By Dr. Nancy Brent
If you have pain in the breast, it may be a breast infection known as mastitis.
This may present as inflammation of the breast or actual infection. In either case, it’s important to contact your primary care provider, who will help you to manage it.
Early signs of mastitis include pain in a localized area of the breast, which may be tender to touch, appear red and feel warmer than the rest of your skin. The tender area may also feel hard underneath the skin. You may feel like you’re getting sick or coming down with the flu. You may or may not have a fever. A breast infection is usually on just one breast.
If your feeding schedule is changed suddenly such that you either missed a feeding or are not feeding as often, the milk may back up. This can present as a clogged duct or a sudden breast infection. For example, if you leave a glass of milk out on a warm day, it will go sour (get infected), but if you drink it within a few minutes, the milk is fine. Situations in which this may occur are going back to work, the baby sleeping through the night, either the mother or baby getting sick, weaning and others. You may first feel a slightly tender, hard area in the breast. If you have none of the symptoms mentioned above, you can initially manage this as a clogged duct. You can see our post about How to Heal a Clogged Duct for more information. However, if you have a fever or feel you are getting sick, or if the breast is very red, you should call your health care provider immediately.
A true breast infection must be treated with antibiotics. The most common reason for complications such as abscess or recurrent mastitis is inadequate treatment with antibiotics. It is also very important for you to empty the breasts often. Feed the baby as often as he will let you. If this is not possible (one of you is sick or you are separated) you will need to use a breast pump or hand expression. The important thing is to keep the milk flowing. Change positions, trying to point the baby’s chin in the direction of the painful area. You can use the cradle, football or side lying position. You may also find a creative position of your own which works for you. Gently massage the painful area while you are nursing or pumping. As a supportive measure, get plenty of rest and increase fluid intake.
If these measures don’t solve the problem, call your doctor or the Breastfeeding Center of Pittsburgh.
Dr. Nancy Brent is the former Medical Director of the Breastfeeding Center of Pittsburgh.