Breastfeeding Day Four: What to Expect

How do you know what to do on day four of breastfeeding?? As an IBCLC, nurse, and third time mom, you might think that I have breastfeeding down to a science. While it’s true I have lots of tips and tricks, every breastfeeding experience can be so different! This series came about when I had my third baby. I wanted to share my experiences in real time and while I had another new breastfeeding journey fresh on my mind. So, this post about day four in the series covers the real experiences I had during my first week of breastfeeding!

(This post was originally a video. Check it out, here!)



Breastfeeding Day Four Can Be Another Hard Day

We are going to talk mostly about engorgement and how to deal with that. I’m sure your baby has been really hungry and your milk is transitioning and filling your breasts. Engorgement is super normal and not a bad thing, it’s not fun, but normal. Things like clogged ducts and mastitis are not normal. Those are problems that need fixed. But engorgement is part of the nursing process so please expect that to happen.


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What is Engorgement?

Engorgement is when your milk is increasing in quantity quite a bit and also some swelling in your breasts. It’s not all milk that is causing those swollen hard breasts, it’s also some fluid and swelling. Keep that in mind. Taking out all the milk is not going to solve your engorgement problem.


When to Expect Relief from Engorgement

Please know that your milk supply is going to regulate out. Don’t think this is going to be your new life forever. Within the next week, you should be feeling some relief but it will take a few more weeks for your milk to really stabilize and get into a good flow. The engorgement really should just last a few days. This is a tough part.


Checking for Engorgement

A way to check and see if your breasts are engorged is that if they feel soft like your cheek, there is no engorgement. It they are firmer like your nose, that would be a moderate engorged breast feel. It they are hard like your forehead, that is a very engorged breast. This is a good way to tell where you are at in that process. A little bit of engorgement, like the end of your nose, is manageable and I would suggest just continuing feeding baby as much as they want, alternating sides just like normal.

If you are having severe engorgement and your breasts are very very hard, warm, tender, that is when you might consider doing a couple of options to help. Read on!

The most important thing to remember with engorgement is that the more milk you remove, the more milk you make!



Pumping on Breastfeeding Day Four is Not a Good Idea

Hooking yourself up to a pump this day is a really bad idea. It might feel good for a little bit but your body is just going to replace that milk thinking that it needs more. Be careful what signals you are telling your brain and your body. Don’t create an over supply for yourself, because that creates a whole other problem. I know some moms worry about undersupply and not having enough milk, but having an oversupply is just as hard to deal with. You might be tempted to pump for relief. Please do not do that.

Now, I love breast pumps! I probably have 15 pumps and lots of videos about pumps. New Little Life also has Facebook page helping mom decide what pump is best for them… so when I say don’t pump, please take me seriously.


What to Do Instead of Pumping

Here is what you can do if you are vey uncomfortable and want some relief. The goal is to get a little bit of milk out and relieve some pressure with the minimal amount of stimulation to the nipple and breast as possible. You are looking for that sweet spot.

  • A great way to do this is in a warm shower. Jump in and see if you can let that warm water on its own stimulate a let down and relax you. You don’t stimulate the nipples at all. The milk will just flow out. This is an easy way to find some relief with minimal stimulation.
  • You can also fill a basin with warm water and lean over it and rest your breasts in there. The dangling of the gravity will sometime draw the milk out and the warm water might cause a let down. This is another great way to release pressure without stimulation of the nipple and sending messages to the brain that you need more milk.
  • While you are feeding your baby, you can apply a warm compress or warm rice bag on tender areas. This will help those areas release some milk a little bit better. .
  • When you are not feeding the baby, you can use a cold pack on your breast to help reduce the swelling. Alternating the warm and cold can be a great way to help manage the discomfort of engorgement.
  • Probably the best thing actually that you can do is just to feed your little one often. That quantity of milk is going to be awesome for them. It will help flush that yucky poop and other stuff out of their system. If they have jaundice, you really want that quantity in there. So it’s great for them and it’s also going to give you some relief.


Heat/Cold Packs Can Also Provide Relief

A product that I found on Amazon that looked really cool is a hot or cold pack called 3 in 1 Hot/Cold Therapy and it is specifically designed for your breasts. It comes with two round beady things and covers for them. You can put them in the freezer or microwave them. It is designed to go around a breast with a opening for the nipple. You could put one in the freezer and one ready for the microwave, because realistically you are probably only going to be dealing with one breast at a time.

As I have just been through this, I found that I had one side that was more engorged than the other. The right breast that baby had just nursed from was feeling ok. But it seemed that my left breast wasn’t getting emptied enough and was giving me more problems.


What If I Feel I Really Really Need to Pump on Breastfeeding Day Four?

Okay, so some moms do pump. If you find you have to do that, do just enough that you can tolerate the engorgement. Just know that a traditional pump will be stimulating the breast and nipple and causing more milk to be made. It would be better to hand express or use a hand pump where you can control the slow pressure to take a little bit or milk.

On breastfeeding day four, I broke out my Haakaa pump. Now, you can use this too much and cause problems. I used it once on day four and once on day five. It was the time of the day when that one breast was really full and very uncomfortable.

I fed him on the right side and attached the Haakaa on the left side because that was the side that needed a little bit of help. It took out about 2 ounces of milk and that was enough to give me some really nice relief. It was still firm and engorged, but I could manage though. The Haakaa does have slight suction, so put it on so that it will be at the least amount possible.



How Do I Latch A Baby On An Engorged Breast?

It can be tricky to latch a baby onto a really hot and swollen breast. Something that you can try is called reverse pressure softening. If things are really tight on the front and there is not much for the baby to latch onto, (like a basketball) you need to soften up the front for baby.

Put your fingers on either side of the nipple and press down into the breast. Hold it there for about 15-30 seconds then change your position on the nipple and repeat that process. The idea is that you are trying to take the swelling and milk away from the front of the breast a bit.

After you do this for a minute or two, you should notice that the areola and nipple are softer there even though the rest of the breast is still engorged. That should help make it easier for baby to latch on to that nipple.

Hang in there with this tenderness. It definitely won’t be like this forever. It will get better.


Other Changes on Breastfeeding Day Four

You should on Day 4 notice that your baby’s poop is changing too. That is due to the milk going though their bodies. Hopefully it is kind of turning green and eventually to that beautiful mustard yellow color. Remember, this is a great way to monitor how much your baby is getting depending on many wet and poopy diapers your baby is having every day.

You should be able to hear them swallow quite a bit more as your milk it transitioning because they are taking in more fluids. Listen for that too!


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You’ve made it more than halfway through breastfeeding week one! Hang in there. It gets better!


Check out this whole series, linked below!

Breastfeeding Week One

First Day

Second Day

Third Day

Fourth Day (this post)

Fifth Day


Breastfeeding Day Four: What to Expect

Meet Allison Tolman, LPN, IBCLC!

She is the owner and founder of New Little Life, a company dedicated to providing objective information and support for pumping mothers. With 15+ years of experience in various pregnancy and postpartum fields including as an LPN, birth doula, childbirth educator, and IBCLC, her current research focuses on testing and exploring breast pumps to find the most practical way to help pumping mothers reach their goals as well as teaching lactation professionals to better understand the complex art of pumping. 

She runs a long-term coaching program to support working mothers who are pumping

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