ENGORGEMENT & MASTITIS

Presented by: Moya McLeod

Sheena-Gay Jackson
Robert Hamilton

Engorgement
Sometimes few days after parturition, the breasts

will become full, firm, warm, and perhaps tender.

Engorgement is normal, and lasts for various periods
of time depending on the individual woman. Some
women experience only a day or so of mild, easy-tomanage engorgement. For other women,
engorgement may be more intense, and can last from
several days to two weeks.

Improper Latching
If the baby is not latching properly or feeding

frequently enough, the breasts may become overly

full. This reduces the elasticity of the breasts and
nipples.
When the breasts are too firm, some babies cannot
grasp enough tissue to latch on well.
The baby may suck overly hard trying to pull in the
breast tissue, which can lead to sore nipples.

Signs & Symptoms

The breasts may redden and become painful.
. Mothers may sometimes develop a low-grade fever.

(Fever may also signal infection).

Severe engorgement may interfere with milk
production.

The milk pooling in engorged breasts releases chemical signals

that tell the body to decrease milk production. If unrelieved,
prolonged engorgement can contribute to insufficient milk
supply or begin the weaning process.

ENGORGED BREASTS

Prevention
Begin breastfeeding as soon as possible after the birth, to

give the baby time to learn to breastfeed before the

breasts become full and firm.
Unless medically indicated, avoid early use of bottles and
pacifiers while the baby is learning to breastfeed.
Once the milk comes in, breastfeed at least 8 times in 24
hours to prevent over fullness.
Ask for help from the hospital lactation consultant so
that latch-on problems are solved as soon as possible.
Any time a feeding is missed, use hand expression or a
breast pump to remove the milk.
Always wean gradually.

Treatment
Use moist heat on the breasts for a few minutes, or take a brief

hot shower before breastfeeding. This may help the milk begin
to flow. Note: Use of heat for extended periods of time (over 5
minutes) may make swelling worse.
Use cold compresses for 10 minutes after feedings to reduce
swelling.
Gently massage and compress the breast when the baby
pauses between sucks. This may help drain the breast, leaving
less milk behind..
A well-fitted, supportive nursing bra makes some women feel
better. Others prefer to go bra-less during engorgement.
Gentle breast massage and relaxation techniques may help
improve milk flow and reduce engorgement.

Treatment
Hand expression or brief use of a breast pump may help soften the

nipple and areola so that the baby can get a better latch.
Some women find that a single use of a breast pump to soften
severely engorged breasts diminishes painful inflammation. They
then return to frequent breastfeeding as the main way to manage
engorgement.
Pumping, hand expressing, or nursing to comfort prevents the
negative consequences of retained milk. Relieving the milk pressure
will not make engorgement worse.
If the baby is premature or complications interfere with
breastfeeding, a hospital grade pump can help the mother through
engorgement until her baby can breastfeed.
Fever higher than 101 F or severe pain may signal a breast
infection.

mastitis

Mastitis
Mastitis is a condition that causes a woman's breast

tissue to become painful and inflamed.

Mastitis related to breastfeeding is sometimes called
lactation mastitis or puerperal mastitis.
Non-breastfeeding women often have a type
called periductal mastitis.

Causes
In breastfeeding women, mastitis is often caused by

a build-up of milk within the breast. This is known as

milk stasis.
Milk stasis can occur for a number of reasons,
including:

a baby not properly attaching to the breast during feeding

a baby having problems sucking
infrequent feeds or missing feeds

Causes
In some cases, this build-up of milk can also become

infected with bacteria. This is known as infective

mastitis.
In non-breastfeeding women, mastitis most often
occurs when the breast becomes infected as a result
of damage to the nipple, such as a cracked or sore
nipple, or a nipple piercing.

Symptoms
Mastitis usually only affects one breast, and symptoms

often develop quickly.

Symptoms of mastitis can include:

a red, swollen area on your breast that may feel hot and painful to
touch
a breast lump or area of hardness on your breast
a burning pain in your breast that may be continuous, or may only
occur when you are breastfeeding
nipple discharge, which may be white or contain streaks of blood

Mothers may also experience flu-like symptoms, such as

aches, a high temperature (fever), chills and tiredness.

Treatment
Mastitis can usually be easily treated and most women will make a

full recovery very quickly.

Self-help measures are often helpful, such as:

getting plenty of rest and staying well hydrated

using over-the-counter painkillers, such as paracetamol or ibuprofen to reduce
any pain or fever
avoiding tight-fitting clothing (including bras) until your symptoms improve
if you are breastfeeding, continuing to feed your baby and making sure your baby
is properly attached to your breast

Breastfeeding the baby with mastitis, even if there is an infection, will

not harm the baby and can help improve the mothers symptoms. It
may also help to feed more frequently than usual, express any
remaining milk after a feed and express milk between feeds.
For non-breastfeeding women with mastitis, and breastfeeding
women with a suspected infection, a course of antibiotic tablets will
usually be prescribed to bring the infection under control.

Prevention
Although mastitis can usually be treated easily, the

condition can recur if the underlying cause is not

addressed.
Breastfeeding mothers can help reduce the risk of
developing mastitis by taking steps to stop milk building
up in breasts, such as:

breastfeed exclusively for around six months, if possible

encourage the baby to feed frequently, particularly when breasts feel
overfull
ensure the baby is well attached to the breast during feeds
let the baby finish their feeds most babies will release the breast
when they have finished feeding;
avoid suddenly going longer between feeds if possible, cut down
gradually
avoid pressure on the breasts from tight clothing, including bras.

References
Wilson, W. 2014. Relieving and Treating Engorged

Breasts. Retrieved from

http://www.medelabreastfeedingus.com/tips-andsolutions/47/relieving-and-treating-engorgedbreasts#RelatedFiles on September 30, 2014