Breasts Are Sore

OH MY GOODNESS!! I slept with a heating pad on my chest for the first month and a half after giving birth. This REALLY helps a lot and also helps (I think) in keeping the milk ducts from getting really clogged up too. It's like a deep achiness inside, behind the boobs and the heat really helped out. It will get better, hopefully in a couple weeks! This was my third time giving birth and I still needed a heating pad, so she is probably doing everything right.

Hi Gina,

It sounds like your sister has either one of two options: a plugged duct which can develop into mastitis or a yeast infection of the breast, called thrush.

1) Plugged duct - the best remedy for the plugged duct is to apply heat (hot shower works well) and massage the breast and either manually express or nurse the baby. It is important for her to use heat and not cold as this will allow for easier passage of the plug. She should also try nursing from different positions, i.e. football hold, cradle hold, lying down. This will ensure that all the ducts within the breast are emptied properly. With a plugged duct the more she nurses the better and always w/ warmth and massage. If she has developed mastitis she would exhibit a fever, body aches, and a red, hot and sore breast. If she doesn't feel better within a couple of days I would advise her to see her doctor and a lactation consultant to work on the latching. The latch should be unpleasant for the first few days, but it should definitely not hurt. For mastitis, her Dr. will prescribe an antibiotic. Mastitis does not affect the milk, nor can she pass it on. The best thing is to nurse more often to make sure it doesn't reappear.

2) Thrush or a yeast infection of the breast is very painful. This occurs when yeast from the baby's mouth enters the breast through small cuts in the nipple. If the baby has a poor latch, and the nipple has been damaged, it is very possible then that she would have this. If it is in the beginning stages, she would only have pain in the nipple area, however, if the yeast has traveled into the breast tissue, then she would feel the pain deep within the breast. The pain usually occurs at the start or end of the nursing session and is quite painful. If this sounds more like what she has, she definitely needs to see her OB, so they can prescribe either Diflucan, or a topical cream called triple nipple which they make at people's pharmacy. Some people have also had success w/ gentian violet, however, it stains clothing and the mouth of the baby. With thrush, the baby may or may not have the infection to have passed it to her. If the baby has it in his mouth, she would see white, creamy patches in his mouth, and/or a prolonged diaper rash that doesn't go away w/ cream. Yeast is very, very, persistent so if she has it she will need to continue treatment to avoid her passing it to her son, and then him re-passing it to her.

Either way I would suggest she visit her doctor, and a lactation consultant to make sure that the latch issue is not contributing to any of these issues.

Best of luck, and let her know that it does get easier with time, and although both of these are painful, once she gets past them, she should enjoy nursing..Like I said if there is pain, there is definitely something wrong. Hope this helps!

Hi. there are some good comments here. I would say Heather H said something key. emptying the breasts completely is a must. pumping and nursing signals to your body to make a greater supply of milk and she may not be emptying her breasts fully during a feeding. this happened to me and I finally spoke to a lactation consultant who advised me to begin each feeding on the sore breast. After soreness subsided I began each feeding on the breast the baby finished on during the last feeding. eventually my milk supply decreased and the clogged ducts were no longer a problem.

second thought, its always good to have the baby nurse from different positions(ie side-lying , cradle hold, football hold)this helps to better empty breast.

antibiotics are the usual protocol for mastitis, however to avoid killing the friendly bacteria my body so needs, I used echinacea and vitamin C to treat my infections. each one cleared in 24 to 48 hours

one last thought: nursing mommas need lots of rest. whenever i would take on too much, the soreness and clogging seemed to return.
hope this helps!

She may have a clogged duct. In which case she can massage her breast, typically in the shower works best. She may also have a yeast infection in her breast. It's really easy to treat. She just needs to take a diflucan pill. Also check baby's mouth for thrush. That will typically indicate a yeast infection in the breast. If baby does have it he needs to be treated with an oral antifungal which can be aquired with a trip from the pediatrician. If neither then consult the lactation nurse.

soreness is normal at first like that but if it continues or she sees red streaks or has fever then it could be and infection called Mastitius that is very painful and you will need medication from a Dr. for it. For soreness the heat and or cold help but for the nipples themselves being sore I would use lanolin cream. It is safe for the baby to digest. I put this on before and after each feeding until the soreness went away. The cream helps with cracked skin. Also, she could just pump for a while to help with healing and then breastfeed when she feels her nipples arn't sore anymore. Hope that helps.

Is the baby happy, or crying during feedings/fussy/etc.? A quick swab at the docs office might help determine if she has thrush, or if it simply is latching issues. Sometimes thrush goes unnoticed because Mom is in pain and assumes it's latch. It never hurts to have a lactation consultant or even just her doc watch her during a feeding. Tell her to look into it, but to hang in there! It's very easy to give up nursing at this point, but the best is yet to come!

It does take about 6 weeks to get totally comfortable with nursing and then it is the easiest thing, but usually the initial soreness is around the nipples. I would think if she is having soreness deep within her breast that I would have it checked out. Altho if it were an infection she would be running fever and have flu like syptoms. I would ask a La Leche League person or someone who knows.

