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.
Click here to read about engorgement and plugged ducts.
Click here to read about other causes of breast pain.
What is mastitis?
Mastitis is inflammation of an area of a breast.The inflamed area of the breast is swollen, painful, red, and warm.
You may have a headache, fever, chills, and nausea. You may also feel tired, achy, and perhaps dizzy.
Mastitis can usually be managed by treating the inflammation, and thus antibiotics may not be needed.
If treating the inflammation (as described below) doesn't help, a bacterial infection is likely contributing to the inflammation, and antibiotics will be necessary.
Note the difference between engorgement, plugged ducts, and mastitis.
- Engorgement is typically seen throughout both breasts when the milk producing sacs are very full. It usually occurs when milk first comes in, but can also happen later.
- A painful lump can develop within an area of just one breast. The lump is from milk sacs that are overly full. These sacs remain full because milk ducts that drain them are narrow and compressed by all the swelling around them. Milk flows slowly, but there is NO plug (as previously thought). Thus squeezing will not help, as there's no "plug" to dislodge.
- The congested area can progress to mastitis.
Risk factors for mastitis
- abundant milk supply
- suddenly removing milk less frequently than usual
- nipple wounds
- excessive pumping
- use of a nipple shield
- history of previous mastitis
- wearing a tight bra
To manage mastitis
- Rest.
- Take Tylenol for pain. Take Ibuprofen for pain and inflammation.
- Wear a supportive bra to help swelling.
- Apply ice or cold compresses. This reduces pain and inflammation, like when managing a sprained ankle.
- Do not do deep massage or squeezing, as this causes injury and more inflammation.
- Continue removing your milk as usual. Don’t remove milk more frequently or more aggressively on the problem side, as this will further increase your milk production and possibly cause more inflammation.
- Stop feeding or pumping if no milk comes out. First resolve the swelling.
- If you don't feel better within 12-24 hours, contact your prescribing provider to consider antibiotics.
- If antibiotics fail to help, there may be an abscess (collection of pus) that needs to be drained.
- Your baby can nurse and drink the breastmilk during mastitis, an abscess and while on antibiotics.
Ongoing chronic breast pain and mastitis
Mammary dysbiosis, otherwise known as subclinical or subacute mastitis, is a rare and newly recognized condition of chronic mastitis. Most women with this condition have an over-supply of milk and a history of acute mastitis and plugs.- You'll likely have ongoing chronic breast pain when you massage your breasts or hand express milk.
- There's often pain upon latching, which improves during the feeding.
- Deep breast pain occurs intermittently between feedings.
- Your breast might look normal, or perhaps faintly pink.
- Your nipples may have small yellowish scabs at the tips, or perhaps a white biofilm on the surface.
To manage this
- Work with a lactation specialist to control your over supply of milk.
- Sometimes breastmilk cultures are done.
- A few weeks of antibiotics might help.
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