything. The tenderness will pass within a few months of delivery as the milk supply decreases to where it is more in line with the baby’s needs.   

2) Starting tools

If your breasts are so full and uncomfortable that you need to do something, you can use the same treatment as for engorgement. This includes:

  1. Breastfeeding when the baby is hungry.
  2. Massaging the breast using a small amount of cooking oil on your hands until the breasts are comfortable. This is about two to five minutes.
  3. Using green cabbage compresses.

3) Expressing

If you are still very uncomfortable and feel you also need to express, express only as much milk as you need to feel comfortable, not to empty the breast.

Emptying by expression can increase the milk supply and may force you to express more and more frequently just to be comfortable, creating a nasty cycle of a growing milk supply, increasing fullness, and more and more expression.

If you are already over-expressing and want to stop, express a little less at each session until you are no longer expressing. Combine this with massage and green cabbage compresses.

C) Decreasing the milk supply

If you are having frequent or severe complications, you may need to decrease your milk supply.

References

Dewey KG, Lönnerdal B. Infant self-regulation of breast milk intake. Acta Paediatr Scand. 1986 Nov;75(6):893-8