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SORE BREASTS
Pain in the breasts may be caused by engorgement, a plugged duct, mastitis or something else. It is
often difficult for a mother (and doctor) to tell whether the inflammation is due to
engorgement or a plugged duct, neither of which needs antibiotics, or
mastitis, which usually, but not always, requires antibiotics. Use the guidelines in the chart to
help you figure out what the problem is and how to treat it. Use the links to find additional information
on how to relieve sore breasts.
SORE BREASTS: STAGES OF SEVERITY
| FEATURES |
NORMAL BREAST FULLNESS |
ENGORGEMENT |
PLUGGED DUCT |
MASTITIS |
| Usual onset |
2-4 days after birth |
Within the first two
weeks |
Most noticeable after
feedings |
Most common
around third week
postpartum; may
occur at any time
during lactating. |
| Where/Location |
Both breasts |
Both breasts |
Localized area in one breast |
One breast |
| Breasts feel: |
Generally swollen, uncomfortable, not hard, but tight |
Hard, swollen, sore, warm |
Mildly tender lump beneath areola, reddened skin above |
Very painful: hot, tender, swollen, red streaking |
| Maternal fever |
None |
101 or below |
None |
Higher than 101 |
| Mother generally feels: |
Well |
Well |
Well; may see a white milk plug in a nipple opening. |
Achy, tired, chills, "like I've got the flu." |
| Treatment |
Frequent, unrestricted feeding, empty breasts |
Frequent, unrestricted feeding, empty breasts alternating warm and
cold compresses; rest |
Frequent,
unrestricted feeding;
moist, hot packs,
massage plugged
duct to loosen plug
and encourage milk
flow |
Frequent,
unrestricted feeding,
empty breasts; rest,
relaxation;
physician may
prescribe antibiotics |
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