Engorgement

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WonderWomanExtrodinare's picture
Joined: 05/26/07
Posts: 1192
Engorgement

Hi ladies!
I am a little over 5 weeks out PP and breastfeeding has been going great! The night before last though, I woke up with my right breast (only) engorged. It's normal to wake up with them full but not painfully engorged like this, and like I said, it was only my right breast. Then, again last night, just my right breast got engorged again. It's also very lumpy and tender, I'm really starting to get concerned with Mastitis. DS is hitting a six week growth spurt so he is nursing more but wouldn't both my breasts be more full if it were increased milk supply due to him nursing more and they wouldn't be this engorged, would they?

WonderWomanExtrodinare's picture
Joined: 05/26/07
Posts: 1192

Ok, I've been doing research and it sounds like a plugged duct... it is painful during let down and feels better after nursing... so what can I do??? Should I just nurse on my right side. I was told to avoid nursing baby during let-down for a few days as I have a forceful let-down and he was choking, getting fussy at the breast and then not wanting to suck when the flow wasn't coming as easily and was still fussy at the breast... do you think from him getting, for lack of a better word, lazy at the breast from the easy flow of the let-down made him not suck enough of the hindmilk out and now it's plugged??? TIA ladies!

mommycarrie's picture
Joined: 09/07/06
Posts: 358

I was going to say plugged duct as well. I don't know that it's him being "lazy" I'm sure he's fine, but it could be his need for a more normal amount of milk rather than his super ravenous stage. Keep nursing normally, but when it's time to nurse on the right, use a warm compress (or take a warm shower, although I understand with three kiddos around that's often not a choice) and massage the painful area (yeah, not that fun.) Then nurse on that side and hopefully he will drain it for you. You can also try different positions, cradle, football, sidelying so that he is sure to drain all parts of the breast well.

If that doesn't work, you can let gravity help you by laying him down, crouching over him and getting him to latch on and nurse (without smothering him, of course.) That way gravity is pulling down in the same direction you need the plug to come out. You can also massage that spot while he nurses.

Hope you find some relief soon! I know how painful they can be.

PS: I think it's not considered mastitis unless you get a fever. If you do, then I'd call the doc.

TiggersMommy's picture
Joined: 02/14/10
Posts: 6043

Sounds like a plugged duct to me as well. Lots of breast massage in a hot shower should do the trick. I wouldn't necessarily nurse more on that breast though. That will just send the signal for more milk. Continue to alternate and make sure to switch positions frequently. Plugged ducts stink but the good news is the pain stops pretty quickly (or at least it does for me) once the duct is clear.

Joined: 05/23/07
Posts: 88

Definitely massage the breast (especially the sore lumpy parts) while your nursing - also do it in the shower. I found that my husband was a huge help when I was getting clogged ducts - he would help massage the lumpy areas when I was nursing/pumping. He was probably a little more forceful (is that the right word) than I was, since it freaking hurt! Smile But, it worked!

ErikaArcher's picture
Joined: 09/06/04
Posts: 379

Ok, I've been doing research and it sounds like a plugged duct... it is painful during let down and feels better after nursing... so what can I do??? Should I just nurse on my right side. I was told to avoid nursing baby during let-down for a few days as I have a forceful let-down and he was choking, getting fussy at the breast and then not wanting to suck when the flow wasn't coming as easily and was still fussy at the breast... do you think from him getting, for lack of a better word, lazy at the breast from the easy flow of the let-down made him not suck enough of the hindmilk out and now it's plugged??? TIA ladies!

It's very normal for one side to produce more than the other. and this side may be a higher producer for you - which means it will also need to be drained more to remain comfortable. Over time this is going to balance out - right now we need to reduce the pain and deal with the plugged duct. The rule with a plugged duct is to nurse nurse nurse and massage (deeply) the lumpy area. It also helps to nurse that side first as the babies suck is stronger at the begining of a feeding. It can also help to position the baby so that his chin points at the lump. Breast massage during nursing (working down and out) is also good. Hot compresses can help and so can hand expression in the shower or into a bowel of warm water. Right now you need to focus on draining the breast. Don't neglect the other side though or you may find the same thing happens on the other side. Now is not the time to worry about a forceful letdown (frankly changing positions is great to help with swallowing air and spurttering....but babies grow into the fast milk supply) and YES some babies DO become accostomed to it and get lazy when the flow slows down. You just have to work them through it - it's temporary

A plugged duct can cause mastitis. Mastitis is infection. If you a spike a fever (a real fever not 99.2 degrees) a real fever like "OMG I feel like I have the flu and feel lethargic WITH a fever" then your guard needs to go up. You can take Tylenol to treat the pain, Ibuprofen to address inflamation - but the real anwer is nurse nurse nurse DRAIN the breasts. You need to call your doctor if you spike a fever with flu like symptoms and it does not start to COME DOWN within 24-48hours. You may not be fever free but as long as it's coming down you are OK. The antibiotic don't solve the root problem they only address infection. The fever is a warning that the body is inflammed and fighting soemthing off. prolonged infection can cause absess which is rare if treated properly. Antibiotics should be avoided bc it can set you up for a secondary battle with thrush - which is AWFUL.

Nice Handout on plugged ducts and mastitis.
http://www.breastfeedinginc.ca/content.php?pagename=doc-BD-M