Several things may cause engorgement, for example, wearing a bra that is too tight or a baby sling that does not fit properly and presses on the milk ducts. Part of the breast then becomes tender to the touch. Without treatment, this area may become red. If the milk is not removed, it remains in the breasts and proteins are released that decrease milk production. If engorgement is not treated it may result in mastitis.
Frequent feeding or expression can help relieve engorgement and encourage milk flow. You should massage the breast, especially the affected area. Hot flannels applied prior to feeding encourage let down. You may also want to change your breastfeeding position so that your baby’s chin is pointing towards the tender spot. Consult a healthcare professional for diagnosis and treatment.
Mastitis is an inflammation of the mammary gland or the breast tissue. It can be caused by prolonged engorgement, untreated cracked nipples resulting in an infection or pressure that leads to milk stasis. Signs of mastitis include:
- tenderness in one particular area of the breast
- a hot, red area on the breast
- generally feeling unwell
- flu-like symptoms and fever
If you have a headache or feel as though you are getting the flu, first examine your breasts carefully in front of a mirror. Do not forget to look at the underside of your breasts as well, since mastitis often occurs here.
If you think you might have mastitis, contact your lactation consultant or doctor immediately. Mastitis can worsen quickly within just a few hours.
Continue to breastfeed – your breasts need to be emptied as much as possible. If you have mastitis it is definitely not a good time to wean your baby – the milk needs to be removed from your breasts. If you need to take medication, ask your doctor for something that does not affect breastfeeding.