Breasts are made of a network of ducts, covered by a layer of fatty tissue. During pregnancy, estrogen and progesterone enlarge the milk ducts and multiply the glandular tissue that produces milk. After birth, estrogen and progesterone drop and prolactin and oxytocin rise. Prolactin makes milk production and oxytocin releases it into the ducts. Extra blood and fluid fill the breast just after birth to supoort your body adding hormone receptors in the breast to make milk. The blood and fluid surrounds the ducts and this extra pressure is what makes your breasts feel full between feeding. This blood and fluid reabsorb around 6-8 weeks once supply is established and you won’t feel that full/soft feeling except when you go a really long time between feeding or pumping. Breasts go back to prepregnancy size when supply regulates around 11-14 weeks but continue to make milk. When you wean from breastfeeding, it can take several months for prolactin levels to return to baseline (which is why you may still see milk for months after weaning). Once you stop breastfeeding, the milk making structures actually self-destruct – a process that involves massive cellular suicide, and the removal of the debris. Around 6 months after weaning, the milk-producing tissue is replaced with fatty tissue. If you return to your pre-pregnancy weight, your breasts most likely will return to the same size. They may not be as “perky” because the skin is a bit more stretched and the connective and fatty tissues in the breasts often shifts during pregnancy and breastfeeding. While they may look smaller after weaning most of us can expect that our breasts will return to a similar size as they were pre-pregnancy. They’re just a little more lived in and well loved.
There are two types of engorgement during breastfeeding.
🌞Primary engorgement occurs in the first week after birth. Hormones shift from pregnancy driven to breastfeeding driven.
🔆Breasts may feel lumpy/bumpy or hard as rocks.
🔆They may feel hot to the touch and you’ll often see visible veins on the surface of the skin.
🔆They can increase up to two cup sizes (or more!!).
🔆Breastfeeding or pumping makes the breasts soften.
🔆This marks the transition from colostrum to mature milk and typically lasts 12-48 hours if baby is frequently, efficiently breastfeeding
🔆Heat, massage, hot showers, hand expression and frequent, efficient feeding are the best to help with this transition
⏰Once your milk supply starts to regulate, around 6-8 weeks, you’ll no longer feel as full between feedings and the veining and huge breast size will go away. Around 10-12 weeks your breasts will transition back to prepregnancy size and you’ll no longer feel engorged between feedings at all.
🌚Secondary engorgement can happen at any time during your breastfeeding journey but usually when:
🌐Poor latch or inefficient feeding
🌐Change in feeding schedule
🌐Mom unable to pump frequently enough while away from baby
🌐Sleeping longer than normal
⏰Cool compresses before to help reduce swelling, hand expression, reverse pressure softening, gentle lymphatic drainage massage, emptying the breasts regularly and temporarily using cabbage leaf compresses can be helpful. If you can reduce the engorgement, schedule an appointment with an IBCLC to help.