Breast pain or lumps

When your baby is about three to five days old, it’s very common for your breasts to become very full for a few days as your milk comes in. Your breasts may feel hard, tight and painful.

Your breasts can also feel engorged if you leave more time between feeds. You may also find you leak a little milk.

Easing breast engorgement

• continue to feed your baby responsively
• try expressing a little milk to relieve some of the discomfort
• ensure your baby has a good latch
• wear a well-fitting breastfeeding bra that does not restrict your breasts
• soothe your breasts with a cold compress to help reduce any swelling (some mums swear by cabbage leaves!)
• take some paracetamol or ibuprofen at the recommended dose to ease the pain

If you are still feeling discomfort after trying these steps, please do reach our for support.

Mastitis can be a painful condition that can cause your breasts to become swollen, painful and inflamed.

Symptoms of mastitis include:

• a breast that feels hot and tender
• a red patch of skin that’s painful to touch
• a swollen breast that does not reduce following a good feed
• a general feeling of illness, as if you have flu
• feeling achy, tired and tearful
• a high temperature

If you are breastfeeding and think you may have mastitis, it’s important to continue to breastfeed your baby to help keep your milk passing through the milk ducts. If that’s not possible, express regularly.

There’s no need to increase expressing or express after each feed to ‘empty the breast’. Doing so can lead to an oversupply which could make the mastitis worse. Hand expressing a small amount of milk until comfortable is a better option if your breasts are uncomfortably full.

Easing mastitis symptoms

• continue to responsively breastfeed your baby when they want, and for as long as they want
• start your breastfeed with the affected breast first
• make sure your baby is attached to your breast well
• ask your midwife or a peer supporter to check your latch and make sure your baby is positioned properly
• if the affected breast still feels full after a feed, or your baby cannot feed for some reason, try expressing your milk by hand
• a warm compress applied to the breast, a warm shower or bath may also help to improve milk flow
• breast pain may be soothed using a cold compress (for example a cloth soaked in cold water or a cabbage leave)
• try to get plenty of rest and drink lots of fluids
• take paracetamol or ibuprofen to reduce any pain or high temperature

If you start to feel unwell, achy, flu like symptoms or you develop a fever please contact your GP straight away as you may require antibiotics.

If you are prescribed antibiotics, it’s important to carry on breastfeeding while you complete the course. If you have questions about the medication prescribed to you visit The Breastfeeding Network.

Breast and nipple pain can also be caused by a thrush (candida) infection.

Breastfed babies can also develop thrush in their mouths.

Thrush can develop when your nipples become cracked or damaged. The candida fungus lives on the skin, mouth, gut and vagina. It may occur in breastfeeding women and babies when the candida fungus can get into your nipple or breast, causing pain and discomfort for you and your baby.

Symptoms of thrush:

• you start to feel pain in both nipples and/or breasts after feeds, having previously had no pain after feeding. The pain can be quite severe and last for up to an hour after every feed.

Symptoms of oral thrush in breastfed babies:

• creamy white spots or patches on the tongue, gums, roof of the mouth or insides of the cheeks. These white spots won’t come off when you try to gently wipe these patches with a clean cloth
• your baby being unsettled when feeding
• a white film on the lips
• in some babies, nappy rash that won’t clear up

If you or your baby have symptoms of thrush it is important that you are both treated or you will continue to cross infect each other.

It’s not likely to be thrush if:

• you have experienced breast pain when feeding in the past
• the pain only affects one nipple or breast
• you have a fever and a warm red patch on one of your breasts.

If you think you might have thrush, contact your midwife or GP who will be able to help you treat the infection.