If you have felt a lump or noticed a discharge from the nipple or simply are anxious about any perceived breast problem you should equip yourself with knowledge and consult an appropriately trained health care professional. Please consult our extensive Information topics around breast related topics and breast cancer.
The first step when you feel a lump or many lumps is to STOP FREAKING OUT as the most important thing to know is that most breast lumps do not turn out to be CANCER and are more than often benign or non-cancerous lumps.
The second step is to consult with a Medical Professional this can be your family doctor or GP, a trained sister at a clinic or Dr Sonday.
A full medical history and a breast examination will be conducted by the medical professional during the consultation. Depending on your age, medical and family history you may require a booking for specialised breast imaging such as an Ultrasound and if you are older than 35, a Mammogram may also be requested.
So, what are the most common causes for a Breast Lump or Multiple Breast Lumps besides cancer?
Most women have ‘lumpy’ breasts and breast tissue has a naturally bumpy texture; which is more pronounced during your period. Lumps are often related to your normal menstrual cycle and may disappear after your period.
Besides the normal ‘lumpiness’ that can occur, most lumps are benign. There are a number of different types of benign breast lumps with different names:
Fibroadenoma
These are the most common breast lumps. Usually felt by young women as a firm, highly mobile mass. They can occur in up to 25% of women and are usually painless. There maybe just one or multiple and may affect both breasts.
Fibroadenomas are made up of normal tissue which has an abnormal reaction to your normal female hormones. They can become tender during your period and may enlarge in size during your cycle. They usually become smaller after menopause.
Most fibroadenomas are under 2 cm in size but some can keep on growing bigger and if they get to 3 – 5 cm or if they are painful or growing rapidly they can be surgically removed.
Fat necrosis
After a knock or injury to the breast, there can be hard scarring of the fatty breast tissue, leading to a lump called fat necrosis. It can look and feel like cancer so a biopsy is important to rule out cancer. If the biopsy is negative for cancer then this sort of lump can just be followed-up.
Fibrocystic change
Fibrocystic change is the most common problem of the breast. Fibrocystic change can be characterised by pain in the breast especially the upper outer quadrant, lumps and bumps, hard and soft parts, and cysts.
It is probably caused by an exaggerated response to hormone fluctuations and symptoms maybe more pronounced from the middle of your cycle to just before your period.
It is not related to cancer although this will have to be excluded with appropriate history, clinical examination and imaging.
You might find relief from symptoms of fibrocystic breasts through one of these lifestyle modification or home remedies:
Lumps that are filled with fluid (cysts)
Cysts are round fluid-filled lumps that can be found in up to one third of women, particularly with fibrocystic change. Many of these will be tiny clumps of microcysts but some will be larger in size and feel like a lump.
Ultrasound can identify cysts and unless they are causing a problem or look different or complex, they do not need to be drained.
If the cyst becomes suddenly tender or red, aspiration maybe performed and antibiotics started. Complex cysts or those with lumps in them can be associated with cancer so these should be carefully investigated.
Phyllodes tumour (Cystosarcoma Phyllodes)
Phyllodes tumours can often look like fibroadenomas, but they grow quickly and need to be removed. They are not common and can occur at any age. When Phyllodes tumours are taken out, it need to be with a good margin of normal breast because they do have a risk of returning, and in some cases, can be cancerous.
The second step is to consult with a Medical Professional this can be your family doctor or GP, a trained sister at a clinic or Dr Sonday.
A full medical history and a breast examination will be conducted by the medical professional during the consultation. Depending on your age, medical and family history you may require a booking for specialised breast imaging such as an Ultrasound and if you are older than 35, a Mammogram may also be requested.
So, what are the most common causes for a Breast Lump or Multiple Breast Lumps besides cancer?
Most women have ‘lumpy’ breasts and breast tissue has a naturally bumpy texture; which is more pronounced during your period. Lumps are often related to your normal menstrual cycle and may disappear after your period.
