Breastfeeding may not always be easy, and you can expect to have some discomfort with breast fullness and nipple tenderness, especially when you first start nursing. While other complications may develop—such as engorgement, plugged ducts and mastitis—there are some steps you can take to help ensure proper breast care when nursing:

  • Hand express some milk onto the nipple and allow it to air dry after each feeding
  • Alternate nursing positions to consistently empty milk ducts
  • Avoid using excessive amounts of soap on the breast when showing
  • Wear all cotton bras and change breast pads frequently
  • Use a small amount of ultra-purified lanolin after feedings and allow nipples to air dry

Engorgement

If you baby does not adequately remove the milk from your breasts, it may lead to breast engorgement. This can cause your breasts to feel hard, painful, hot and appear taut or shiny. Engorgement can make nursing difficult for your baby, and painful for you.

Prevention

  • Breastfeed frequently, 8-12 times in 24 hours
  • Express your milk when feedings are missed
  • Wean your baby gradually

Treatment

  • Apply a hot, moist towel or take a hot shower before nursing your baby. Hand express some milk to allow for easier latching.
  • Apply cold compresses or cold cabbage leaves prior to nursing if breasts are severely swollen or engorged. Ice as necessary to relieve discomfort and reduce swelling.
  • Massage breast before and during breastfeeding and pumping.
  • Relax. Try taking deep breaths, listening to music and other techniques to ease discomfort.
  • Use a breast pump as necessary to express milk if your baby is having problems latching or if you only nurse on one side per feeding.

Plugged Duct

Plugged ducts are tender spots or lumps in the breast that occur when milk is unable to flow freely. While a plugged duct may be uncomfortable and painful to the touch, you will generally feel fine otherwise. Symptoms tend to come on gradually and do not include fever.

Prevention

  • Empty the breast completely after each feeding. Use a breast pump, as needed.
  • Position your baby properly at the breast when nursing.
  • Wear a comfortable, properly fitting bra.
  • Reduce the amount of pressure on breasts (includes: heavy bags, baby carriers or sleeping on stomach)
  • Avoid foods high in saturated fats

Treatment

  • Rest
  • Moist heat to affected area before feedings
  • Massage lump before and after feeding from behind the lump toward the nipple
  • Nurse (or pump) often. Remember your baby is more efficient at emptying the breast than a pump.

Mastitis

One of the more serious complications of breast feeding includes a breast infection, otherwise known as mastitis. Mastitis can be caused by an improperly or untreated plugged duct or cracked nipple, as well as from anemia, stress or fatigue. Unlike with a clogged duct, symptoms of a breast infection may come on a suddenly and be more bothersome, including:

  • Fatigue and flu-like muscle aches
  • Fever above 101
  • Headache
  • Intense, localized pain
  • Red, hot and swollen breast

Treatment

  • Talk with your physician and determine if antibiotics are necessary.
  • Rest.
  • Breastfeed frequently and try to keep breasts as empty as possible. Your baby will not get ill from the milk.
  • Try not to skip or delay feedings. Pump frequently if unable to nurse.
  • Apply moist compress or soak breast in warm water before feedings. Massage the affected area using a gentle but firm circular motion after warm soaks.
  • Wear a support bra that does not cause painful pressure.
  • Take Tylenol for fever or discomfort.

Determining the cause of the infection will help to prevent a recurrence, as will proper breast care.

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