Pain and swelling in the breasts
A woman’s breasts are too full (engorgement)
When the milk first comes in, the breasts often feel
swollen and hard. This can make it difficult for the baby to
suckle, and the nipples may get sore. If you breastfeed less
because of the pain, your milk supply will be less.
Prevention and treatment:
• Start breastfeeding within the first hour after birth.
• Make sure you are holding the baby well (see page 108).
• Feed the baby often, at least every 1 to 3 hours, and
on both breasts. Sleep with the baby nearby so you can
breastfeed easily during the night.
• If the baby cannot suckle well, remove some milk by
hand—just enough to soften the breast—and then let
the baby suckle.
• After feeding, apply fresh cabbage leaves or cool wet
cloths to the breasts.
After 2 or 3 days, the swelling should go down.
Engorgement that does not improve can become mastitis
(a hot, painful swelling of the breast).
Blocked duct, mastitis
If a painful lump forms in the breast, it may mean that
a duct is blocked by thick milk. When milk flow stops in
part of the breast, it can also cause mastitis. If a woman has
a fever and part of her breast is hot, swollen and painful,
she probably has mastitis. It is important to continue
breastfeeding so that the duct can empty and the breast
does not get infected. The milk is still safe for the baby.
Treatment for blocked duct and mastitis:
• Apply warm wet cloths to the painful breast before you breastfeed.
• Continue to feed the baby often, especially from the painful breast. Make sure the
baby is holding the breast well in its mouth (see page 108).
• As the baby feeds, gently massage the lump, moving your fingers from the lump
toward the nipple. This will help to clear the blocked duct.
• Change feeding positions to help the milk flow from all parts of the breast.
• If you cannot breastfeed, remove your milk by hand or use the warm-bottle
method. The milk must be kept flowing from the breast to clear the blocked duct.
• Wear loose-fitting clothing, and rest as much as you can.
Most mastitis clears up in 24 hours. If you have fever for more than 24 hours, you need
treatment for breast infection.
Where Women Have No Doctor 2012