Common Breast/Feeding Concerns

Breastfeeding may come naturally for some women, but it’s not always a piece of cake. For some breastfeeding mothers, it can be challenging or even painful.

Help and support is available if you experience these or have any concern about breastfeeding.

To speak to a Public Health Nurse, call: 519.426.6170 or 905.318.6623 Ext. 3250

Sore Nipples

Signs & Symptoms

• Nipples feel sore, painful, burn or itch
• Nipples look red, shiny or cracked
• Nipples are blistered, bleeding or have discharge

Treatment

• Seek lactation support to improve latch
• Change nursing positions
• Apply breastmilk onto nipples and air dry
• For more severe concerns, ask a health care provider about ointment or saline compresses

Engorgement

Can occur in breastfeeding and formula feeding mothers after birth

Signs & Symptoms

• Breasts look and feel full
• Breasts may be painful to touch
• Usually occurs 3-6 days after birth when
  “milk comes in”
• Difficulty latching

Treatment

• Frequent breastfeeding (at least 8 times in 24 hours) without restrictions
• Before breastfeeding, hold baby skin-to-skin, apply warm moist compresses (hot showers work well), gently massage the breast
• After breastfeeding, apply cool compress to breasts
• Use hand expression if needed to remove milk for comfort
• Analgesics as needed
• Seek lactation support as needed

Mastitis

Signs & Symptoms

• One-sided breast pain
• Breast looks red, swollen and/or shiny and may have red streaks
• Breast feels hot
• You may have flu-like symptoms (ie. chills,
  aches, fatigue or fever)

Treatment

• Always breastfeed from the affected side first
• Before breastfeeding apply heat to the affected breast (hot showers work well), gently massage the area
• After breastfeeding, apply cool compress to breasts
• Use hand expression if needed to remove milk for comfort
• Get plenty of rest and maintain good hydration and nutrition
• Analgesics as needed
• Seek lactation support as needed
• If symptoms persist more than 12-24 hours, seek medical attention for antibiotic prescription

Plugged Ducts

Signs & Symptoms

• One-sided or localized tenderness in one
• area of the breast
• There may be a lump

Treatment

• Frequent breastfeeding (at least 8 times in 24 hours) and hand
• expression, starting on the affected side
• Before breastfeeding, gently massage toward area and apply warm moist compresses to the area
• After breastfeeding, avoid pressure on the breast (ie. tight bra, underwire)
• Analgesics as needed
• Seek lactation support as needed

Nipple Bleb

Signs & Symptoms

• Nipple pain
• White or yellow dot on the nipple
• May be painful, but not always
• Looks like a “milk blister”

Treatment

• Frequent breastfeeding (at least 8 times in 24 hours) and hand expression from both sides
• Before breastfeeding, apply warm compresses and gently massage
  affected breast
• Analgesics as needed
• Seek lactation support for further treatment (lancing)

Breast Abscess

Signs & Symptoms

• History of recurrent mastitis
• One-sided breast pain
• Swelling and redness
• Possible lump
• Fever and feeling unwell
• Antibiotic treatment not enough

Treatment

• Breastfeed from non-affected side
• Seek medical attention for treatment (ie. drainage)
• Should only resume breastfeeding on affected side after medical assessment and treatment

Thrush (Candidiasis)

Can occur in breastfeeding and formula-fed babies

Signs & Symptoms (Breastfeeding mother)

• Sharp shooting pain or burning pain in breast
  that develops suddenly
• Persistent cracked or painful nipples
• Sever nipple pain that lasts throughout the feeding and immediately after feeding
• Nipples may look red or cracked
• Nipples may feel sore, itchy, burning or painful
• Areola may look red, swollen, flaky or shiny
• History of recurrent mastitis

Signs & Symptoms (Infants)

• White patches on tongue, cheeks or soft
• palate that cannot be wiped off
• Diaper rash that has raised, red, and/or sore-looking bumps; and does not go away when treated with zinc-based ointment

Treatment

• Seek medical attention for treatment of mother and baby (ie. topical or
• oral prescription)
• Frequent hand-washing
• Sterilize all objects that come in contact with baby’s mouth (ie. toys, bottles, soothers)
• Breastfeed on pain-free side first, then offer affected side
• After breastfeeding, wash breasts and nipples and air dry
• Apply cool compress for comfort
• Express milk from both breasts if baby is unable to breastfeed effectively
• Avoid using breast pads when possible

Tongue Tie

Signs & Symptoms (Breastfeeding mother)

• Nipple pain and damage
• Misshaped nipple (compression or stripe mark) after breastfeeding
• Poor latch and/or inefficient feeding

Signs & Symptoms (Infants)

• The baby’s mouth makes a clicking sound while feeding
• Poor infant weight gain
• Tongue can’t touch roof of mouth, poke out
  past the lips and/or be moved sideways
• Tongue looks heart-shaped

Treatment

• Seek medical assessment and treatment (ie. tongue-tie release)
• Seek lactation support if breastfeeding