Breast Fullness, Milk Stasis and Mastitis

Did you notice that the breasts grew heavy, swollen, feel discomfort. Relax, read, what to do in the case of breast fullness and milk stasis. It is very important in order not to cause mastitis.

Consultation: Danuta Chrzanowska-Liszewska MD, neonatologist; Aleksandra Łada, NDT SLT Senior Tutor; Agata Serwatowska-Bargieł Ph.D., International certified lactation consultant (IBCLC), neonatologist

Breast fullness 

The first breast fullness, i.e. high milk supply, occurs between 3 and 5 days after birth. Later on it can occur after a longer than usual break between feedings, or when the baby does not empty the breast well enough. Breasts become hard, tense, sometimes hot,  and milk flows easily.

The reasons of breast fullness:

  • Starting increased milk production

  • Expressing large quantities of milk with a breast pump that overstimulates milk production

  • Longer than usual break between feedings

  • Child does not empty the breast well enough (incorrect latch on, biting the breast instead of suckling, e.g. during teething)

Breast fullnes - what can you do?

  • Latch the baby on as often as possible.

  • To stimulate the milk flow shower the breast with warm water or put a warm diaper compress.

  • Express some milk with a breast pump before feeding to help your child latch on. Do not express large amounts of milk because it stimulates lactation even more.

  • You can drink sage infusion to reduce milk production.

  • Use a cold compress after feeding (e.g. chilled diaper)

Milk stasis

The symptoms are similar to breast fullness. Breasts are hard, full and warm, and in some cases redness may occur. Milk accumulated in alveoli does not flow when it is expressed with a breast pump. You may feel small bumps under the skin - it means that a milk duct has been blocked.

The reasons of milk stasis during breastfeeding:

  • Incorrect feeding technique or position

  • Long interval between feedings

  • Incorrect technique of expressing milk manually (painful chest compressions)

  • Stopping the night feedings (feeding the baby with infant formula)

  • Wearing a too tight bra pressing the breasts and blocking milk flow

  • Fatigue, pain, stress, illness disrupting oxytocin production, and disrupting the let down reflex

Milk stasis - what can you do?

  • Make sure your bra does not compress the breasts. You can even give it up for some time.

  • Encourage your child to suckle as often and as long as possible.

  • Drink plenty of fluids.

  • Take a warm shower before feeding - it will facilitate the let down.

  • Change feeding positions so that the child empties the whole changed breast.

  • After feeding put chilled cabbage leaves on the breasts (peel a leaf, wash it, crush it a bit with a pestle and slid inside your bra). They have painkilling and anti-inflammatory properties.

  • Latch the baby on more often to the breast with stasis.

  • Do not use strong massage of the breast and do not express large quantities of milk with a breast pump.

  • You can gently stroke the breast towards the nipple.

  • Avoid manual milk expression.

  • Avoid stress and try to relax so as not to inhibit the let down reflex.

Mastitis 

Mastitis is characterized by weakness, high fever, muscle pain. Breasts are hot and hurt. Improper conduct during milk stasis is a common cause of mastitis: reducing drinking liquids, stopping breastfeeding with the sick breast, strong and painful breast compression.

What can you do?

  • Breastfeed from the sick breast often and long, every 1.5 - 2 hours.

  • Use different feeding positions, especially the clutch hold.

  • Use anti-inflammatory cabbage compresses.

  • Take a painkiller with ibuprofen or paracetamol.

  • Contact a doctor if there is no improvement after 1 day. He will probably prescribe an antibiotic, which is harmless for your baby and allow you to continue breastfeeding.

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