engorgement vs mastitis

Engorgement vs Mastitis: What’s The Difference?

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Breastfeeding is a beautiful experience for both the mother and her baby. It creates an unbreakable bond and provides essential nutrition for the baby. However, it can also come with challenges, including understanding breast engorgement vs mastitis. These conditions can occur anytime and cause discomfort and pain, making it difficult to continue breastfeeding. In this article, we will discuss the difference between engorgement and mastitis, their causes, symptoms, and treatment options.

comparison of engorgement vs mastitis

How to tell the difference: Engorgement vs mastitis

FeverNo fever
Painful, hard lumpMay/may not be a painful lump
Extreme tirednessNo extreme tiredness
Body achesNo body aches
Shivers and flu-like symptomsNo shivers or flu-like symptoms
Emptying the breast does not relieve the symptomsEmptying the breast relieves the symptoms
Red, angry, hot area on the breastNo red, angry, hot area on the breast
Extremely tender breastA tender breast that can still be touched

Here’s what you need to know:

What is engorgement?

Breast engorgement is when there is an overabundance of milk in the breast tissue, causing them to feel swollen, hard, and quite tender. It can happen at any point during your breastfeeding journey, but it’s especially common during the first few weeks after delivery as your body adjusts to your little one’s feeding needs. When your hormones shift, the blood supply to your breasts increases and you make more milk; you’ll feel as if your breasts are fuller. Basically, engorgement arises when milk is not being effectively drained from your breasts, leading to a backlog of milk (known as milk stasis) and some discomfort.

This condition can affect one or both breasts and can happen when there’s a sudden increase in milk supply or if you’re having difficulty with breastfeeding. Most often engorgement happens when it’s been a few hours since the last breastfeeding or pumping session (very common in the morning). When milk ducts become blocked, breast engorgement can become a real pain in the…well, breast. But don’t worry, there are things you can do to ease the discomfort and get back to enjoying your breastfeeding journey.

Causes of breast engorgement

Engorgement can be caused by various factors, including:

  • Too much milk: When there is an oversupply of milk, it can cause the breasts to become engorged.

  • Infrequent breastfeeding: If the baby does not nurse frequently enough or feeds are supplemented with expressed or formula milk, breast milk can build up in the breasts.

  • Difficulty latching: When the baby has difficulty latching onto the nipple, due to tongue tie, for example, it can lead to engorgement.

  • Blocked milk ducts: If a milk duct is blocked, it can cause milk to back up in the breast tissue, leading to engorgement.

  • Not emptying the breast at each feeding session: Not alternating sides or rushing feeds can mean that both breasts are not fully emptied leading to engorgement.

baby keeps pulling off breast and relatching

Symptoms of breast engorgement

Breast engorgement can cause the following symptoms:

  • Swollen breasts that feel hard and painful or tender to the touch

  • Nipple pain

  • Warmth in the affected breast

  • Difficulty latching

  • Tight clothing can make the pain and discomfort worse

  • Blood vessels on an engorged breast may be more visible.

How to relieve engorgement

If your breasts are engorged relieve the symptoms by trying the following:

  • Avoid tight clothing

  • Drink plenty of fluids

  • Frequent breastfeeding: Nursing your baby frequently and allowing them to finish one breast before switching sides can help alleviate engorgement.

  • Pumping: If your baby is not nursing effectively, pumping can help drain the breast and reduce swelling.

  • Gentle massage: Gently massaging your breasts in a circular motion can help increase milk flow and reduce swelling.

  • Warm shower: Taking a warm shower and allowing the water to flow over the breasts can help reduce swelling.

  • Warm compress or moist heat: Placing a warm compress or moist heat on the affected breast can help reduce swelling and relieve pain.

  • Seek medical advice: Discussing engorged breasts with a lactation consultant is important – there may be latching issues causing sore nipples or another problem with breast feeding causing engorgement.

What is mastitis?

Mastitis is a condition that results from a blocked milk duct, leading to the growth of bacteria in the breast tissue. It’s an infection that can happen in one or both breasts, and it can cause flu-like symptoms such as body aches, fever, and fatigue. For breastfeeding mothers, this condition can be particularly uncomfortable, and they may experience soreness, redness, and pain in the nipple area on the affected side.

In some cases, bacteria (staphylococcus aureus) or a fungus (candida albicans) from your baby’s mouth or throat can enter your breasts via the nipple (especially if there is a nipple fissure or crack) and can cause mastitis.

Mastitis can occur at any time during breastfeeding, but it’s most common during the first few weeks after giving birth. If breast pain is left untreated, mastitis can lead to an abscess, which can require antibiotic treatment. So if you’re experiencing any of these symptoms, it’s essential to seek medical attention as soon as possible.

Symptoms of mastitis

Mastitis symptoms appear rapidly and can be a combination of the following (usually in just one breast):

  • Localised breast discomfort, pain and tenderness, which can be severe
  • A swollen, sore breast

  • Warmth and redness in the affected breast

  • Body aches

  • Fever

  • Flu-like symptoms

  • Hard lump in the breast

  • Nipple discharge

How to treat mastitis

If you experience any symptoms of a mastitis infection, it is crucial to seek medical advice promptly. Your doctor will probably prescribe antibiotic therapy to treat the infection and treat mastitis. The following treatments can also help alleviate the symptoms of mastitis:

  • Effectively draining the breast by continuing to breastfeed or pump milk: This helps relieve blocked ducts and prevents engorgement.

