18 March 2019 The most common breast complaints arising in the course of natural breastfeeding include: Painful and/or cracked nipples; Breast engorgement; Blocked breast ducts; Mastitis. Painful and/or cracked nipples when breastfeeding The most common cause of these problems is a poor adaptation of the baby to the breast , particularly when the baby suckles only on the nipple and not on the nipple and aureole together. Cracks may be present at the tip or the base of the nipple. Ways of dealing with the problem: If necessary, correct the position adopted by the baby during breastfeeding; Start the baby’-s feeds with the nipple that is least painful or has fewer cracks; Apply an appropriate healing ointment; Apply cold to the area to relieve pain. Prevention: Make sure both the nipple and the aureole are placed well into the baby's mouth; To remove the baby from the breast, gently press on the baby’s mouth or insert the tip of a finger into the baby’s mouth so it moves away from the breast; Wash breasts daily when showering, using neutral soap or lotion; At the beginning and end of each feed, extract a few drops of milk and massage the nipple. Breast engorgement when breastfeeding Breast engorgement is the term applied when breasts have become hard, red and hot and have increased greatly in size. It usually happens on the second or third day after giving birth, when the milk comes down. It may cause some discomfort , and it may be difficult for the baby to feed from a nipple and aureole that have been tightened as a result of the stretching caused by the milk. In order for the baby to adapt well and to help resolve the engorgement , certain measures can be adopted. Ways of dealing with the problem: Before breastfeeding, massage your breast with your fingertips in a circular movement, from the base to the nipple, expressing a little milk with your hand; If after breastfeeding the engorgement is still marked, you can express milk manually or with a pump until the discomfort is relieved; Between feeds, apply cold to your breasts to reduce swelling and discomfort; Reduce fluid intake for as long as breast engorgement continues to be a problem. Blocked breast ducts while breastfeeding Breast ducts are the channels through which the milk is drained . Sometimes they can become blocked when the milk comes down, and a nodule is formed that prevents the passage of the milk , accompanied by localised pain and redness. Prevention: Vary the position of the baby when breastfeeding in order to empty all parts of the breast; Avoid wearing very tight clothes and choose an appropriately fitting bra that provides proper support. Mastitis when breastfeeding Mastitis is a breast infection . It may occur as a result of: Blocked breast ducts; Cracked breasts. It is characterised by increased pressure in the breast, which becomes red and hot to the touch. The milk may show visible changes in consistency and colour , suggesting the presence of blood or pus. In this event, the milk should not be used to feed the baby. If mastitis is suspected, medical attention should be sought. Ways of dealing with the problem: Empty the affected breast manually or with a pump, ensuring that it is fully emptied; Avoid pressure from very tight clothing; If mastitis is only on one side, encourage the baby to feed from the unaffected breast; Apply cold to the area to relieve pain. This article was written with the support of physicians and other clinical professionals from the Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
