Breastfeeding...lump by nipple, pain in underarm. What can it be?
Hello,
I am breastfeeding my 3.5month old and pumping while at work. The other day I noticed a rather large lump right by my right nipple. I just figured I was a little full, so I didn't think much of it. Today, the lump is distinct and I have pain in my right armpit. It does not hurt to nurse my baby, I don't know if I am running fever, and there is no redness or swelling on my breast. What could it be?
That's a plugged duct, if you don't treat it it can turn into mastitis or an abscess but mostly they will go away on their own.
http://www.kellymom.com/bf/concerns/mom/mastitis.html
How do I know if I have a plugged duct or mastitis?
PLUGGED DUCT A plugged (or blocked) duct is an area of the breast where milk flow is obstructed. The nipple pore may be blocked (see Milk Blister), or the obstruction may be further back in the ductal system. A plugged duct usually comes on gradually and affects only one breast.
Local symptoms Mom will usually notice a hard lump or wedge-shaped area of engorgement in the vicinity of the plug that may feel tender, hot, swollen or look reddened. Occasionally mom will only notice localized tenderness or pain, without an obvious lump or area of engorgement. The location of the plug may shift.
A plugged duct will typically feel more painful before a feeding and less tender afterward, and the plugged area will usually feel less lumpy or smaller after nursing. Nursing on the affected side may be painful, particularly at letdown.
Systemic symptoms There are usually no systemic symptoms for a plugged duct, but a low fever (less than 101.3°F / 38.5°C) may be present.
MASTITIS Per Maureen Minchin (Breastfeeding Matters, Chapter 6), mastitis is an inflammation of the breast that can be caused by obstruction, infection and/or allergy. The incidence of postpartum mastitis in Western women is 20%; mastitis is not nearly so common in countries where breastfeeding is the norm and frequent breastfeeding is typical. Mastitis is most common in the first 2-3 weeks, but can occur at any stage of lactation. Mastitis may come on abruptly, and usually affects only one breast.
Local symptoms Local symptoms are the same as for a plugged duct, but the pain/heat/swelling is usually more intense. There may be red streaks extending outward from the affected area.
Systemic symptoms Typical mastitis symptoms include a fever of 101.3°F (38.5°C) or greater, chills, flu-like aching, malaise and systemic illness.
Common (and not-so-common) side effects of plugged ducts or mastitis
Plugged duct
* Milk supply and pumping output from the affected breast may decrease temporarily. This is normal and extra nursing/pumping generally get things back to normal within a short time.
* Occasionally a mom may express "strings" or grains of thickened milk or fatty-looking milk.
* After a plugged duct or mastitis has resolved, it is common for the area to remain reddened or have a bruised feeling for a week or so afterwards.
[...]
What are the usual causes of plugged ducts or mastitis?
Plugged duct
Milk stasis / restricted milk flow
… may be due to:
* Engorgement or inadequate milk removal
(due to latching problems, ineffective suck, tongue-tie or other anatomical variations, nipple pain, sleepy or distracted baby, oversupply, hurried feedings, limiting baby's time at the breast, nipple shield use, twins or higher order multiples, blocked nipple pore, etc.).
* Infrequent/skipped feedings
(due to nipple pain, teething, pacifier overuse, busy mom, return to work, baby suddenly sleeping longer, scheduling, supplementing, abrupt weaning, etc.).
* Pressure on the duct
(from fingers, tight bra or clothing, prone sleeping, diaper bag, etc.).
* Inflammation
(from injury, bacterial/yeast infection, or allergy).
Stress, fatigue, anemia, weakened immunity
What is the usual treatment for plugged ducts and mastitis?
It's always best to treat a plug immediately and aggressively to avoid escalating into mastitis.
CAUTION: Do NOT decrease or stop nursing
when you have a plugged duct or mastitis,
as this increases risk of complications (including abscess).
BREASTFEEDING MANAGEMENT
-- SAME for plugged duct or mastitis
-- important to start treatment promptly
"Heat, Massage, Rest, Empty Breast"
General
* Nurse frequently & empty the breasts thoroughly.
Aim for nursing at least every 2 hrs. Keep the affected breast as empty as possible, but don’t neglect the other breast.
* When unable to breastfeed, mom should express milk frequently and thoroughly (with a breast pump or by hand).
Before nursing
* Use heat & gentle massage before nursing
- Warm compress. Try using a disposable diaper: fill the diaper with hot water (try the temperature on your wrist first to avoid burns), squeeze the diaper out a bit, then put the inside of the diaper toward the breast. This will stay warm much longer than a wet cloth.
- Basin soak. Fill sink or bowl with hot water and submerge breast in water while massaging the plugged area toward the nipple. Some report better results when epsom salts are added to the water -- add a handful of epsom salts per 2 quarts (2 liters) of water. Rinse with fresh water before nursing, as baby may object to the taste.
- Hot Shower. It can be helpfu
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