Understanding Nipple Changes During Breastfeeding: Soreness, Engorgement, and More

Breastfeeding is a beautiful and natural way to nourish your baby, but it can sometimes come with discomfort and changes in your nipples. Many new mothers experience nipple issues, and understanding why these changes occur is the first step towards comfortable breastfeeding. While nipple size can fluctuate due to various factors, during breastfeeding, changes are often related to milk production and your baby’s latch. Let’s explore common nipple concerns during breastfeeding and what you can do about them.

Sore and Cracked Nipples

One of the most frequent complaints among breastfeeding mothers is sore and cracked nipples. This often happens when a baby doesn’t latch onto the breast correctly. Instead of taking the entire areola into their mouth, the baby might only suck on the nipple. This improper latch causes friction as the baby’s tongue or the roof of their mouth rubs against the nipple, leading to soreness and cracks.

If your baby isn’t latching well, your nipples won’t heal properly. It’s crucial to seek help from a lactation consultant, midwife, or health visitor as soon as possible if you experience pain during feeding. They can assess your baby’s latch and provide guidance on achieving a deeper, more comfortable latch.

Engorgement

Breast engorgement is another common condition where your breasts become overly full with milk. This typically occurs when your milk first comes in, usually a few days after birth. Engorgement can also happen later on, for instance, when your baby starts eating solid foods and breastfeeds less frequently, or if you miss feedings.

Engorged breasts can feel hard, warm, and throbbing, and can sometimes cause the nipples to appear larger and firmer due to the swelling and milk buildup. If you’re experiencing engorgement and continuing to breastfeed, ensuring a correct latch is vital. A healthcare professional can assist you with this.

To relieve breast engorgement, you can try the following:

  • Feed your baby on demand: Frequent breastfeeding helps regulate milk supply and prevent excessive fullness.
  • Express a little milk: Manually expressing or using a breast pump to release a small amount of milk can soften the areola, making it easier for your baby to latch.

You might also find relief from:

  • Wearing a supportive nursing bra: Choose a well-fitting bra that provides support without being restrictive.
  • Warm compresses before expressing: Applying warm flannels just before expressing can encourage milk flow if your breasts are leaking.
  • Cold packs after feeding: Applying a cold pack or damp flannel to your breasts after feeding or expressing can help reduce pain and swelling.
  • Pain relief: Taking paracetamol at the recommended dose is safe while breastfeeding and can help ease the pain.

Blocked Milk Ducts

Sometimes, a milk duct can become blocked during breastfeeding or even when you’re stopping breastfeeding. This blockage can cause localized discomfort.

You might notice a small, painful, hard lump or a bruised sensation in your breast.

To help relieve a blocked milk duct:

  • Feed more often: Frequent feeding can help clear the blockage.
  • Change feeding positions: Experimenting with different positions can help drain all areas of your breast more effectively.
  • Massage the lump: Gently massage the lump towards the nipple while your baby is feeding.
  • Apply warmth: Warm flannels or a warm shower can encourage milk flow.
  • Stay hydrated: Drink plenty of water to maintain good hydration.
  • Wear loose clothing: Ensure your bra and clothes are not too tight, allowing milk to flow freely.

If you suspect you have a blocked milk duct, it’s essential to have it checked by a healthcare professional, especially if you develop fever or flu-like symptoms.

Mastitis

If engorgement or blocked milk ducts persist, the breast can become inflamed or infected, leading to mastitis. Mastitis can affect one or both breasts.

Symptoms of mastitis can include:

  • Red, hot, and painful breast(s)
  • Flu-like symptoms such as headaches, nausea, and fever

Your baby might become fussy while feeding on the affected breast(s) because the milk flow may be slower.

It’s important to continue breastfeeding or expressing milk, especially from the affected breast, as this can help clear the infection and is safe for your baby. You don’t need to increase feeding frequency, as there’s no evidence it speeds up recovery and might worsen inflammation.

To alleviate mastitis symptoms:

  • Apply cold compresses: Cold to the affected area can help reduce inflammation and pain.
  • Stay hydrated: Drink plenty of fluids.
  • Pain and fever relief: Use paracetamol or ibuprofen to manage pain and fever.
  • Wear loose clothing: Avoid tight bras or clothes until your symptoms improve.

If you think you have mastitis, consult your healthcare provider. They might prescribe antibiotics or anti-inflammatory medication.

Breast Abscess

If mastitis or an infection is left untreated, a breast abscess, a collection of pus, can develop in the breast.

It’s crucial to see your doctor if you suspect a breast abscess, as they might refer you to a breast clinic.

Treatment for a breast abscess usually involves antibiotics and drainage of the pus. Drainage is often done using a needle and syringe, sometimes guided by ultrasound. For larger abscesses, a small incision might be needed to drain the pus. Local anesthesia is typically used to numb the area.

As with mastitis, healthcare professionals usually advise continuing breastfeeding or expressing milk regularly to aid in recovery.

Thrush

Thrush, a yeast infection caused by Candida albicans, can occur on the nipple and areola during breastfeeding. It can develop if nipples are cracked or damaged, or even suddenly, even after breastfeeding for some time.

Nipple thrush symptoms can include:

  • Itching
  • Pain
  • Sensitivity to touch
  • Shooting pains deep in the breast after feeding, lasting for hours

Thrush can be challenging to diagnose because its symptoms can resemble those of a poor latch.

Thrush can also be passed between mother and baby. Signs of thrush in babies may include:

  • Creamy patches in the mouth or on the tongue that don’t wipe off
  • Sore mouth, causing restlessness during feeding and pulling away from the breast
  • Nappy rash that is red, sore, and slow to heal

If you suspect thrush in yourself or your baby, consult your doctor or healthcare provider. Antifungal creams or tablets might be prescribed for treatment. Both you and your baby will need treatment simultaneously to effectively clear the infection.

Understanding the common causes of nipple discomfort and changes during breastfeeding empowers you to take appropriate steps for relief and ensures a more comfortable breastfeeding journey for both you and your baby. Always seek professional advice for persistent or concerning symptoms.

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