Day 4 postpartum
In short: what happens on day 4 postpartum?
On day 4 postpartum milk production rises quickly, and many mothers’ breasts become swollen, hard and warm; this is called engorgement. The most effective remedy is to feed your baby often with a good latch. A warm shower before feeds and a cold compress afterwards bring relief. Engorgement usually eases noticeably within 24–48 hours.
Day 4 postpartum – animated guide
Day 4: the 40-day postpartum dial, your womb shrinking, postnatal bleeding, your baby’s stomach capacity and weight change (illustrative animation).
What the animation shows
- RING
- Coloured ring: the 40-day postpartum period and its stages; the gaps in the ring mark the weeks
- LOCHIA
- Inner band and pad: the colour of postnatal bleeding (red → pinkish-brown → yellowish-white) and how heavy it is
- BLUES
- Blue arc: days 3–14, when the baby blues may appear
- UTERUS
- Womb: its weight (g) and height relative to the belly button (cm); the dashed line marks the belly button
- STOMACH
- Circle: roughly how much milk your baby can take per feed (ml); dashed rings show day 1, day 3, week 1 and month 1
- FEED
- Drop and nappy: feeds in 24 hours and the minimum number of wet nappies to expect
- WEIGHT
- Graph: your baby’s weight compared with birth weight (%)
- ICONS
- Outer icons: first feed, milk coming in, heel prick test, cord falling off, back to birth weight, 1 month, 6-week check
Stage
Milk comes in
Postnatal bleeding
Red (lochia rubra)
Womb
≈ 750 g
Milk
Transitional milk
Baby’s stomach (per feed)
32 ml
Baby’s weight (vs birth weight)
-7%
Wet nappies (24 hours)
4
Days until day 40
36 days
What’s happening in your body?
As your milk comes in, more blood and fluid flow to your breasts, which can cause fullness, tightness and a slight rise in warmth. Postnatal bleeding is still red, which is expected for the first 4 days. Your breasts may feel hot, but your measured temperature should not go above 38 °C.
Your baby today
Your baby can now stay awake for longer and suck more strongly. Poo starts changing from greenish-brown to yellow, and wet nappies increase. If your breast is very tight your baby may struggle to latch; expressing a little milk first helps.
Feeding and nutrition
Feed whenever your baby wants, waking them every 2–3 hours if needed, and let them drain one breast well. If the area around the nipple is very tight, hand-express a little milk before feeding to soften the areola.
Emotions and rest
Breast pain and the pace of frequent feeds can test your patience; remind yourself that this intensity will settle within a few days.
Care and hygiene
Wear a supportive bra that doesn’t dig in, and apply a cold compress for 10–15 minutes after feeds. As your bleeding is still red, keep changing your pad every 4–6 hours.
Tips for today
- A warm shower or gentle breast massage before feeding helps milk flow
- A chilled cabbage leaf or cold gel pad after feeds can be soothing
- Avoid very long gaps between feeds at night to prevent morning overfullness
When to seek medical help
A red, hot, painful area on the breast with a temperature of 38 °C or above, shivering or flu-like symptoms may be mastitis; see your doctor.
Tradition and evidence
In some traditions, including parts of Turkey and the Middle East, a newborn’s skin is rubbed with salt or salty water, with the aim of stopping sweat from smelling and toughening the skin. The wish to protect behind this custom is meaningful, but newborn skin is very thin: salt irritates it, can cause sores and may be absorbed, leading to a dangerous salt–water imbalance. Plain warm water is all your baby’s skin needs; salting should not be done.
Postpartum day-by-day table
| Day | Topic | Stage |
|---|---|---|
| Day 1 | The First Day After Birth | First 72 hours |
| Day 2 | Colostrum (First Milk) | First 72 hours |
| Day 3 | Milk Coming In and Jaundice | First 72 hours |
| Day 4 | Breast Engorgement | Milk comes in |
| Day 5 | The Baby Blues | Milk comes in |
| Day 6 | Stitch Care and the Toilet | Milk comes in |
| Day 7 | The End of Week One | Milk comes in |
| Day 8 | When Can I Have a Bath? | Healing |
| Day 9 | Sleep and Tiredness | Healing |
| Day 10 | The Umbilical Cord Falls Off | Healing |
| Day 11 | Eating Well After Birth | Healing |
| Day 12 | Yellowish-White Discharge | Healing |
| Day 13 | Caesarean Wound Care | Healing |
| Day 14 | The End of Week Two | Healing |
| Day 15 | Postnatal Depression | Settling in |
| Day 16 | Cracked Nipples and Mastitis | Settling in |
| Day 17 | Visitors and 40-Day Beliefs | Settling in |
| Day 18 | Pelvic Floor and Kegels | Settling in |
| Day 19 | Night Sweats and Hormones | Settling in |
| Day 20 | Can I Go Out With My Baby? | Settling in |
| Day 21 | The Three-Week Growth Spurt | Settling in |
| Day 22 | Tummy, Binders and Diastasis | Settling in |
| Day 23 | Lifting and Driving | Settling in |
| Day 24 | Support From Partner and Family | Settling in |
| Day 25 | Medicines, Tea and Coffee | Settling in |
| Day 26 | Expressing and Storing Milk | Settling in |
| Day 27 | Anaemia After Birth | Settling in |
| Day 28 | Week 4: Is the Bleeding Ending? | Settling in |
| Day 29 | Exercise After Birth | Recovery and day 40 |
| Day 30 | Your Baby’s First Month | Recovery and day 40 |
| Day 31 | Losing Weight After Birth | Recovery and day 40 |
| Day 32 | Sex After Birth | Recovery and day 40 |
| Day 33 | Contraception After Birth | Recovery and day 40 |
| Day 34 | Hair Loss and Skin Changes | Recovery and day 40 |
| Day 35 | Week Five: Building a Routine | Recovery and day 40 |
| Day 36 | Preparing for Your 6-Week Check | Recovery and day 40 |
| Day 37 | Pelvic Floor and Core Strength | Recovery and day 40 |
| Day 38 | Saunas and 40th-Day Bath Rituals | Recovery and day 40 |
| Day 39 | What to Watch for After Day 40 | Recovery and day 40 |
| Day 40 | Day 40: The End of Postpartum | Recovery and day 40 |
Frequently asked questions
What should I do if my breasts are rock hard?
Feed often, take a warm shower and express a little milk before feeding, then use a cold compress afterwards. Pain and fullness usually ease within 1–2 days.
How long does breast engorgement last?
It usually eases within 24–48 hours after your milk comes in. Feeding often and effectively is the best way to shorten it.
How long is postpartum bleeding red?
It is normal for it to stay red for about the first 4 days. After day 5 it usually turns pinkish-brown; if it becomes bright red and heavy again, see your doctor.
Postnatal care at SoftCare Clinic
Book an appointment with our specialist doctors for a postnatal check, breastfeeding problems, a stitch or wound check, or support with postnatal depression.
The information on this page is general guidance for an uncomplicated postpartum period and does not replace a medical examination. Heavy bleeding, fever, breathlessness, chest pain, or thoughts of harming yourself or your baby are emergencies: call your local emergency number (999 / 911 / 112).
Medical content editor: Op. Dr. Şükrü Sanus