Postnatal breast problems

If you’re breastfeeding (or even if you aren’t) there are various postpartum niggles that can affect your breasts.

Some can be very uncomfortable, even painful, but if you want to keep nursing don’t give up – often the problems that arise are connected to your breastfeeding technique and can be easily solved with some assistance from a lactation counselor. Here are some common problems:

Sore, cracked nipples

You may experience some discomfort in the first few days of breastfeeding, as your breasts get used to the sensation, but as long as your baby is latching on correctly this shouldn’t persist. Soreness that doesn’t ease is usually due to your baby not latching on correctly – this will result in him suckling from your nipple when he should actually have a good large mouthful that includes your areola (the darker area immediately surrounding your nipple).

It’s a vicious circle because your baby needs to suckle properly to stimulate milk production. If he isn’t latched on properly he won’t be doing this and if your milk flow suffers as a result he’ll be so hungry he’ll suckle for hours at a time… and that gives your sore nipples no time to recover.

If you’re finding feeds are still painful on day three, speak to your OB-GYN or nurse-midwife, who may recommend you consult a lactation counselor who can check your technique. Many women find that if they can just hang on until their milk comes in, around day four, their baby doesn’t have to suckle so hard and their sore nipples start to recover. However it is possible the soreness might be due to thrush, in which case you’ll be prescribed a cream to treat it.

Engorged breasts

This happens when your milk comes in or if your baby hasn’t fully drained your breasts, perhaps because he isn’t latching on correctly or slept through a night feed. Your breasts will feel hard and painful so the best solution is to feed your baby or express some milk with a pump. If your breasts are very full it may be difficult for your baby to latch on, so express a little before you feed him.

Your milk supply will start to self-regulate according to your baby’s needs so engorgement will become less of a problem after the first couple of weeks. In the meantime, some women swear by cold cabbage leaves in their bra to ease the discomfort and reduce the heat and swelling that accompanies engorged breasts.

Blocked milk ducts

It’s important to keep an eye out for these as they can develop into mastitis if left. Symptoms include a painful area and engorgement and the best way to avoid them is to make sure your breasts are emptied regularly (use a breast pump if necessary). Wear a comfortable bra, avoiding under-wired designs as these can cause your milk ducts to become blocked. Again, if your baby is not latched on properly this can also contribute to this problem.

You may find that massaging your breast downwards as your baby feeds will unblock the duct; if it’s on the underside of your breast, try feeding your baby lying down so her jaw can work on the blocked side to get your milk flowing again. If you develop a hot, red patch on your breast or a fever contact your physician straightaway, as this could signal mastitis.

Mastitis

This can be a very painful condition that makes you feel extremely unwell. It is basically inflammation of the breast, which can become infected if it isn’t dealt with promptly. Mastitis is caused by the breast not being adequately emptied of milk – symptoms include blocked milk ducts and red patches appearing on the breast. Often, the breast feels hot and painful and you may develop flu-like symptoms, such as aching bones and a feverish temperature.

The best course of action is to empty your breast of milk, and you should keep breastfeeding as this will help decrease the inflammation. If your baby is having trouble feeding from the infected breast, use a breast pump to empty it. If your symptoms show no sign of abating, your physician may prescribe antibiotics.

If you have any unanswered questions, use our answers page to gain wisdom from other moms or our resident experts for all those pregnancy or baby-related niggles.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.

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Last Modified: 09/07/2007

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