Besides the normal ‘lumpiness’ that can occur, most lumps are benign. There are a number of different types of benign breast lumps with different names:
Fibroadenoma
These are the most common breast lumps. Usually felt by young women as a firm, highly mobile mass. They can occur in up to 25% of women and are usually painless. There maybe just one or multiple and may affect both breasts.
Fibroadenomas are made up of normal tissue which has an abnormal reaction to your normal female hormones. They can become tender during your period and may enlarge in size during your cycle. They usually become smaller after menopause.
Most fibroadenomas are under 2 cm in size but some can keep on growing bigger and if they get to 3 – 5 cm or if they are painful or growing rapidly they can be surgically removed.
Fat necrosis
After a knock or injury to the breast, there can be hard scarring of the fatty breast tissue, leading to a lump called fat necrosis. It can look and feel like cancer so a biopsy is important to rule out cancer. If the biopsy is negative for cancer then this sort of lump can just be followed-up.
Fibrocystic change
Fibrocystic change is the most common problem of the breast. Fibrocystic change can be characterised by pain in the breast especially the upper outer quadrant, lumps and bumps, hard and soft parts, and cysts.
It is probably caused by an exaggerated response to hormone fluctuations and symptoms maybe more pronounced from the middle of your cycle to just before your period.
It is not related to cancer although this will have to be excluded with appropriate history, clinical examination and imaging.
You might find relief from symptoms of fibrocystic breasts through one of these lifestyle modification or home remedies:
- Wear a firm support bra, fitted by a professional, if possible.
- Wear a sports bra during exercise and while sleeping, especially when your breasts are extra sensitive.
- Limit or avoid caffeine, a dietary change many women report as helpful, although medical studies of caffeine’s effect on breast pain and other premenstrual symptoms have been inconclusive.
- Decrease the fat in your diet, which may decrease breast pain or discomfort associated with fibrocystic breasts.
- Reduce or stop taking hormone therapy if you’re postmenopausal — but be sure to talk to your doctor before making any change in your prescription medications.
- Use a heating pad or warm water bottle to relieve your discomfort.
- Stop smoking.
- Vitamins and dietary supplements may lessen breast pain symptoms and severity for some women.
- Evening primrose oil. This supplement may change the balance of fatty acids in your cells, which may reduce breast pain.
- Vitamin E – early studies showed a possible beneficial effect of vitamin E on breast pain in premenstrual women who experience breast pain that fluctuates during the menstrual cycle.
Lumps that are filled with fluid (cysts)
Cysts are round fluid-filled lumps that can be found in up to one third of women, particularly with fibrocystic change. Many of these will be tiny clumps of microcysts but some will be larger in size and feel like a lump.
Ultrasound can identify cysts and unless they are causing a problem or look different or complex, they do not need to be drained.
If the cyst becomes suddenly tender or red, aspiration maybe performed and antibiotics started. Complex cysts or those with lumps in them can be associated with cancer so these should be carefully investigated.
Phyllodes tumour (Cystosarcoma Phyllodes)
Phyllodes tumours can often look like fibroadenomas, but they grow quickly and need to be removed. They are not common and can occur at any age. When Phyllodes tumours are taken out, it need to be with a good margin of normal breast because they do have a risk of returning, and in some cases, can be cancerous.
Breast pain, or mastalgia, is a really common problem and up to half of women will have out of the ordinary pain which may prompt them to visit a doctor. Even though it is uncommon for Breast cancer to cause pain any change in your breasts that is unusual should prompt a consultation with your doctor. This would include a full medical history and examination and may include some investigations, depending on your symptoms and age.
Your doctor will evaluate your pain based on whether it is related to your period (Cylcical Mastalgia), pain that occurs at any time (Non-cyclical Mastalgia) or Non-breast causes. It is important to remember that you may have elements of more than one of these types of pain.
Cyclical Breast Pain
This type of pain is related to the fluctuations in different hormones your body produces during your monthly cycle. It is most common in younger women, 20-30 years old and can get better during pregnancies and after menopause. Although mastalgia is common during early pregnancy.
Normally the pain is felt as heaviness or an aching in the breasts. The pain can be worse in the upper outer quadrant and might spread to the shoulder or arm.
