Linda Jones is pulling back the curtain on a little-known breastfeeding side effect: painful, swollen armpits filled with breast milk.
Jones, a 39-year-old mother of six, gave birth to triplets on January 10 at 34 weeks gestation, after being admitted to the hospital for high blood pressure. While all three babies were admitted to the neonatal intensive care unit (NICU), Jones started pumping, determined to provide her babies breast milk.
"The first couple times I tried to pump I got some colostrum," Jones tells TODAY Parents, referring to the first form of breast milk produced by a lactating parent. "And then after that, nothing was happening. The lactation specialist told me, 'Oh, just keep pumping. It'll come in. It'll come in.' So I still kept pumping every 2-3 hours. But I was just pumping air — there was nothing happening."
Jones says that after day two of pumping, she started to feel a fullness in her breasts. But when she woke up in the morning on day three, she knew something had gone awry.
"I was in so much pain, my armpits were filled up, and my breasts were huge," she explains. "Just rock hard."
To her dismay, Jones realized that her armpits had filled with breast milk — a little known but not uncommon side effect of engorgement, which is when an increase in blood flow and milk supply to the breasts causes swelling, tenderness and pain.
Jones decided to document her experience on TikTok, sharing a video of her swollen armpits filled with milk six days after giving birth. The video has since gone viral, with over 470,000 likes and more than 6,000 comments.
What causes engorged armpits?
Dominique Weiss, registered nurse, international board certified lactation consultant and founder of Baby Zone NYC, explains that breast or mammillary tissue actually extends all the way into our armpits, which is why Jones experienced engorgement underneath her arms.
"That's why when we do breast exams, we're also supposed to massage and feel under our arms — your breast tissue can extend all the way up top to your armpit," Weiss tells TODAY. "So it's not that milk got trapped there. What happened to this mom is that she has lobules in her armpit."
Lobules are milk-producing clusters in the body, and Weiss says a lactating parent will typically have between 15 and 20 lobules per breast.
"In this mom's case, she clearly has lobules in her underarm area," she adds. "All women have lobules, but the distribution is unique to us. Just like we're all different, and everyone has a different cup size and breast shape, the distribution of the lobules can be different as well."
Weiss says the number of lobules is not based on breast size, but rather genetics. So while Jones has highlighted a possible outcome of engorgement, not all lactating parents will experience engorgement underneath the arms, or even at all.
How do you treat engorged armpits?
Jada Shapiro, maternal health expert and founder of Boober, a platform where new and expectant parents can find lactation consultants, birth and postpartum doulas, and other support, says there are a number of treatments for lactation engorgement.
"Cold compresses on the breast and armpits, and very limited touching of the armpit tissue to discourage any activity and stimulation there, which can increase swelling," Shapiro tells TODAY. "Frequent feeding of the baby to reduce engorgement (also helps)."
Shapiro adds that if the lactating parent has a fever, red streaking — a sign of infection — or very painful lumps, they should seek medical treatment.
"If the parent is unsure, they should call their midwife or doctor to rule out mastitis," she explains, "and connect to a lactation consultant for professional advice."
Weiss says that time will also help with lactation engorgement, even in severe cases that cause swelling of the armpit.
"What will happen over the next six weeks, her body will see which lobules are being emptied," she explains. "It's essentially the law of supply and demand. Thankfully, our breasts aren't capitalists; they're not going to withhold the supply. They're really going to give us what we're asking for."
Weiss says other options are, if needed and approved by the lactating person's doctor or midwife, using over-the-counter anti-inflammatory medicines, like Motrin, and applying heat to the breasts prior to pumping in order to dilate the milk ducts and warm the milk so the liquid flows out easier.
"So first we heat the breast, and then we would pump and massage. You can even use the end of an electric toothbrush (on the breast) —the vibration will empty those lobules," she explains. "And then after she pumps, we would want to ice the area to discourage milk from filling back in."
Is it safe to continue breastfeeding when you're experiencing severe engorgement?
Both Weiss and Shapiro say that it is perfectly safe to continue breastfeeding when you're experiencing painful engorgement, though Weiss stresses that continuing is entirely up to the lactating parent.
"It's such a personal decision," Weiss says. "What I've experienced, as a lactation consultant, is a mother's desire to breastfeed is going to determine her tenacity. And there's a guilt factor in not wanting to do it, or stopping. So I think the most important thing is that moms examine if they really want to breastfeed. If you say, 'No, I don't like it, it's too hard, it hurts' — stop. We have enough solutions, we have so many different types of formula, to feed our babies."
Weiss says it's also important to acknowledge how much work, time, mental, physical, and emotional labor goes into breastfeeding, regardless of engorgement.
"We can do hard things, and if it's just a matter of being scared that it's going to be hard, I really encourage and motivate my moms to keep going," she adds. "Because moms are accomplished — whether our accomplishments are something that we can put on our resume or not, it doesn't matter. Parenting is hard work. It's hard work, but it's good work."
Why more people need to know about engorgement
Jones, who is at home with Baby A while Baby B and Baby C remain in the NICU and continue to grow, says this isn’t the first time her armpits have become swollen when she’s tried to breastfeed.
“This happened with my first three kids, and I just quit (breastfeeding),” she explains. “But this has always happened to me. And I was determined to keep (breastfeeding) this time, because the triplets are in the NICU and I wanted to provide them with breast milk. So that’s when I called the lactation specialist and they came in and they kind of broke down engorgement for me.”
But it was a shock the first time it happened to her, and she didn't want it to shock future moms, too.
"I posted this because I thought this is very uncommon and that I was maybe one of the few people who have gone through this, because nobody really talks about it," she says. "I've seen no videos about it. If you look it up, there's not much there. I've talked to my doctors about it and some of them were clueless as to what's in my armpits. And so I just posted the video to kind of put awareness out there."
"I think it's really important to put it out there, that this could be a side effect or that this is a possibility and what could happen," Jones adds. "You want people to know the good parts of parenting, but you kind of also want people to know the bad parts. And this isn't the best part of having a child, but I think it'd be important to put it out there and talk about it."
Weiss agrees, and says that if more parents had access to information and support, fewer new moms would feel alone.
"I think that our society doesn't put enough information out there about what's 'normal' for a newborn," she says. "How long do they sleep for? How often should they be feeding? What does feeding look and feel like? And yes, let's talk about some of those emotional changes, because everyone tells you you'll be so happy to have this healthy little baby, meanwhile you're exhausted and questioning your life choices. So I definitely think education in prenatal education is a really big deal."
Jones says the reaction to her viral TikTok videos documenting her extreme engorgement has been overwhelming, albeit sometimes comical.
"Some women are like, 'Yes, this happened to me too, and I didn’t know what it was, thanks for posting this,'" she explains. "And then there’s the other half who are like, 'Thanks for reminding me to take my birth control. I don’t want to go through this.'"