Lansinoh Moms' Club

Early Hurdles-Soreness, Engorgement and Plugged Ducts

Mom using Therapearl breast therapy

Early Hurdles-Soreness, Engorgement and Plugged Ducts

Breastfeeding is natural but it does not come naturally for everyone.

It is very common to have some early challenges. Here are a few of the most common early hurdles so you know what to watch for and how to overcome them.

Soreness

The most common issue experienced by breastfeeding moms is sore nipples. It is important to understand the underlying cause of soreness so you can properly treat it. Breastfeeding soreness can be caused by baby not having a proper or deep enough latch, an incorrect position causing baby to slip off or down onto your nipple only, or some other issue.

The first step is to make sure baby is positioned and latched on correctly. It is important to bring baby to the breast instead of leaning down and bringing breast to baby. One tip is to use your breast and nipple to tickle baby's cheek and lips to get her to open wide, and then latch her on that way. You can also make your hand into a position as if you are holding a sandwich (called the c-hold), so your thumb is under the areola and your index finger on top. This makes the breast a little more compressed and easier to get in baby's small mouth. If soreness persists, consider seeing a lactation consultant to make sure a tongue or lip-tie isn’t the issue.

If baby’s latch is good but breastfeeding soreness persists, check with a lactation consultant to make sure there isn’t another issue at play, such as a tongue tie.

Engorgement

Around day three postpartum, your breasts may swell (a common condition called engorgement) as your first milk, colostrum, is replaced by mature milk. The good news is that it’s a temporary condition. Your supply will even out and you will not be as swollen. Nursing frequently during this period is the best way to alleviate breastfeeding engorgement, but it can be difficult because baby may have trouble properly latching onto an engorged breast.

Don't let this discourage you! The nipple needs to touch the roof of baby’s mouth to stimulate latch on, suck and swallow. If your nipple is flattened by engorgement, try Lansinoh® LatchAssist ® Nipple Everter. This simple tool helps the nipple temporarily “stand out,” making it easier for baby to establish a good latch.

Other things to try:

  • Take a hot shower to help soften breasts
  • Express some milk using hand expression or a breast pump, getting out just enough milk to soften the breast so baby can properly latch on
  • Use ice packs after nursing to reduce swelling and relieve pain. When frozen and used cold, Lansinoh® THERA°PEARL® 3-in-1 Breast Therapy packs can help ease the pain and soreness that can accompany engorgement.

Plugged Ducts

A plugged duct is an area of the breast where milk is blocked. It creates a small bump and can be tender to the touch. It can also be swollen, red, or feel hot, and it’s important to know that sometimes there is no bump, there is only tenderness. Some moms experience milk appearing stringy or thickened. The clogged milk duct could be in a couple of places – the nipple pore may be blocked, or the obstruction may be further back in the breast in the channel where milk flows to the nipple. A breastfeeding plugged duct usually comes on gradually as milk gets backed up and it generally only affects one breast.

Some causes of breastfeeding plugged ducts can include:

  • Engorgement. Watching the clock and not your baby can cause delays in your feedings and can cause plugged ducts as the milk has nowhere to flow once it has built up.
  • Infrequent or skipped feedings. It is important to feed on demand so you are watching your baby’s hunger cues and your body gets regular signals to keep replenishing your milk supply. If, for instance, mom and baby are apart during a feeding, it is very important for mom to pump in order to release the milk that is built up and so her body can continue to receive the signals needed to make more milk.
  • Restrictive clothing (especially underwire bras). Any pressure that causes a kink in the channel where milk flows can cause an obstruction and a plugged duct. It is important to avoid underwire bras and any tight clothing that will put pressure on your breasts, especially on the underside of the breast, where an underwire or tight strap would be.

A plugged duct can feel more tender before nursing and less so afterwards because the strength of baby nursing can dislodge some of the plugged duct. Mom can also feel tenderness between feedings as milk builds up. While it is not always the case, mom can sometimes get a low fever (less than 101.3°F).

If you think you have a plugged duct:

  • Continue nursing, and get proper rest and nutrition
  • Nurse frequently to drain the breast
  • Use heat and gentle massage on the affected area before and during nursing to encourage milk flow
  • Loosen tight clothing or bras
  • Nurse on the plugged duct side as baby’s strong sucking at the beginning of breastfeeding can help dislodge the plug
  • After nursing, pump to ensure milk has been drained
  • Use cold compresses or cooled THERA°PEARL® 3-in-1 Breast Therapy packs between feeding sessions to soothe and reduce inflammation

Mastitis

Plugged ducts and mastitis (a breast infection) often go hand in hand, but you can get one without the other. It is possible to get a breast infection from sore, cracked, or bleeding nipples as they can create a breeding ground for bacteria. A surface infection on the nipple and previous bouts with mastitis are also risk factors. Some moms may find their milk seems more fatty or stringy, much like when a duct is plugged. Milk could also taste saltier to baby and baby could temporarily refuse to nurse on that side. The milk from a breast with mastitis could also have blood or mucus in it. It is important to offer baby that breast and not to stop nursing if you have mastitis. If baby is refusing, it is very important to pump to ensure that your milk is being drained regularly.

Mastitis symptoms can come on very suddenly and you may feel like you have the flu - lethargic, tired, and achy. If the issue is not resolved in the first 12-24 hours, you may need to go on antibiotics. It is important to consult with a lactation consultant and your physician to ensure that breastfeeding is not interrupted unnecessarily.

If you think you have mastitis:

  • Continue nursing and get proper rest, hydration, and nutrition
  • Nurse frequently to drain the breast. If baby won’t nurse from one side, continue to pump to maintain your milk supply
  • Use heat and gentle massage on the affected area before and during nursing to encourage milk flow
  • Loosen tight clothing or bras
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