October 8, 2019

Reviewed by Kimberly Langdon M.D.

Almost 20% of new moms in the US don’t breastfeed, and they don’t always get the support they need. There’s a lot of guidance available about breastfeeding, but if you’re not breastfeeding, you also deserve to have your questions answered in a supportive, non-judgmental way. So we’re going to walk you through what you can expect the first few weeks after giving birth if you’re not going to breastfeed.

What happens biologically?

During pregnancy, your body starts the process of producing milk (lactation). You may have even leaked a little colostrum (the early milk) while you were still pregnant. The delivery of your baby and placenta sends a signal to your breasts to start milk production. Between 2 and 5 days after delivery, your mature milk will start to come in. As your milk builds up, you may experience engorgement, which is when your breasts become swollen (sometimes rock-hard) and painful. Engorgement usually goes away on its own, but occasionally, it leads to plugged milk ducts or a breast infection called mastitis.

Related: Postpartum Conditions: Engorgement

How do I get my milk to dry up and how long will it take?

Milk production is driven by supply and demand. That means that the amount you produce (the supply) depends on how much you breastfeed or express milk (the demand). If you do not breastfeed or express milk, your milk will dry up on its own, usually within 7-10 days. While many formula feeding mothers want their milk to dry up as quickly as possible, this may be the more painful approach. A more gradual approach, with some expressing (either from a breast pump or by hand) may take longer, but will be less likely to lead to engorgement and other painful issues.

What can I do to ease the discomfort of engorgement?

Until your milk dries up, here’s what you can do to ease the pain:

• Wear a supportive bra or sports bra. Do not “bind” your breasts or wear a bra that’s too tight, which can lead to more pain and potentially plugged ducts or mastitis.
• Apply ice packs or cold compresses to your breasts for 15 minutes every hour to reduce swelling. Wrap the ice pack in a thin cloth to protect your skin. Pro tip: make your own ice packs using clean disposable newborn diapers. Just pour clean water on the diaper, freeze, and place in your bra.
• Take pain medication, like ibuprofen (Advil), as needed.
• Express milk (by pumping or by hand) if you’re very uncomfortable, but only enough to soften the breasts. The more you express, the more milk you will produce, and the longer it will take for your milk to dry up.
• Consider applying cold cabbage leaves to help reduce pain and swelling. Evidence is mixed, but it is inexpensive and considered safe.
• In the shower, try not to let the water run directly on your breasts, as this may stimulate letdown (release the milk) and therefore increase milk production.

Sources:

Centers for Disease Control and Prevention (CDC). Breastfeeding Among U.S. Children Born 2009–2016, CDC National Immunization Survey. Retrieved from https://www.cdc.gov/breastfeeding/data/nis_data/results.html

American College of Obstetricians and Gynecologists. (2016). Your Pregnancy and Childbirth: Month to Month, 6th edition.

Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Cabbage. [Updated 2018 Dec 3]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501774/

Michigan Medicine, University of Michigan. Breast Engorgement. Retrieved October 1, 2019 from https://www.uofmhealth.org/health-library/hw133953

Kimberly Langdon M.D. is a retired University-trained obstetrician/gynecologist with 19-years of clinical experience. She graduated from The Ohio State University College of Medicine and then completed her OB/GYN residency program at The Ohio State University Medical Center. Recently, she founded a medical device start-up company that focuses on non-drug treatment for common maladies.