The pain can be minor, manageable or significantly debilitating. It can be a normal part of a woman’s life, but if it reaches a point where the pain is interfering with sleep, work physical activity and sexual activity then a management plan needs to be instituted in conjunction with your doctor.
Using oral contraceptives may make this pain better or worse.
This type of pain normally gets better with age and will improve after the menopause.
Non-Cyclical Mastalgia
Non-cyclical mastalgia involves occasional or long-lasting pain which occurs at any time and is not related to a specific time in your cycle. It is more common after the age of 40 years old and can affect up to one third of women.
The actual pain may be similar to cyclical pain with heaviness, tenderness and the breasts feeling engorged or it may be concentrated to a specific area of one or both breasts.
There are lots of reasons why this type of pain occurs. It may have a hormonal cause like cyclical pain, can be associated with hormone replacement therapy (HRT) or may have an anatomical reason. One-sided focal intense pain was associated with breast cancer in a small percentage of women and it is particularly important to rule out cancer through clinical examination and mammogram.
More severe pains may respond to stronger prescription medicines such as Danazol and Tamoxifen but these have significant side-effects and should only be started by a specialist and used for a short period of time.
Extramammary Pain
When is a breast pain not a breast pain?… when it doesn’t come from the breast.
There are lots of structures which surround the breast that can cause pain which feels as if it is related to the breast. That is why a good consultation and examination looking at the whole chest and body can help.
Most common is pain from the chest wall- called costochondritis- where there is an inflammation of the muscles and bones of the rib cage causing pain in the whole chest. Caused by repetitive sports using these muscles, a viral infection or simply with no cause, the junctions of the rib cage can become inflamed and cause a tenderness, making it difficult to be touched, sometimes difficult to move easily and cause a general aching all over the breast region. Rest, a course of anti-inflammatory medications and reassurance often help although these problems can reoccur.
Other more distant causes of pain can include reflux, heartburn and indigestion; heart problems such as angina and inflammation of the heart; and shingles- especially if the pain is really really sore on one side only.
Increased Breast Size
The breasts need support, especially if they are large, otherwise they will pull on the muscles, bones and skin of the chest wall. This can cause pain inside the breast, most commonly towards the end of the day, and pain in the back and shoulders.
The first step in combatting this is getting a good well-fitting bra (Are you wearing the right size? Check here, paying particular attention to the cup size, wide shoulder straps, and making sure your breasts are supported from below. If your breasts are very large or uncomfortable, breast reduction surgery may be a possibility. This is carried out by a plastic surgeon, and is available to government and private patients, although most medical aids do not routinely cover this procedure.
Your doctor will evaluate your pain based on whether it is related to your period (Cylcical Mastalgia), pain that occurs at any time (Non-cyclical Mastalgia) or Non-breast causes. It is important to remember that you may have elements of more than one of these types of pain.
Cyclical Breast Pain
This type of pain is related to the fluctuations in different hormones your body produces during your monthly cycle. It is most common in younger women, 20-30 years old and can get better during pregnancies and after menopause. Although mastalgia is common during early pregnancy.
Normally the pain is felt as heaviness or an aching in the breasts. The pain can be worse in the upper outer quadrant and might spread to the shoulder or arm.
The pain can be minor, manageable or significantly debilitating. It can be a normal part of a woman’s life, but if it reaches a point where the pain is interfering with sleep, work physical activity and sexual activity then a management plan needs to be instituted in conjunction with your doctor.
Using oral contraceptives may make this pain better or worse.
This type of pain normally gets better with age and will improve after the menopause.
- Wear a firm support bra, fitted by a professional, if possible.
- Wear a sports bra during exercise and while sleeping, especially when your breasts are extra sensitive.
- Limit or avoid caffeine, a dietary change many women report as helpful, although medical studies of caffeine’s effect on breast pain and other premenstrual symptoms have been inconclusive.
- Decrease the fat in your diet, which may decrease breast pain or discomfort associated with fibrocystic breasts.
- Reduce or stop taking hormone therapy if you’re postmenopausal — but be sure to talk to your doctor before making any change in your prescription medications.
