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My breast hurts. What can I do?

For someone who is new (or not so new) to breastfeeding, a sore breast can be a painful and alarming experience. A mother with a sore breast may be told she has a breast infection or mastitis. (The terms breast infection and mastitis are often used interchangeably.) Breasts can become sore when milk is blocked from flowing. A plugged milk duct may decrease the flow of milk from a section of the breast. However, once the milk is flowing the soreness will decrease. Sore breasts can occur after an illness, such as a cold, goes through the family, or during a particularly busy or stressful time, or just without warning.

What do all these terms mean?

Sore breast Occurs when the milk flow is blocked. Breast feels tender. There may or may not be redness or a hard spot in that area of the breast.

Plugged duct Milk flows through a duct system in the mother's breasts. Sometimes an area of the ducts becomes blocked and milk no longer flows as well. A section of the breast may or may not be red. When a mother has a plugged duct, her breast is usually tender and painful. If the blockage is not treated, the area may become infected.

Breast infection A sore breast or plugged duct can become a breast infection. This means that not only is the breast tender, but also the mother feels achy, run-down and feverish. Mastitis is another term that may be used. This condition may or may not be treated by antibiotics.

Whether coping with a sore breast, a plugged duct or a breast infection, the initial care is similar. Nurse frequently, rest and apply heat to the tender area.

  • Frequent nursings serve to provide comfort, reduce inflammation and encourage opening the blocked area. Mothers find that varying breastfeeding positions drains all areas of the breast more effectively. For example, if you most commonly use the cradle hold, try the clutch ("football") hold or lying down to breastfeed. (Please note that it is a common myth that it is unhealthy for the baby to breastfeed when the mother has a breast infection. This is definitely not true. The antibacterial properties of human milk protect the baby from infection.)
  • Rest is an important component in recovery from sore breasts, plugged ducts or breast infections. To do this, try resting in bed with baby cuddled next to you. This will also encourage frequent breastfeeding sessions to drain the breast. Keep supplies such as diapers, toys, books, the telephone, a glass and a pitcher of water nearby to minimize trips out of bed.
  • Applying wet or dry heat with a heating pad or hot water bottle and gently massaging the sore area of the breast before breastfeeding can assist the breast in further emptying. Many mothers find that taking showers or baths and gently massaging with a warm cloth on the sore breast is a relaxing treatment during a stressful time. Another technique is to lean over a basin of warm water and soak the sore breast for about 10 minutes three times a day. This will also remove any dried milk secretions that may be blocking the flow of milk out of the nipple. Breastfeed immediately, while the breast is warm, to help unplug the blocked duct.

If fever and discomfort are still present after about 24 hours of rest, heat, massage and frequent nursing, then the mother may want to contact her health care professional. If a medication is prescribed, it is important to remind health care professionals that it should be compatible with breastfeeding. While the mother is on medication, continued rest, heat treatment and frequent breastfeeding will promote recovery. If an antibiotic has been prescribed, using the entire prescription will help to avoid recurrence of the infection.

Breastfeeding should continue during treatment of any of these conditions. If an infection is present, the baby is safe from any germs due to the antibacterial properties of human milk. Continuing to breastfeed when experiencing a sore breast, plugged duct or breast infection will speed recovery.

In order to prevent future plugged ducts or breast infections, the breastfeeding mother may find it helpful to be cautious of sudden long stretches between nursings. A poorly fitting bra, or a bra that constricts (such as an underwire bra) may contribute to plugged ducts. Heavy purses, diaper bags and baby carriers can also contribute. When breastfeeding, periodically changing the baby's position, while maintaining good positioning will help to empty all the ducts around the breast. Maintaining general health through a healthy diet and getting extra rest may help keep the breast from becoming sore again.

If you are experiencing repeated bouts of plugged ducts, breast infections or mastitis, please read our FAQ on repeated mastitis.

The comprehensive guidebook from LLLI, THE WOMANLY ART OF BREASTFEEDING is offered for sale by most La Leche League Groups and from the LLLI Online Store. It offers many helpful ideas for breastfeeding and outlines ways to overcome repeated breast infections. La Leche League also offers an information sheet, Care Plan for Mastitis and the pamphlet, Sore Breasts.

Contacting an LLL Leader in your area or attending a meeting may help you cope with your breast infection.

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