She needs to get checked out to see if she has mastitis, a breast infection caused by plugged ducts. If bad, she will need to be on antibiotics, most are cleared up in a couple days. Mastitis usually has a high fever with it and a red streak on the breast. Heat is better than cold because heat will help to open the ducts. Baby needs to nurse as much as possible on that breast. If left untreated an abcess can for and that would require minor surgery to treat.

It sounds like she is not emptying her breasts. With the pumping AND feeding, she has told her body to make more and more. If she's not emptying them, she could be experiencing plugged/clogged ducts. Talking to a lactation consultant or going to a La Leche League meeting and talking to a leader there should help her decide what is wrong. Very important thing to make sure she is emptying the breasts completely.

First, I want to say that nursing should NOT hurt! I used to think, "oh that's true for some women, but I'm not one of them". It hurt - bad. I have since learned that it should not hurt. Pain tells us something is wrong. My guess is that 99% of the time, the issue is latch. That causes the sore nipples, can cause the breast to not be milked evenly (causing plugged ducts, etc), and other challenges. Deep in the breast pain could be plugged duct....Can she point to one localized spot that hurts? Is it red? Warm to the touch in that area? Has she had a fever? Flu-like symptoms? Is there any pain in her nipples? Does latch on or latch off hurt at all?

Also, a lactating breast is never truly empty. It can go from firm to floppy...but not empty.
Changing positions is good.
Nurse on both sides - don't favor one over the other. Both sides need to be nursed on regularly.
IF it's a plugged duct - Warm compresses, water and REST will do wonders.

My main advice would be to contact the local La Leche League Leader or a Lactation Consultant with the letters IBCLC after her name - that stands for Internationally Board Certified Lactation Consultant. Yes, the services for a RN LC would/should be free at the place she birthed her baby...however - not all LCs are the same. Some have more experience than others. Depending on your location, the class they take can be as short as 2hrs. LLL Leaders have many hours of group help as well as extensive resources to fall back on to help a nursing mom. If a Leader is unable troubleshoot with the nursing mom effectively, she will say so and refer the mom to an IBCLC. More information is needed than what you have been able to provide....a few too many possibilities with various treatments.
Please go to http://www.llli.org//Web/Texas.html
and look up a local Leader. Even if there is no meeting in her town, any Leader will gladly take a call to help a nursing mama!

HTH and please email me if you have any questions for me.
I am too happy to share my experiences as a nursing mama.

K., mama to
Catherine, 5y
Samuel, 2y
EDD 9/18

Definitely have her call the nurses line at her OB as well as a lactation consultant. Usually, they are free at the hospital she delivered at. She can always contact La Leche League as well. There's a possiblity that she's developed a clogged milk duct. She should certainly continue nursing through it but it can quickly become infected and cause mastitis (which is really painful and you feel like you are coming down with the flu). If she starts to feel this way, she'll need antibiotics and she SHOULD continue nursing through it. The bacteria will definitely not be passed to the baby. Lastly, as for the pain, it is very normal for many women (including myself with both children; cracking and bleeding can be very normal too). In the next 2 weeks, it should be gone. It's weird, the pain often just abruptly stops. It sounds like she's doing great! Just keep reassuring her that the first month is DEFINITELY the hardest. She's almost there. Next month might have a few challenges but by the 3rd month, she'll likely be a pro and all of this pain will have been worth it!

Hi Gina,
This happened to me after my first baby and it was YEAST. I had no idea that you could have a breast yeast infection but it is pretty common. It is that toe curliing pain upon let down. I was put on antibiotics.
Please tell her to consult a lactation consultant.

Please do advise her to seek out a LaLecheLeague group near her. It is free and she will receive so much support and advice. It is so great that you both understand the value of BFing! I applaud you.

Nursing can be painful, and it can take 2 months for it to become really comfortable. Latching incorrectly usually manifests itself as a sore nipple issue. I'm a training Lac. Consultant and I had a hard time with nursing my second baby in terms of pain. I had a deep shooting pain, too, but it did go away. I nursed him for 18 months and it did reappear at times, very briefly, then disappear again. He latched on correclty and everything seemed fine, textbook fine, but it hurt for a while.

It sounds like this could be a clogged milk duct issue. A warm compress will help restart the flow. Ice should only be used on nipples if one can stand it, but pain in the rest of the breast usually requires heat unless it is swollen. If she has a fever or starts running a fever she should contact her doctor. This could be a very painful mastitis and might require that she have help caring for baby while she recovers.

Either way, do encourage her to see a LC or attend a LLL meeting. They're invaluable resources in a culture which does not support BFing enough.

I had this same problem and for me it was a latching problem. I consulted a lactationist, it worked for about a week and it still did not help with the discomfort. I stopped giving the beast and pumped only and that is when I received relief. My pediatrician said, "It doesn't really matter how you give the breast milk, only that the baby receives it."

Not latching properly would cause sore nipples not, sore breasts. If she is having pain deep in her breast she could have a clogged duct which could lead to mastitis. She needs to make sure that her breast is completely empy at each feeding.

Lisa