Engorgement
What it is? This is what happens when your breasts are full and firm. It’s uncomfortable for sure and you may have difficulty getting baby latched on. It frequently happens in the early days as your milk transitions, or when you’ve gone too long between pumping or feeding. Part of it is fullness from the volume of milk within the breasts, and part of it is inflammation of the breast tissue. Sometimes the breasts will feel lumpy in some spots.
What can you do? Drain the breasts! Because the breasts are never truly empty, we’ll avoid the use of that term. Instead, think “well drained.” If baby is unable to latch due to the fullness, then pump or hand express. Feed baby until content. If still feeling full, pump or hand express until the breasts are soft. Massage any lumps or hard spots. Ice packs after draining the breasts can help to calm the residual inflammation.
Plugged Duct
What is it? A plugged duct closer to the surface of the breast can be felt as a lump. Often it is tender. This is where milk flow is blocked and it can cause the tissue around it to become inflamed. See this image from Love and Breastmilk for a better idea.
What can you do? Apply a warm compress. Massage the area gently, especially between the lump and the nipple. Have an electric toothbrush or something else that vibrates? Apply the base of the toothbrush to the plugged duct to help it to clear. Then keep the milk moving, making sure the breasts are well-drained!
Blebs
What is it? A nipple bleb is sometimes called a nipple blister or blocked nipple pore. It appears like a small white speck on the surface of the nipple. Sometimes it can be tender, sometimes it is only known by looking at the nipple.
What can you do? Soak the nipple in warm water and epsom salt, five minutes at a time at least three times a day Apply a warm compress prior to feeding/pumping. Use a wet washcloth to gently exfoliate the nipple. Nipple blebs can be small bits of calcified milk or strings of fat moving through the nipple pore. They can also be an inflammatory response to nipple trauma. Recurring blebs can be a sign that the latch isn’t quite right.
Warning Signs
Reach out to your IBCLC if you’re experiencing engorgement, plugged ducts, or nipple blebs more than occasionally. If you’re having a fever and/or feeling flu-ish/run down, give your trusted healthcare provider a call.
Amanda is an RN, IBCLC (lactation consultant) who helps breastfeeding families through classes and home visits in the greater Baton Rouge, La area. Secure virtual visits are available for breastfeeding support no matter the location.
All information on this website is intended for educational purposes only and should not be construed as medical advice. Magnolia Lactation Consulting encourages all families to have close communication with the medical providers of their choice.