- Use a heating pad or warm water bottle to relieve your discomfort.
- Stop smoking.
- Vitamins and dietary supplements may lessen breast pain symptoms and severity for some women.
- Evening primrose oil. This supplement may change the balance of fatty acids in your cells, which may reduce breast pain.
- Vitamin E – early studies showed a possible beneficial effect of vitamin E on breast pain in premenstrual women who experience breast pain that fluctuates during the menstrual cycle.
Non-Cyclical Mastalgia
Non-cyclical mastalgia involves occasional or long-lasting pain which occurs at any time and is not related to a specific time in your cycle. It is more common after the age of 40 years old and can affect up to one third of women.
The actual pain may be similar to cyclical pain with heaviness, tenderness and the breasts feeling engorged or it may be concentrated to a specific area of one or both breasts.
There are lots of reasons why this type of pain occurs. It may have a hormonal cause like cyclical pain, can be associated with hormone replacement therapy (HRT) or may have an anatomical reason. One-sided focal intense pain was associated with breast cancer in a small percentage of women and it is particularly important to rule out cancer through clinical examination and mammogram.
More severe pains may respond to stronger prescription medicines such as Danazol and Tamoxifen but these have significant side-effects and should only be started by a specialist and used for a short period of time.
Extramammary Pain
When is a breast pain not a breast pain?… when it doesn’t come from the breast.
There are lots of structures which surround the breast that can cause pain which feels as if it is related to the breast. That is why a good consultation and examination looking at the whole chest and body can help.
Most common is pain from the chest wall- called costochondritis- where there is an inflammation of the muscles and bones of the rib cage causing pain in the whole chest. Caused by repetitive sports using these muscles, a viral infection or simply with no cause, the junctions of the rib cage can become inflamed and cause a tenderness, making it difficult to be touched, sometimes difficult to move easily and cause a general aching all over the breast region. Rest, a course of anti-inflammatory medications and reassurance often help although these problems can reoccur.
Other more distant causes of pain can include reflux, heartburn and indigestion; heart problems such as angina and inflammation of the heart; and shingles- especially if the pain is really really sore on one side only.
Increased Breast Size
The breasts need support, especially if they are large, otherwise they will pull on the muscles, bones and skin of the chest wall. This can cause pain inside the breast, most commonly towards the end of the day, and pain in the back and shoulders.
The first step in combatting this is getting a good well-fitting bra (Are you wearing the right size? Check here, paying particular attention to the cup size, wide shoulder straps, and making sure your breasts are supported from below. If your breasts are very large or uncomfortable, breast reduction surgery may be a possibility. This is carried out by a plastic surgeon, and is available to government and private patients, although most medical aids do not routinely cover this procedure.
Noticing a discharge from your nipple can be worrying. Most of the time, a good consultation and examination can determine what the cause could be, and investigations such as a mammogram, ultrasound or blood tests will help confirm.
Questions to ask yourself
There are three questions you should ask yourself about your discharge:
Are you squeezing?
Does the discharge come only when you squeeze or do you notice it on your clothes or the inside of your bra?
Squeezing your breast or nipple can often result in normal discharges or fluid being expressed. It can also stimulate the breast to produce fluid. It is a good idea to avoid squeezing your nipples yourself.
Is the discharge from one duct, one breast or both breasts?
This helps determine what is causing the discharge. Discharges from both breasts tend to have a hormonal cause more than discharges from one duct- which are more likely to have a problem going on in that duct alone.
What is the colour?
Infections and inflammation can cause a yellow, green or white discharge and other causes lead to a clear or milky discharge. Blood in a discharge is an important sign.
What Can Cause a Discharge?
Physiological discharges
These discharges occur in both breast and tend to be due to a hormonal problem. They can also occur if the nipple is excessively stimulated such as in with the friction of clothes on the chest wall in runners or by squeezing the nipples. The discharge is most commonly milky. The hormonal problems may be due to the thyroid, the pituitary gland producing too much prolactin, or medications such as anti-depressants or other medicines causing a block in hormone levels.
