5 breastfeeding health questions

Are your breasts painful and you don't know why? Our health visitor answers these common mum queries...

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My breasts really hurt during breastfeeding

Q: I’ve just got over sore nipples, but now I’m getting deep pain in my boobs, and they really hurt when I breastfeed. What can it be?

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A: It sounds like you might have developed thrush, which is common after a bout of sore nipples, as the skin has been broken and moist. Thrush infections can pass back and forth between mum and baby, so you’ll both need to be treated, even if your little one isn’t showing any signs of infection (these can include soreness and little white patches like cottage cheese in and around the mouth). Your GP will probably prescribe an antifungal medication and the pain should ease after a few days. You can carry on breastfeeding, although short feeds may be more comfortable than long ones. Change breast pads after each feed and wash and dry your nipples thoroughly, as thrush thrives in damp conditions. Wash your clothes and towels on a hot cycle to kill bacteria and clean dummies and toys to avoid re-infecting yourself or your little one.

How can I relieve mastitis?

Q. What can I do to relieve the discomfort from mastitis when breastfeeding?

A. Mastitis is inflammation of breast tissue, characterised by red, tender areas on the breast. It’s caused by blocked milk ducts if the breast is not being emptied properly, usually if your baby is having trouble attaching, so speak to your health visitor for advice on getting your baby to attach.

Continuing feeding is the quickest way to get better as it helps unblock your ducts, especially after attachment has improved. Also try feeding from the sore side first to drain it thoroughly, feeding more frequently, or expressing between feeds if you’re uncomfortably full. Place warm flannels on the breast to ease discomfort, and get some rest.

Breastfeeding for the first time, have I got mastitis?

Q. Breastfeeding for the first time keeps giving me mastitis. What can I do?

A. The first sign of mastitis is a red, swollen and often painful breast. You normally get it because of prolonged engorgement (when your breasts become full, hot and inflamed) or from a blocked milk duct which results in milk leaking into the breast tissue.

As well as sore breasts you may also have flu-like symptoms, and it’s important to keep feeding as this will get the milk moving through your breasts – start with the sore side first and try different feeding positions too.

Feed her on demand for as often and as long as she needs it as this will encourage effective drainage of milk and reduce the likelihood of blocked ducts and engorgement. Check your bra fitting and avoid tight clothing, which puts pressure on breast tissue.

It hurts to feed

Q. I’ve been breastfeeding for a month now and still have painful breasts, although my nipples aren’t sore and my baby latches on well. Is there a problem?

A. There is a problem, yes. As your baby has learnt how to latch on, it could be nipple thrush. This can cause a deep, stabbing or burning pain in the breast after feeding. Your areola may also appear shiny, red or flaky.

Thrush can enter the nipple area if you’ve had cracked nipples. It’s also more likely if you’re prone to thrush or have had a recent course of antibiotics.

Thrush can be passed between you and your baby, so check for signs such as a white coating in his mouth and on his tongue. Also, does he have nappy rash that isn’t healing and could be thrush?

Your doctor will be able to prescribe medication for you and your tot to treat thrush quickly.

Thrush concerns

Q. I’m breastfeeding and think I’ve got thrush in one of my breasts. What should I do?

A. First, double-check your symptoms. If you’ve got a thrush infection you’ll notice sharp, sudden pains in your breast and/or nipple, with deeper breast pain after feeding. Your nipples may feel itchy and sensitive too. There’s a chance you might have passed the infection on to your baby – look for a white-coated tongue, or white patches inside his mouth, but keep an eye on his bottom too as thrush can also show up in the nappy area.

You’ll both need treatment at the same time, so go to your GP who’ll prescribe medication for both of you. In the meantime, take paracetamol to ease the pain and keep breastfeeding.

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It can be tough coping with thrush symptoms, but with the right treatment breastfeeding will return to being pain free, as it should be.

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