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Breastfeeding

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SORE BREASTS

Pain in the breasts may be caused by engorgement, a plugged duct, mastitis or something else. It is often difficult for a mother (and doctor) to tell whether the inflammation is due to engorgement or a plugged duct, neither of which needs antibiotics, or mastitis, which usually, but not always, requires antibiotics. Use the guidelines in the chart to help you figure out what the problem is and how to treat it. Use the links to find additional information on how to relieve sore breasts.

SORE BREASTS: STAGES OF SEVERITY
FEATURES NORMAL BREAST FULLNESS ENGORGEMENT PLUGGED DUCT MASTITIS
Usual onset 2-4 days after birth Within the first two weeks Most noticeable after feedings Most common around third week postpartum; may occur at any time during lactating.
Where/Location Both breasts Both breasts Localized area in one breast One breast
Breasts feel: Generally swollen, uncomfortable, not hard, but tight Hard, swollen, sore, warm Mildly tender lump beneath areola, reddened skin above Very painful: hot, tender, swollen, red streaking
Maternal fever None 101 or below None Higher than 101
Mother generally feels: Well Well Well; may see a white milk plug in a nipple opening. Achy, tired, chills, "like I've got the flu."
Treatment Frequent, unrestricted feeding, empty breasts Frequent, unrestricted feeding, empty breasts alternating warm and cold compresses; rest Frequent, unrestricted feeding; moist, hot packs, massage plugged duct to loosen plug and encourage milk flow Frequent, unrestricted feeding, empty breasts; rest, relaxation; physician may prescribe antibiotics

   
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