Sore breasts/chest tissue

You may experience breast/chest engorgement where your breasts/chest become overly full (swollen), hard and painful.

• Swollen breasts/chest
• Tender, warm and throbbing breasts/chest
• Reddened breasts/chest
• Taut, shiny and transparent skin on breasts/chest
• Low-grade fever
• Flattened nipples

• Day three or four when the milk volume increases
• If feedings are missed
• If baby is not sucking and latched correctly and not emptying the breast/chest fully
• If birth parent and baby are separated
• Long night sleeps or missed night feeds

• Breastfeed/Chestfeed your baby early and often after birth.
• Breastfeed/Chestfeed your baby frequently on demand (eight or more times in 24 hours).
• Feed baby every two to three hours day and night at first, then learn to watch baby’s cues.
• Make sure your baby is latched on and positioned correctly.
• Wake a sleepy baby to breastfeed/chestfeed every two to three hours during the day. If baby is growing well, they may go a little longer at night.
• If you are separated from your baby, begin hand expression as soon as possible after birth, preferably within one hour. Your baby may be able to take drops of your colostrum. After the first 24 hours, continue to hand express and use an effective and efficient pump to establish a good milk supply and pump often (eight or more times in 24 hours).
• Avoid any unnecessary supplementation.

• Use Advil or Motrin (ibuprofen) to maintain comfort and decrease pain.
• Use cold compresses between feeds to reduce swelling and discomfort. Do not place the ice pack directly onto the skin.
• Some people report improved comfort when raw cabbage leaves are applied to the breasts/chest. Once the discomfort goes away, stop using cabbage leaves as they can decrease your milk supply.
• Hand express a little prior to breastfeeding/chestfeeding to help soften the dark area on your breast/chest or nipple (areola) so your baby can latch more easily.

If you have a red sore area in your breast/chest, you may have a plugged duct. A plugged duct can happen if milk builds up in a milk duct and does not flow. Pressure builds up behind the duct and can cause soreness in the surrounding area.

Plugged ducts can become infected. With continued nursing and massage of the area, plugged ducts usually clear up in one to two days. Find ways to relieve plugged ducts.

Sometimes the small ducts or tubes in your breast or chest tissues to become congested and inflamed. Feeding your baby or expressing regularly when away from your baby can help prevent this. The congested tissues can be painful and is called mastitis, which is an inflammatory condition. 

Here are some tips you can try to help: 

• Feed your baby based on their hunger signs. This can help move the milk and prevent your breast tissues from getting too full and congested. 
• Wear a well-fitted comfortable, supportive bra. As your breast or chest tissue size increases from fullness, your bra may get too tight, which can cause blocked ducts (hard, painful lumps in your breasts or chest tissues). Your bra should not compress or pinch your breast/chest tissue as this can cause tissue congestion, inflammation and plugged ducts.  
• Some parents find that stretchy sports bras can offer the flexible support as your breast or chest tissue size changes compared to underwire, fixed size bras. 
• You can use breast pads (absorbent nursing pads) to soak up any leaking milk. Change them as they become wet.
• Try applying cold packs to your breasts/chest tissue for 15 to 20 minutes, as needed during the day. This will help reduce inflammation.  One study showed cold cabbage leaves (from the fridge) work just as well as cold compresses.
• Use very light sweeping motions over your skin and a very gentle touch. Make gentle sweeping motions from your nipple toward your underarm and chest. Avoid deep massage that could damage swollen breast tissue  or chest tissue  and increase inflammation even more.
• Consider taking non-steroidal anti-inflammatories like  ibuprofen [Advil, Motrin] if your breasts/chest tissues are painful. These medications will help with the inflammation that is causing tissue congestion and pain. Follow the directions on the package.
• If your breasts or chest tissues are uncomfortably full, you could hand express or pump just a little to comfort. Save this milk for your baby. 

Mastitis can also be caused by a range of causes such as bacterial infection, yeast or thrush, or from allowing milk to stay in your tissues for long periods, such as when you are stopping your milk supply. 

Call your health care provider right away if you have:

• a fever over 38.5°C (101.3°F)
• pain in your breast  or chest tissue continues or gets worse
• muscle aches/chills
• fast heartbeat
• feeling like you have the flu
  
  *Continue your comfort measures while you wait to see  your health care provider. 

Find ways to treat mastitis on La Leche League Canada's and La Leche League International's websites