  • Seeking medical advice promptly if symptoms do not improve: Prompt medical attention can prevent complications and ensure proper mastitis treatment.

  • Pumping: If the affected breast is too painful to nurse from, pumping can help drain the milk and relieve engorgement. Make sure to use a high-quality breast pump and properly sanitize it before and after each use. This will help to keep milk flowing.

  • Warm compresses: Applying warm compresses to the affected breast can help increase milk flow and reduce pain. You can use a warm towel or a warm water bottle.

  • Moist heat: Taking a warm shower or bath can also help relieve pain and reduce swelling. Make sure the water is not too hot and avoid using soap or harsh shower gels, as they can dry out the breast tissue.

  • Pain medication: Over-the-counter pain relief medication such as ibuprofen or acetaminophen can help relieve pain and reduce inflammation.

  • Gently massage the breast: Massaging the affected breast can help reduce swelling and relieve pain. Use gentle pressure and work towards the nipple to help unclog plugged milk ducts.

  • Applying ice packs: Using ice packs on the affected breast can also help reduce inflammation and relieve pain.

  • Rest: Getting plenty of rest and avoiding tight clothing can help reduce the risk of developing mastitis.

  • Remember, the key to preventing mastitis is to effectively drain the breast, and that can be achieved by breastfeeding or pumping regularly. If you experience any symptoms, it’s important to seek medical advice promptly.

    If left untreated, infective mastitis can lead to an abscess, a painful collection of pus within the breast tissue that may require surgical drainage. Therefore, seeking medical advice promptly is essential if you experience any symptoms of mastitis.

Engorgement and mastitis: Risk factors and prevention

Many breastfeeding mothers are at an increased risk for engorgement and mastitis, particularly during the first few weeks after delivery.

Risk factors for engorgement include:

Risk factors for mastitis include:

  • Cracked nipples – nipple fissures can act as an entry point for infection

  • A weakened immune system

  • Poor breast hygiene

How to prevent engorgement and mastitis

Moms can prevent engorgement and mastitis by:

  • Establish a good breastfeeding routine

  • Ensure proper breast hygiene

  • Avoid wearing tight clothing

  • Let your baby finish feeding from the first breast before offering the other

  • Seek medical advice if symptoms occur

  • Wean slowly – moms are more likely to experience engorgement if the wean too quickly

  • Continue to breastfeed on side with the blocked duct

  • Alternate breasts when pumping and breastfeeding

  • Reguarly inspect your breasts for hard lumps, red areas and pain

  • Take care of nipple fissures by pumping and using nipple creams.


In conclusion, engorgement and mastitis may have similar symptoms, but they are different conditions that require different treatments. It’s important to realize that engorgement will ALWAYS affect the whole breast and not parts whereas mastitis tends to affect sections of one breast. Engorgement is caused by too much milk in the breasts, while mastitis is an infection of the breast tissue. Both conditions can be prevented with good breastfeeding practices and proper breast hygiene. Seeking medical advice is crucial to ensure effective treatment and relief.

Final thoughts

For most women, engorgement is an inevitable part of breastfeeding. Many moms first experience it on day 2 or 3 after birth when their milk comes in – it’s a very strange feeling! Mastitis on the other hand may or may not be experienced by breastfeeding moms.

Your breasts are hardworking life-giving machines so treat them with care and respect. Always seek help from a lactation consultant if you have any concerns about breastfeeding in general or engorgement specifically. This is one of those occasions in life when it is absolutely OK to ask for help as often as you need it. And don’t hesitate to be seen by a doctor if you feel unwell with flu-like symptoms or have a painful breast – mastitis is no joke and needs urgent treatment.

Engorged vs mastitis FAQs

Mastitis and engorgement are two different conditions. Mastitis is an infection of the breast tissue, while engorgement is caused by a buildup of milk in the breasts. Signs and symptoms of mastitis include pain, redness, swelling, heat and tenderness, while signs of engorgement are swollen breasts that are hard to the touch.

No, breast engorgement and mastitis are not the same. Mastitis is an infection of the breast tissue, while engorgement is caused by a buildup of milk in the breasts.

No, engorgement does not always lead to mastitis. Engorgement is caused by a buildup of milk in the breasts and signs include swollen, hard breasts. Mastitis is an infection of the breast tissue that can cause pain, redness, swelling, heat and tenderness.

Yes, expressing or pumping your breast milk can help to relieve engorgement. This will help reduce the swelling and make it easier for your baby to latch on and feed, preventing mastitis from developing.

For more breastfeeding advice check out my other posts:

16 Breastfeeding essentials

The best wearable breast pumps

The best nipple cream for breastfeeding

When does breastfeeding get easier?

The 11 best books about breastfeeding

11 common breastfeeding problems

Successful breastfeeding: A comprehensive guide

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