What to do if your breasts are sore or swollen
Often referred to as blocked or plugged ducts, inflammation of the breast can occur at any stage of your breastfeeding journey. When breasts become over-full due to delayed breastfeeds or pumping, when feeding patterns change suddenly or from outside pressure from tight clothing etc, swelling can happen inside the breast tissue.
How we refer to this common condition and the best management of it has changed recently, with better understanding of how breasts make and store milk leading to new guidelines globally. So let's look at what you need to know.
Language to describe the changes in the breast has been refined to be more accurate.
Milk is no longer referred to as “coming in” a few days after birth. There is milk - in the form of colostrum - ready for your baby immediately. Around 72 hours after delivery, the next stage of breastmilk develops, a mix of colostrum and mature milk known as “transitional milk”. And in the second week, colostrum production ends and the breasts produce mature milk exclusively.
Engorgement describes the unique breast fullness some people experience during the 24 hours or so around the milk transitioning, as the volume of milk increases and the breasts adjust. Breast fullness that occurs at any stage of breastfeeding due to changes in feeding or pumping patterns are different to engorgement.
Localised breast inflammation describes what used to be called blocked or plugged ducts. This swelling around the milk ducts can narrow them temporarily and reduce flow but the lumps we can often feel are this swollen tissue, not a blockage we need to remove.
Inflammation in the breast due to any cause is treated with the following simple measures:
Continue your normal pattern of breastfeeding and/or pumping. You do not need to increase milk removal.
Massage is no longer recommended as it can make matters worse.
Cold packs are more effective than heat packs. Applying cold helps reduce pain and inflammation.
Over-the-counter anti-inflammatory medication available from pharmacies can relieve pain and reduce swelling. Your pharmacist or doctor can advise you on the best option for you.
If you experience other symptoms, such as fever or other flu-like symptoms, your breast becomes red or noticeably swollen or you feel the inflammation is getting worse, you might be developing mastitis and need medical attention. If you don’t feel better or you begin to feel worse after 12-24 hours of the above treatment, then seeing a doctor is important. Infection may be present and need additional treatment. Untreated mastitis can lead to a breast abscess if left too long. Mastitis is not something to be frightened of but should be treated promptly. You do not need to stop breastfeeding because you have mastitis.
