Breast pain can be caused by engorgement, plugged ducts and mastitis, among other things.
The findings and symptoms of these conditions sometimes over lap a bit, so it's best to read about all three conditions.
Engorgement and plugged ducts are described in this article below.
Click here to read about mastitis.
Click here to read about causes of breast pain.
Engorgement Pain
Normal breast swelling can progress to engorgement as your milk first comes in. Engorgement can occur later If your baby suddenly sleeps longer overnight, your return to work routine results in less regular milk removal, or when you start the weaning process.
With engorgement, usually both breasts become diffusely warm, tight, sometimes shiny, and rarely a little pink.This is different from plugged ducts and mastitis, which is usually an isolated area on one breast.
Engorgement happens when the milk producing sacs become overly full and distended as milk production increases, or when less milk is removed all of a sudden. This swollen breast tissue (the sacs) compress the milk ducts, making them narrow. Milk flows very slowly through this area of the breast, which then gets congested. Perhaps inflammatory body fluid moves into the breast tissue and causes more swelling. Excess IV fluid during labor increases the risk of engorgement. If milk is "stuck" in the milk sacs deep in the breast tissue, and can't flow out, milk production will decrease.
When breast tissue is engorged, the areolar tissue around the nipple gets firm. It's difficult for your baby to latch on and compress this tight tissue, so the latch is very shallow. This may result in sore cracked nipples. Click here to read more about nipple pain. When possible, it's best to have your baby remove milk from the breast, rather than pumping. Click here to watch a video that shows you how to do Reverse Pressure Softening to soften the breast tissue around the nipple.
To manage engorgement
- Manually express milk to soften the areola (see above). Hand expression may work better than pumping for this early engorgement.
- Perform Lymphatic Breast Massage between and before nursing, to lessen the swelling.
- Apply ice or cold compresses to your breasts while lying on your back.
Plugged Duct Pain
Click here to read about nipple blebs, which is a plugged duct opening on the nipple.If there is an isolated area on one breast that feels tender, warm, swollen and full, a plugged duct is often diagnosed, although there's actually not a "plug" (see below). Pain often radiates to and from the nipple during nursing. The breast swelling does not resolve when you try to remove milk.
What is often diagnosed as a '"plugged duct" is not an actual plug of dried milk in a milk duct. Instead, recent research has shown that milk simply can’t move freely through the milk ducts due to swelling and congestion within and around the duct system. The ducts are narrowed and compressed by overly full milk sacs, and perhaps some inlammatory body fluid in the tissue.
Risk factors for "plugged ducts"
- an abundant milk supply
- a sudden decrease in the frequency of milk removal
- wearing a tight bra that compresses milk ducts
To manage plugged ducts
- Get control of an abundant milk supply. Click here to learn more.
- Resume your typical milk removal patterns.
- Don't pump more frequently or more aggressively on the problem side, as this will cause more inflammation and swelling, as well as further increase your milk supply.
- Vary the nursing positions to drain all parts of the breast.
- Perform Lymphatic Breast Massage between and before nursing.
- AVOID DEEP MASSAGE, VIBRATION, and SQUEEZING as this causes more swelling and tissue damage.
- Apply cold compresses. If you think heat would feel better - perhaps in a hot shower - that's OK too.
- Take Tylenol or Ibuprofen.
- Rest
- Consider taking Sunflower Lecithin oil – this it not proven to help.
- Make sure your pump is working well.
- Be sure the pump flange fits you properly.
- Be sure there is no compression on the milk ducts from tight clothing or a pumping bra.
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