Breast engorgement is part of breast-feeding if mother is producing milk well. Engorgement may make latch on difficult and can cause pain and discomfort for the mother. In order to relieve engorgement, pumping may be necessary to soften the breast. This can be done with an electric or manual pulp or with your hands. The breast-milk can be stored for future use.
Typically this is due to poor latch on or friction on the nipple from tight clothing. Sore nipples can be very painful. Be sure to wear loose-fitting clothing. A breast pad may be helpful. 100% lanolin cream will provide some relief. Clean sore nipples after each feeding with water and coat the nipple with breast-milk or lanolin. Do not use alcohol or soap as they can cause drying and cracking. Technique should be reviewed and latch on should include both the nipple and areola. Begin feeding on the less sore nipple as babies are more vigorous at first and the milk let down will be established by the time of the feeding on the sore breast. If nothing helps, limit breast-feeding to ten minutes on the sore side, or pump instead of nursing on the sore side.
There are multiple ducts inside the breast and they become plugged. This may be due to incomplete emptying of the breast. A plugged duct needs to be relieved in order to prevent the development of infection. Increasing nursing on the plugged breast, applying heat, messaging the breast, avoiding tight-fitting clothing, and sleeping on your side to use gravity to promote milk flow can all help to do this.
When Not to Breast Feed:
There are certain instances where it is not safe to breast-feed a baby. Although not many, it is important to know these restrictions. These include maternal infection with HIV I, HIV II, Human T-Lymphotrophic Virus (HTLV I and II), active tuberculosis, and active herpes simplex virus (HSV I) lesions on the breast. Any drugs of abuse should preclude breast-feeding, as they will reach the same concentration in the infant as in the mother. Also certain prescribed drugs can preclude breast-feeding. See the section on drugs and breast milk for a complete list.
Drugs and Breast Milk:
There are many reasons for a mother to be prescribed medications. Some of these medicines can cause problems in a breast-feeding baby. The first option for a mother is to avoid any drugs unless absolutely necessary. For example, don't use an antibiotic for a viral infection - use a humidifier and saline drops for the common cold, and use heat and message for muscle pain. If medicine can be postponed without danger to the mother, then do that. When taking medicines that are absolutely necessary try to ask for the ones that cannot be absorbed into the blood stream, such as a nasal spray for a cold, instead of an oral cold medicine. Also try to use medicines that are known to be safe for breast-feeding. If an unsafe for breast-feeding medicine is necessary, use as short a course as possible and pump and discard the milk during the course of medicine. In worse case situations, breast-feeding must be stopped.