Papilloma
These are non-cancerous growths of the cells that line the breast ducts. 10-20% of these growths can hide small areas of early cancer therefore it is recommended that they are surgically removed with a small operation.
Duct ectasia
The breast ducts closest to the nipple can become enlarged as they lose their elasticity. The duct then fills with debris and can become inflected or inflamed. There is no increased risk of cancer with this problem, but infections, pain and itching. The symptoms can be treated with simple measures but in a few complicated cases, some surgery to remove the ducts is required.
Questions to ask yourself
There are three questions you should ask yourself about your discharge:
Are you squeezing?
Does the discharge come only when you squeeze or do you notice it on your clothes or the inside of your bra?
Squeezing your breast or nipple can often result in normal discharges or fluid being expressed. It can also stimulate the breast to produce fluid. It is a good idea to avoid squeezing your nipples yourself.
Is the discharge from one duct, one breast or both breasts?
This helps determine what is causing the discharge. Discharges from both breasts tend to have a hormonal cause more than discharges from one duct- which are more likely to have a problem going on in that duct alone.
What is the colour?
Infections and inflammation can cause a yellow, green or white discharge and other causes lead to a clear or milky discharge. Blood in a discharge is an important sign.
What Can Cause a Discharge?
Physiological discharges
These discharges occur in both breast and tend to be due to a hormonal problem. They can also occur if the nipple is excessively stimulated such as in with the friction of clothes on the chest wall in runners or by squeezing the nipples. The discharge is most commonly milky. The hormonal problems may be due to the thyroid, the pituitary gland producing too much prolactin, or medications such as anti-depressants or other medicines causing a block in hormone levels.
Papilloma
These are non-cancerous growths of the cells that line the breast ducts. 10-20% of these growths can hide small areas of early cancer therefore it is recommended that they are surgically removed with a small operation.
Duct ectasia
The breast ducts closest to the nipple can become enlarged as they lose their elasticity. The duct then fills with debris and can become inflected or inflamed. There is no increased risk of cancer with this problem, but infections, pain and itching. The symptoms can be treated with simple measures but in a few complicated cases, some surgery to remove the ducts is required.
With the precious gift of motherhood, a woman is given a second gift, in the ability to nurture and sustain her new child through breastfeeding. Breastfeeding is a wonderful source of infant nutrition and immune system support and helps mothers and babies bond. But sometimes it is not all easy or uncomplicated.
Mastitis
Breast infections (known as ‘mastitis’) occur in approximately 10% of breastfeeding women and can be distressing and miserable at a time where the new motherhood is already exhausting and emotional: for a first-time mom or even for an experienced mother. It can interfere with bonding and can discourage breastfeeding completely, with all its health benefits for baby and mother.
Infections most often occur within the first three months of breast-feeding, with a second increase around weaning. If you are have diabetes, smoke or have other risk factors you can be at particular risk.It is commonly caused by bacteria present normally on the skin but which enter the breast and cause an infection.
Risk Factors For Breast Infection
I Think I Have A Breast Infection
An infection causes a part of the breast to become hard, red, painful and swollen in size. Generally, you may find you have a fever, feel unwell and tired with flu-type aching.
Not all breast pain is an infection however. A blocked duct can also cause the breast to be painful and red, but these will clear in 1-2 days. Massage to ensure emptying of that area, and simple measure such as hot/cold compresses and simple painkillers can help. If your symptoms don’t get better after 2 days, there is a risk of an infection and you should see your doctor or come for help.
The best way to prevent infections is teamwork- get you and your baby breastfeeding really well. All babies know how to suck, but they are not born knowing how to breastfeed and neither is a mom. Breastfeeding needs practice and support. It can require perseverance and patience! Don’t wait until you are exhausted and anxious, try to get help early from a lactation consultant, specialist midwife or breastfeeding support network.
Baby should latch with a wide-open mouth, and it may help to change baby’s position through the feed to drain all areas of the breast. Tight bras and some breast pads can cause your nipple to be moist after a feed rather than allowing the nipples to air.
