Feeding
Breast Engorgement & Mastitis
Engorgement: Breasts become overly full, hard, painful, and swollen (usually days 2-5 postpartum when milk comes in). Makes latching difficult for baby. Normal engorgement resolves in 24-48 hours with frequent feeding.
Mastitis: Breast infection, often starts with clogged duct. Symptoms: Red, hot, painful wedge-shaped area on breast, fever >101°F, flu-like aches, chills. Requires antibiotics.
Mastitis is urgent - untreated can lead to abscess. Usually affects one breast, most common in first 3 months of breastfeeding.
What to Do
- For engorgement: Nurse frequently (every 1-2 hours) to relieve fullness
- Hand express or pump just enough to soften before feeding (helps baby latch)
- Apply cold compresses AFTER feeding (ice packs, frozen peas in towel) for 15 minutes
- Apply warm compress or take warm shower BEFORE feeding (helps milk flow)
- Massage breasts gently while nursing to help milk flow
- Wear supportive bra but not too tight (avoid underwires during engorgement)
- For mastitis: Continue nursing/pumping frequently - emptying breast is crucial
- Start feeding on affected side first (when baby's suck is strongest)
- Call doctor for antibiotics - safe while breastfeeding and necessary
- Take full course of antibiotics even if feeling better
- Rest, drink fluids, take ibuprofen for pain and inflammation
- Apply warm compress before feeding, cold after
- DO NOT stop breastfeeding - milk is safe for baby and stopping worsens mastitis
When to call a doctor
Call doctor immediately if you have fever >101°F, red streaks on breast, severe pain, pus or blood in milk, or symptoms don't improve within 24 hours. Mastitis needs antibiotic treatment. Also call if severe engorgement prevents baby from latching for multiple feeds.