Sore breasts Engorgement Blocked ducts and mastitis What to do to help See also the Pain and pain relief topic page in the Questions and answers index section. Note: For all the following conditions it is important to continue breastfeeding as it is part of the solution/treatment. Back to the Potential problems and solutions page Engorgement If breasts are really sore and hard and feel too full then put something cool on the breasts after a feed to help reduce what feels like hot swelling. Cool packs from the freezer (even frozen peas!) can give relief. Even though there is no research evidence to recommend using cold cabbage leaves straight from the fridge on hot and full breasts many women have found relief by using them inside a firm bra. The leaves are placed over the breast but not the nipple. Remove the leaves after about ten to fifteen minutes as they become warm and soft quickly (and smelly!). If the too full breasts continue, but a mother otherwise feels well then the above treatment can be repeated making sure the baby is latched well at the breast at each feed. Talk to the Lead Maternity Carer (LMC), midwife, or contact a local La Leche League or other appropriate support group for more help. More detailed advice can be found on the kellymom.com website - Engorgment. Back to top Blocked ducts and mastitis The next most common reason for sore breasts is when an area inside the breast is not draining properly and a breastmilk duct becomes blocked. When the milk doesn’t drain well this causes a build up of milk which causes an inflammation of the breast. It can be milk solids that blocks the milk flow down the milk passage. A blocked duct causes what is termed mastitis. Mastitis just means inflammation and does not mean there is an infection of the breast, but blocked ducts and non-infective mastitis can lead to infective mastitis if untreated. Treatment may be conservative as outlined below but antibiotics are necessary if there is no improvement in the breast within twenty-four hours, if a mother continues to feel very unwell and/or has a temperature. Whenever the body has an inflammatory response of any sort, women may start to feel a bit unwell. Breast inflammation produces some of the same symptoms that may be experienced when getting a bad cold or the flu. Often a headache is the first symptom followed by general aching, tiredness, a raised temperature and sometimes shivers. A mother's breasts may be tender and she may see a reddened area and feel a lump inside the breast which will be painful to touch. This lump is caused by a duct being blocked (with milk) and the area becoming inflamed. See also: Plugged Ducts and Mastitis - information about plugged ducts and mastitis on the kellymom.com website. Mastitis topic page in the Question and answers index. Mastitis and breast abscesses health practitioner information sheet in the Breastfeeding information resources section. Back to top What to do to help ‘Heat, massage, rest and empty your breast’ Rest. Inform the Lead Maternity Carer (LMC) midwife what the symptoms are as soon as possible and if feeling generally unwell make an appointment to see a midwife or GP. Feed the baby using very early feeding cues as they will help reduce the blockage and keep the milk flowing well. Wake the baby to feed if the breasts feel very full and the baby is still asleep. Mothers should look after themselves – is there someone to give a hand around the house so that the mother can really rest? Babies sometimes do not feed well when a mother has a blocked duct and inflammation – this is exactly the time a mother REALLY needs a baby to feed well. Some people think this happens because the milk feels hotter than usual to the baby and it has been suggested that the milk has a salty taste. Eating lots of fresh garlic mixed in with food may be helpful as garlic has been shown to have an anti-bacterial effect and babies can like the garlic taste. View the related article - Maternal diet alters the sensory qualities of human milk and the nurslings behaviour. Apply some heat to the sore area, using either a wheat pack or a hot water bottle, carefully wrapped in a cloth to avoid burning the sore area. Very gentle massage of the blocked or reddened area when the baby is feeding or if you are removing milk from the breast by expressing can help. Breastfeed on the sore breast first if possible and if the baby only takes this breast at the feed there may be a need to express some milk from the other breast to keep that breast comfortable. Anti-inflammatory medications can ease your symptoms and make a mother feel much better and relieve the pain. Ibuprofen tablets may be useful when taken as prescribed. See also the Drugs topic page in the Question and answer index section. If mothers continue to feel unwell and the symptoms are not improving and/or they are getting worse they should talk to the LMC midwife if still under LMC care, contact La Leche League for advice, contact a Lactation Consultant or make an appointment to see a GP. Infective mastitis means that a woman may need to take a course of antibiotics for at least ten days. Anti-inflammatory medication is also usually given with the antibiotics by many LMC midwives or doctors. Ultrasound treatment with a physiotherapist can also help the blockage to clear. Ask the LMC midwife or GP about a referral. Mothers should continue to breastfeed their baby. Taking antibiotics may increase a mother's risk of developing thrush. See the Thrush topic page in the Question and answers index for more information. Back to top Back to the Potential problems and solutions page Website feedback We welcome your feedback on this page.

Where to get help Midwives Healthline - 0800 611 116 Well Child La Leche League More information on these and other breastfeeding help providers...

Page last reviewed: 31 July 2009