If I have got mastitis what should I do?
Mastitis is usually treated with antibiotics which can get rid of the bacteria. Simple pain medications that are safe to use in breast feeding can also be taken. Warm showers or cold packs will also help with the pain, along with rest, sleep and plenty of fluids.
I always used to find it infuriating that people tell you to rest and sleep to help with breastfeeding when I didn’t have time to sleep with all the breastfeeding I was doing! But these things do help, and this is the time to enlist family and friends to take the baby to settle after a feed and let you get that rest.
Dealing with an infection is teamwork- you, baby and your doctor. Your baby can play a key role removing milk from your breast by continuing to feed, as milk not removed from the breast can cause the infection to worsen. You might be concerned your milk will contain pus and will be bad for your baby but feeding from an infected breast will not harm your baby. Even if bacteria are present in the milk, the acid in your baby’s stomach will kill them. You can continue to breast feed but sometimes your baby will not like the taste of the milk. In this circumstance you can express the milk (and therefore maintain production) but continue to feed from the other side.
Studies have found that the use of antibiotics is twice as quick at fighting infection. Your doctor will choose an antibiotic that is safe to give in breastfeeding and has the most up to date ability to kill the bacteria. The course should continue for at least 7 days but may need longer.
I Might Have A Breast Abscess
Very occasionally the infection will progress and an abscess will form. This is your body’s way of separating the infection into an isolated collection of pus. This will cause a firm, very painful lump. An abscess can be seen on sonar, which is why it is often good to get specialist help early- to prevent this from happening and act promptly if it does.
Breast abscesses should be managed by a breast specialist, and very rarely need surgery. In the past, women would undergo operation for drainage of the abscess. We now know from studies that using a needle and syringe to drain the breast under ultrasound guidance is just as effective. This prevents an open wound, scarring of the breast and possible later problems with breastfeeding.
Aspiration (sucking out) should be used for breast abscesses in addition to antibiotics and breastfeeding to ensure optimal results. Sometimes you may need aspirations every 2-3 days for 7-10 days, but there should be improvement in your symptoms.
Breast Thrush
Thrush is a yeast infection which can also affect the breastfeeding breast and can be a source of misery!
It causes severe burning, shooting pains during breastfeeding and causing sore patches and red ulcers on the nipples and areolae. Thrush can be passed between the baby’s mouth and the mother’s breast during breastfeeding so reinfection can occur despite continued treatment.
Seek advice early if you are having pain during breastfeeding, it may not be thrush but it can always be helped. Remember that Thrush is a rare cause of breast pain. Most commonly pain is cause by latching and feeding problems that have simple solutions. Don’t start medicine for thrush before you are certain that that is the cause.
If it is thrush, it is important to treat mom and baby at the same time and for long enough to ensure all infection is gone. For deep thrush, you will need an anti-thrush medicine orally as well as an anti-fungal cream for your nipples, and an oral gel for the baby’s mouth. Specialist support is also important as the pain can discourage you from continuing breastfeeding.
Seek help early. Great information for Thrush is available here but you should be examined and started on treatment by someone used to treating the problem.
Mastitis
Breast infections (known as ‘mastitis’) occur in approximately 10% of breastfeeding women and can be distressing and miserable at a time where the new motherhood is already exhausting and emotional: for a first-time mom or even for an experienced mother. It can interfere with bonding and can discourage breastfeeding completely, with all its health benefits for baby and mother.
Infections most often occur within the first three months of breast-feeding, with a second increase around weaning. If you are have diabetes, smoke or have other risk factors you can be at particular risk.It is commonly caused by bacteria present normally on the skin but which enter the breast and cause an infection.
Risk Factors For Breast Infection
- Difficulties with latching
- Infant mouth problems
- First-time mother
- Cracked or sore nipples
- Previous mastitis
- Yeast infection
- Blocked ducts or missed feeds
- Plastic-backed breast pads
- Use of a manual breast pump
- Nipple piercing
- Tight-fitting bra
I Think I Have A Breast Infection
An infection causes a part of the breast to become hard, red, painful and swollen in size. Generally, you may find you have a fever, feel unwell and tired with flu-type aching.
