Ask The Doctor: Painful Breas... Health Article
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Mary Pickett, M.D., is a lecturer for Harvard Medical School and an assistant professor of medicine at Oregon Health & Science University in Portland, OR. At OHSU, she practices general internal medicine and teaches medical residents and students.
Question:
My daughter is breastfeeding, and her breasts have become very painful. It appears she has mastitis. What can she do at home to relieve the symptoms?
Answer:
Mastitis is an infection of the breast, and it is usually accompanied by a fever. One area of the breast becomes red, swollen, firm, and tender. If you have symptoms that resemble mastitis, you should see your doctor so that antibiotic treatment can be started.
It is helpful to continue breastfeeding when you have mastitis. This relieves pressure on the sore area. We do not notice any harms to babies who continue to breastfeed from a mom who has mastitis, although they may swallow some bacteria in the breast milk. Pumping and discarding milk is another option to relieve your breast pressure, but it is usually best for the baby to breastfeed. It is also helpful to make sure you have a bra that fits well and provides support, and it is helpful to use ibuprofen to relieve pain.
Some women who think they have mastitis but do not have a fever may have a separate problem, a plugged milk duct. This can also cause a firm tender area, but it usually is less red and doesn't cause a fever. Do not delay seeing your doctor if you think you may have a plugged milk duct instead of mastitis; let an expert examine your breast. A plugged duct can sometimes be emptied more easily if you use a warm compress on the breast or take a warm shower after breastfeeding, then massage the tender area. Massage of the breast is not recommended until a doctor has reassured you that your problem is a plugged duct instead of mastitis.
If both breasts are painful at the same time, your problem is probably not mastitis. Instead, you may have engorgement, very full breasts. Frequent breastfeeding is the best solution, or breastfeeding followed by warm showers that can help residual milk to exit the breast. Some women find that cold compresses help to relieve discomfort from engorgement, although cold packs do not empty the breasts of their milk.