Breastfeeding Discomforts: Reasons and Relief

Breastfeeding doesn't always go smoothly. Sometimes you might feel uncomfortable or notice pain. This is normal and treatable. Here are a few of the most common breast problems:

• Plugged milk ducts
• Engorgement
• Mastitis

Plugged Milk Ducts

A plugged duct feels like a tender lump or knot in your breast. It happens when a milk duct doesn't drain properly. Pressure builds up and the area gets sore.

Causes for plugged ducts

• Skipping feedings or going longer between feedings
• Very full breasts
• Feeding on only one breast most of the time
• Sore or cracked nipples
• Tight bra, seat belt, or heavy bag strap across your chest

How to treat plugged ducts

Before a feeding

• Take a hot shower. Let the water hit your back, not your breasts.
• Put a warm, moist cloth on the plugged duct.
• Gently massage from the plugged area down to your nipple.

During a feeding

• Feed or pump often.
• Start with the affected breast when starting a feeding.
• Keep massaging the plugged area gently while feeding or pumping.

Other ideas

• Wear a comfortable, supportive bra that's not too tight. Try one without an underwire.
• Get extra rest. A plugged duct can mean you're doing too much.

If plugged ducts keep coming back, talk to a WIC lactation consultant or your health care provider.

Engorgement

Your breasts may feel tender and full after your baby is born. This is normal. Your body is making milk and sending more blood to your breasts.

But if your breasts feel warm, hard, or painful, they may be too full. This is called engorgement.

Engorgement is uncomfortable. It can lead to plugged ducts or mastitis (a breast infection). It can also make it hard for your baby to latch because your breasts are so full.

How to prevent engorgement

• Breastfeed early and often — at least 8-12 times in 24 hours.
• Make sure your baby latches well.
• Let your baby finish the first breast before offering the other side.
• Don't limit how long your baby feeds.
• Avoid pacifiers and bottles for the first 2-4 weeks (unless your health care provider says to use them).
• If you're away from your baby, pump at their usual feeding times.
• Eat well, drink plenty of water, and get enough sleep.

How to treat engorgement

Engorgement usually goes away in a few days. Here's what helps:

Before a feeding

• Put a warm, moist cloth on your breast.
• Massage gently from your chest toward your nipple.
• If your breast is very hard, hand express or pump a little to soften it. This makes it easier for your baby to latch.

During a feeding

• Offer the engorged breast first.
• Keep massaging gently.

After feeding

• Only pump enough to feel comfortable. Pumping too much tells your body to make more milk, which can make engorgement worse.

Between feedings

• Put cold compresses on your breasts for 10-15 minutes as needed to reduce swelling.

Mastitis

Mastitis is a breast infection. It can happen when you're stressed or your routine changes, like going back to work or school after having your baby.

Signs of mastitis

• Fever of 101.3°F or higher
• Chills, body aches, nausea, or feeling very tired
• Yellow discharge from your nipple
• Breast feels tender, warm, or hot
• Breast looks darker, pink, or red (depending on your skin tone)

How to treat mastitis

Medical help

See your health care provider for treatment. The WIC IBCLC can also support you, so don’t hesitate to reach out to your clinic if you need help with mastitis.

At home

• Rest and drink plenty of fluids.
• Ask family and friends to help with chores and other kids, so you can rest.
• Feed your baby often or pump often.
• If you're away from your baby, pump at regular times.
• Put a clean, warm, moist cloth on the affected breast when resting.

If you’re using a breast pump, clean all of its parts after each use. This will help prevent infections.