Not all breast pain is an infection however. A blocked duct can also cause the breast to be painful and red, but these will clear in 1-2 days. Massage to ensure emptying of that area, and simple measure such as hot/cold compresses and simple painkillers can help. If your symptoms don’t get better after 2 days, there is a risk of an infection and you should see your doctor or come for help.
The best way to prevent infections is teamwork- get you and your baby breastfeeding really well. All babies know how to suck, but they are not born knowing how to breastfeed and neither is a mom. Breastfeeding needs practice and support. It can require perseverance and patience! Don’t wait until you are exhausted and anxious, try to get help early from a lactation consultant, specialist midwife or breastfeeding support network.
Baby should latch with a wide-open mouth, and it may help to change baby’s position through the feed to drain all areas of the breast. Tight bras and some breast pads can cause your nipple to be moist after a feed rather than allowing the nipples to air.
If I have got mastitis what should I do?
Mastitis is usually treated with antibiotics which can get rid of the bacteria. Simple pain medications that are safe to use in breast feeding can also be taken. Warm showers or cold packs will also help with the pain, along with rest, sleep and plenty of fluids.
I always used to find it infuriating that people tell you to rest and sleep to help with breastfeeding when I didn’t have time to sleep with all the breastfeeding I was doing! But these things do help, and this is the time to enlist family and friends to take the baby to settle after a feed and let you get that rest.
Dealing with an infection is teamwork- you, baby and your doctor. Your baby can play a key role removing milk from your breast by continuing to feed, as milk not removed from the breast can cause the infection to worsen. You might be concerned your milk will contain pus and will be bad for your baby but feeding from an infected breast will not harm your baby. Even if bacteria are present in the milk, the acid in your baby’s stomach will kill them. You can continue to breast feed but sometimes your baby will not like the taste of the milk. In this circumstance you can express the milk (and therefore maintain production) but continue to feed from the other side.
Studies have found that the use of antibiotics is twice as quick at fighting infection. Your doctor will choose an antibiotic that is safe to give in breastfeeding and has the most up to date ability to kill the bacteria. The course should continue for at least 7 days but may need longer.
I Might Have A Breast Abscess
Very occasionally the infection will progress and an abscess will form. This is your body’s way of separating the infection into an isolated collection of pus. This will cause a firm, very painful lump. An abscess can be seen on sonar, which is why it is often good to get specialist help early- to prevent this from happening and act promptly if it does.
Breast abscesses should be managed by a breast specialist, and very rarely need surgery. In the past, women would undergo operation for drainage of the abscess. We now know from studies that using a needle and syringe to drain the breast under ultrasound guidance is just as effective. This prevents an open wound, scarring of the breast and possible later problems with breastfeeding.
Aspiration (sucking out) should be used for breast abscesses in addition to antibiotics and breastfeeding to ensure optimal results. Sometimes you may need aspirations every 2-3 days for 7-10 days, but there should be improvement in your symptoms.
Breast Thrush
Thrush is a yeast infection which can also affect the breastfeeding breast and can be a source of misery!
It causes severe burning, shooting pains during breastfeeding and causing sore patches and red ulcers on the nipples and areolae. Thrush can be passed between the baby’s mouth and the mother’s breast during breastfeeding so reinfection can occur despite continued treatment.
Seek advice early if you are having pain during breastfeeding, it may not be thrush but it can always be helped. Remember that Thrush is a rare cause of breast pain. Most commonly pain is cause by latching and feeding problems that have simple solutions. Don’t start medicine for thrush before you are certain that that is the cause.
If it is thrush, it is important to treat mom and baby at the same time and for long enough to ensure all infection is gone. For deep thrush, you will need an anti-thrush medicine orally as well as an anti-fungal cream for your nipples, and an oral gel for the baby’s mouth. Specialist support is also important as the pain can discourage you from continuing breastfeeding.
Seek help early. Great information for Thrush is available here but you should be examined and started on treatment by someone used to treating the problem.