1 Nurse your baby often--immediately after birth. Breastfeeding on demand--even if you do not plan to do so long-term--helps prevent and relieve engorgement. This is because, initially, your milk is going to come in regardless(usually within 2-4 days), and more milk released through breastfeeding means there will be less milk present to clog the milk ducts of the breast.
2 Ensure the baby is latched properly so they may get as much milk as possible during the feeding. Do not offer the other breast until your baby has nursed for at least 10 minutes on the first breast. At the next feeding, offer the breast that was last nursed on first. Avoid letting your baby fall asleep at the breast. Stimulate their jaw or rub their back to help keep them awake.
3 If you become engorged (most women do, even with prevention), before and during feedings, massage your breasts. Feel your breasts and try to find knots or lumps. This is where some of the backed-up milk is. Massage those knots and knead them toward the areola. It is most effective to do during feedings, but you should do this periodically during times you are not breastfeeding.
4 Add a cool compress (try an ice pack wrapped in a dish cloth) to your breasts throughout the day for up to 20 minutes each time. This will help with the swelling you will experience and help to relieve some of the pain and tenderness.
5 Only use warm compresses right before nursing. You will want to apply the compress, such as hot wet rags, for just a few minutes before each feeding. Warm compresses will only encourage the milk to begin to flow. You should avoid applying a warm compress for an extended period of time, as excessive use can lead to inflammation.
6 If you are getting no relief from the aforementioned suggestions, it is time to use cabbage leaves. There is no clear evidence as to why cabbage leaves work for so many, but many women tout their effectiveness at discouraging an oversupply of milk.
You may use chilled or room temperature cabbage leaves. Wash them and tear the leaves from the large veins (you do not want cabbage vein imprints on your breasts--trust me) and place them in your bra. Leave them there until they wilt. Those with mild engorgement should only do this 2 or 3 times per day. If you are severely engorged, leave the cabbage leaves in place until your breasts are of normal softness again, and change the leaves once they wilt. It may seem as if it is not working, but many times your breasts suddenly seem to return to normal in as little as 24 hours.
7 Using a breast pump is also a good option. Breastfeed as often as possible, but try to pump or hand express between feedings. This will greatly help some, but help little or none at all for others. It will depend on your level of engorgement and if your breasts respond well to simulated sucking.