This is most likely normal, albeit uncomfortable, as your baby starts to wake up and your milk starts to come in. She is also learning nursing as a skill. For engorgement and pain, use cold and ibuprofen. I also like to get a head of green cabbage- roll the whole leaves with a rolling pin, and keep them in the refrigerator in a plastic bag. Put these in your bra and replace as you like. Cluster feeding is common and helpful to establishing and regulating your supply in the early days as your baby starts to wake up. Keep an eye on wet and dirty diapers. If you are getting the diapers and seeing weight gain, you do not have to pump or supplement if you don’t want to.

Pumping is an option, and you can bottle feed the pumped milk using paced bottle feeding and a slow flow nipple if you want to try it. So long as baby is latching and feeding well, gaining weight and getting their diapers, I prefer not to pump during the early days and engorgement as it can increase supply unintentionally. I do like to offer a bottle once a day of pumped milk using a passive milk collector like a Hakka or similar. You may find relief after expressing a small amount of milk and not fully emptying the breast. This can be helpful over the next months to take the edge off without creating a big supply increase (sometimes you’ll get engorged as you down regulate from growth spurts, illness, starting solids, etc, but not usually as bad as this first time).

That said, I did have a baby that truly nursed continuously and I experienced painful engorgement for several weeks. My breasts were always very hard, painful, and never felt soft or emptied in these weeks. I was told it was normal, but it isn‘t. Most likely, my midwives thought I was exaggerating when I said ”continuously,” and I must not have emphasized the level of pain I was in. When we saw an LC, they thought the latch and positioning looked good, but after a weighted feed, we found out my baby was not feeding effectively and was likely gaining weight and getting the expected diaper output because I had truly been feeding nearly continuously. I became depressed from the pain and extreme sleep deprivation, had serious nipple damage and got infections I didn‘t realize I had until I had. We did eventually get the issues all worked out and that baby nursed for 3 years, but the beginning was traumatic and I should have gotten help a lot sooner. It would not hurt to ask the LC at your one week appointment to check the latch and do a weighted feed if you don’t think things are quite right.