Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
You may notice small, red, tender lumps within the breast caused by milk ducts (tubes) that have become clogged (blocked with dried milk or other material).
The best treatment is to increase flow to open these blocked ducts.
Increase breastfeeding frequency and offer the affected breast first.
Pump the breast after breastfeeding if the baby is not emptying the breast.
Keep pressure off the duct. Make sure your bra is not putting pressure on the duct.
Do not wean baby at this time, or pain and complications may increase.
Apply moist heat to the affected area to increase blood flow and healing. (When applying heat, be careful not to burn yourself or the baby. Try 10-20 minute sessions two to four times per day for one to three days. Applying a warm water bottle over a warm, wet washcloth is one method to apply heat.) A warm shower and massaging the area will allow resolution of this problem.
Sometimes the baby will refuse the affected breast because the milk develops a sour taste. Pump the breast and empty it as well as possible. Continue to offer that breast to the baby until baby breastfeeds again.
For sore nipples
Expose sore or cracked nipples to the air as much as possible.
Use a hair dryer on a low setting to dry nipples after breastfeeding.
Wash only with water, never with soap, alcohol, benzoin, or premoistened towelettes.
Unmedicated lanolin may help if nipple cracking is severe, but petroleum-based ointments and other cosmetic preparations should not be used.
Medical care
Breast inflammation (mastitis, possibly caused by infection)
Continue to breastfeed. Breastfeeding helps to empty the breast and prevent clogged milk ducts.
Rest or get in bed at first sign of infection.
Breastfeed and pump the affected breast as much as possible.
Pump the breast to express milk on that side.
Apply moist heat for 10-20 minutes at a time at least four times per day. Heat increases blood flow to the area, aiding in fighting infection. A warm shower with water on the affected breast may help facilitate healing.
Watch for additional signs of a localized infection called a breast abscess.
The baby may not want to breastfeed on the affected side, so pump until the baby accepts the breast again.
A delay in treating mastitis could lead to a more severe infection and possible breast abscess. If you are experiencing any of the following symptoms, go to a hospital’s emergency department.
A localized swelling that generally increases in size
Pain
Tenderness
Possibly warmth and redness if close enough to the skin surface
Fever greater than 101 F (may be associated with shaking chills alternating with sweating)
Breast abscess (pocket of infection)
Surgical drainage may be indicated.
Breastfeeding with the affected breast is generally stopped.
A breast pump should be used regularly to empty the breast until breastfeeding can be restarted or symptoms could worsen.
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