Nursing Roadblocks

Engorgement & Mastisis


Julie Vanneman, of Pittsburgh, had a textbook case of engorgement. "My breasts were rock-hard, enormous, and painful," she says. It usually happens when your milk first comes in or if you've gone too long between feedings. Luckily, it's easy to remedy. The most important step you can take is to pump or hand-express some milk.

"Latching onto an engorged breast can be difficult for a baby, so pumping or hand expressing just enough milk to soften the areola can help get the baby on," says Costello. Ultimately, the more you nurse, the less likely it is you'll get engorged in the future.

Dr. Mass advises frequent nursing, warm compresses before feeding, and cold compresses after to relieve pain. Costello recommends an old-fashioned pain reliever: cabbage leaves. Place a head of cabbage in your freezer. When you need a breast-shaped ice pack, peel off a leaf and place it on your breast for 15 to 20 minutes.

How to Avoid Breast Engorgement
How to Avoid Breast Engorgement


Two weeks after her baby was born, Katie Moody, of Oak Park, Illinois, had some serious breast pain. "One quarter of my right breast was very painful, red, and hot, and I had a 102-degree fever," she says.

She'd come down with mastitis, which can also include other flu-like symptoms, such as body aches, and is most common two to three weeks after giving birth, according to Dr. Mass. It can also happen during weaning.

The cause? "A bacterial infection, often due to a break in the skin, plugged milk ducts, or engorgement," Dr. Mass says. The first sign of it is usually breast pain, so contact your doctor if you have any symptoms. Mastitis requires antibiotic treatment and frequent hot compresses to help break down the blockage. It's also very important to continue breastfeeding, drink lots of fluids, and get as much rest as you can.

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