OTHER CHALLENGES

Breast fullness is normal in the first weeks. After each feeding, your breasts will be soft. Engorgement occurs when the milk does not flow easily from the breast. Your breasts may be hard, swollen, painful and/or reddened. Your baby may have trouble latching.

How to prevent engorgement:

• Position and latch your baby correctly.
• Feed your baby often during the day and night (8 to 12 times in 24 hours)
• Feed for as long as your baby wants
• Do not miss feedings
• If you are not able to breast/chestfeed, use an electric pump.

If your breasts are very full, try the tips listed below.

You should notice a decrease in the swelling and pain within 24 hours. Engorgement can lead to blocked ducts and/or mastitis. If there is no improvement, contact a lactation specialist.

Blocked milk ducts occur when a milk duct is not draining properly and has become inflamed. Pressure can build up behind the duct, causing inflammation in the surrounding tissues. These localized areas may be tender and lumpy, reddened and sore.

Continue to feed often, starting on the affected side. Try massaging the breast before and during feeding to stimulate the milk flow. Change your baby’s position to help the milk flow from all areas of your breast. The baby drains the milk best from the area where their chin is. Plugged ducts usually improve within 24 to 48 hours.  If there is no improvement contact a lactation specialist. If blocked ducts do not get better it can cause mastitis.

Mastitis is in inflammation of the breast, often accompanied by localized breast tenderness, areas of the breast are inflamed, red and have a painful, hard swelling. Mastitis can progress to an infection. Flu-like symptoms such as fever and chills can develop suddenly. Mastitis usually clears up quickly with treatment. It is important to seek medical attention from your health care provider if you are experiencing these symptoms.

• Position and latch your baby correctly. Get help if your nipples are sore and not improving
• Feed your baby often, using different feeding positions. This will help to drain all the milk ducts
• If you have lumpy areas on your breast, using your fingertips gently massage from behind the area all the way to the nipple to clear the duct before and during breastfeeding
• Avoid suddenly decreasing how often you feed. Avoid the use of soothers or bottles to feed, as they cause your baby to miss or delay a feeding
• Be careful not to restrict milk flow while breast/chestfeeding or pumping. Gently support your breast while feeding or pumping. Gently position the shield on your breast while pumping
• Wear a well-fitted (but not tight) bra and comfortable clothing. Avoid underwire bras and wearing a bra to bed unless necessary
• Avoid carrying heavy diaper bags or purses with shoulder straps as they can put pressure on your breasts
• Sleep when your baby sleeps. Ask family members for help with other children and household tasks

• Continue to feed often to keep your milk flowing (suddenly stopping feedings can make the mastitis worse)
• Place warm cloths on your breasts 5 – 10 minutes before feeding to help milk drainage
• Using your fingertips, gently massage from behind the tender area all the way to the nipple before and during the feed
• Have your baby feed on your tender breast first. Continue to nurse on both breasts. Breast/chestfeed frequently
• Position and latch so that you baby’s chin is close to the tender area. The baby drains the milk best from the area where his or her chin is
• Rest. Ask your family and friends to help you at home
• Drink plenty of fluids
• You may need to take a mild pain medication to relieve your discomfort. Antibiotics may also be necessary if the mastitis is caused by an infection. See your doctor if the mastitis does not improve within 24 hours
• If your baby is unable to breast/chestfeed, you will need to express your milk regularly