Breastfeeding: what to do for fissures, engorgement and mastitis


  • 1 Breastfeeding and fissures
  • 2 Breastfeeding: remedies for fissures
  • 3 Breastfeeding and breast engorgement
  • 4 Breastfeeding: what to do against engorgement
  • 5 Breastfeeding and mastitis
  • 6 Breastfeeding: solutions for mastitis

Even though it is a very intense experience also from an emotional point of view, breastfeeding can sometimes reserve some annoying surprises. For example, fissures, engorgement and mastitis are three problems that can occur quite frequently and, at times, make good breastfeeding difficult. But nevertheless, in most cases, these are problems that are easy to solve. Even with the help of a good lactation consultant. Let's see in detail.

Breastfeeding and fissures

In the first days of breastfeeding, the nipples are particularly sensitive and this is completely normal. However, if over time there is intense pain and small cuts appear, then fissures have formed. The main trigger is the incorrect position of the baby when suckling. If he's not latched on properly, he'll grab the nipple badly, and moving his mouth in the wrong places will result in nicks.

Another cause of the fissures can be candidiasis, that is a candida mycosis. The nipples appear slightly shiny at first, then take on a deep pink color, are shiny or red. Sometimes they are cracked, torn, itchy or covered with a white sheen. Candidiasis causes pain during and after feeding, but may sometimes be symptomless. The newborn may have whitish spots inside the mouth, on the cheeks and on the tongue. In this case, the pediatrician should be consulted.

Breastfeeding: remedies for fissures

  • Do not abandon your breastfeeding, even if the wound is bleeding. It is advisable to have the baby latch on often and for shorter periods, rather than giving very long feeds.
  • Check that the baby is latched on well and that the position is correct. Alternate the different positions, so as to stress the sore nipple as little as possible.
  • After feeding, let the milk dry on the nipple. The nipples must be as dry as possible: from time to time they must be kept in the air. Use bras made of breathable fabric (cotton) and change the breast pads often so as not to macerate the skin.
  • Wash your hands often and, once a day, your breasts with warm water. No to healing creams, unless they are based on natural products.
  • If the pain is really unbearable, you can try emptying the breast for 24 hours, manually or with a breast pump, and then gradually resume breastfeeding. It may also be helpful to use silicone nipple shields.
  • It is a good idea to prepare the breasts already during pregnancy, for example by taking a collagen supplement: it is able to increase the elasticity of the skin of the nipple.
  • In case of mycosis it is necessary that the doctor prescribes an ad hoc antifungal therapy and strict rules of hygiene must be followed.

Breastfeeding and breast engorgement

Breast engorgement in breastfeeding is recognized by a warm, sometimes red and sensitive area of ​​the breast or by a palpable, often painful lump with well-defined margins. It usually occurs when the milk ducts are not completely emptied. The causes are various: very abundant production of milk, predisposition of the mother, blows or pressure on the breast, scars, stress, clothes that are too tight.

Breastfeeding: what to do against engorgement

  • Breastfeed often.
  • Warm the breasts before feeding: a warm-moist compress, the application of a warming pillow (for example, filled with cherry pits and heated) or a hot shower are fine.
  • While feeding, massage the affected area or lump.
  • Cool the breast after the baby has finished sucking with cold packs of 20 minutes: they relieve pain.
  • Position the baby so that its lower jaw rests on the engorgement: the milk ducts stressed in this way are emptied better. For example, the baby can be placed upside down from the mother, while both are lying down.
  • Drink a lot.
  • Avoid tight clothing.

Breastfeeding and mastitis

Among the common problems in breastfeeding, mastitis is inflammation of the breast accompanied by various symptoms, similar to those of a flu: fever, pains in the limbs, malaise. Typically, a red and sensitive area appears on the breast, the breasts are hard. It is appropriate to stay in bed. The causes can be infections (mostly bacterial) or milk stagnation (stagnation), which occurs when the breast is not completely emptied by the baby.

Breastfeeding: solutions for mastitis

- Consult your doctor.
- Continue to breastfeed, emptying the breasts well.
- In early forms, follow the same rules valid for breast engorgement, limiting warm applications to 5 minutes before feeding.
- If the fever does not go away within 24 hours you will probably need an antibiotic compatible with breastfeeding. For pain and to lower the temperature, paracetamol and ibuprofen can be used.
- Not only drugs can be useful, but also supplements against water retention.

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