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 Breastfeeding
Auch! When breastfeeding hurts

It’s day three after your baby arrived and you are sitting with breasts as big as Dolly Parton’s. What can you do to prevent and treat engorged breasts and blocked milk ducts?

Breast engorgement

 
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Signs

Soon after you give birth, you may find that your breasts feel very swollen, tender, throbbing, lumpy, and uncomfortably full. Sometimes the swelling extends all the way to the armpit and you may run a fever too.

The nipples may appear flattened and sore and the baby may suck, but not receive much milk.

Causes

During the first few weeks after birth, your breasts will produce colostrums or ‘starter milk’. As this changes into mature milk, the breasts swell as a result of expanding veins as more blood flows to your breasts, causing some of the surrounding tissue to swell. The pressure of the milk let-down may also cause tenderness and swelling. Fortunately, this problem is usually temporary and should only last a few days.

Treatment

  • When breasts are severely engorged, pumping or manually expressing some breast milk can help to reduce swelling and allow the baby to suckle.
  • Nurse frequently, every two to three hours. Make sure your baby nurses on both breasts at each feeding.
  • Wear a supportive nursing bra, even during the night. But be sure that it isn't too tight.
  • Apply cold packs to the breast for a short period after nursing to soothe the pain and help relieve swelling.
  • Don't apply direct heat, such as warm washcloths, heating pads, or hot water bottles, to your engorged breasts unless it's to soften the areola and help your milk let-down. Rather take a warm shower just before feeding.
  • Massaging the breasts as the baby nurses can help get out as much milk as possible.
  • If you have further problems, contact your doctor.

Prevention

  • Nurse often to prevent engorgement. This is important as when breasts become swollen, they are more prone to infections.

If you are worried about a possible infection or your breasts remain swollen, consult your doctor.

Blocked Milk Ducts

This is literally when one or more of the milk ducts in your breasts become blocked, not allowing any milk through.

Signs

Breasts usually enlarge somewhat and there will also be a small, hard lump or a tender spot in your breast. You may also notice some redness. The milk flow on the affected side may also be slower than usual and your baby may become fussy when nursing on that breast.

If you feel achy, run down, and feverish, the clogged duct may have become infected, in which case you should see a doctor as soon as possible.

Cause

What occurs is that one or more of the milk ducts becomes blocked so that milk cannot pass through to the baby. Milk flowing through the ducts then fails to drain completely.

Treatment

  • Blocked ducts usually resolve spontaneously a day or two after onset, but if the lump remains more than three days, whether you are still having pain or not, you should consult your doctor.
  • Applying warm compresses before breastfeeding can help milk flow more freely and empty the breast.
  • Changing breastfeeding positions can help to drain all areas of the breast. Try lying down to breastfeed for example.
  • If a blocked duct has not settled within 48 hours, therapeutic ultrasound often works. This can be arranged at a neighbourhood physiotherapy office or sports medicine clinic.

Prevention

  • Check your breasts daily for any lumps or any other symptoms of a plugged duct. It is often easiest to check while you are showering or massaging your breasts during feeds.
  • Avoid long stretches between breastfeeding.
  • A poorly fitted bra, or a bra that constricts (such as an underwire bra) may contribute to plugged ducts.
  • When breastfeeding, periodically changing the baby's position
  • Keep the nipple clear of any crusting or dried milk. Gently clean your breasts with a soft cloth and warm water (no soap) when necessary
  • Maintain a healthy diet and get lots of rest.

 
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