Breast Pain and Infections

Breastfeeding can be rewarding, but it’s not always smooth sailing. If you’re dealing with pain, swelling or tenderness, you’re not alone. Many parents experience engorgement, plugged ducts, mastitis or thrush at some point. The good news is most causes are manageable — and knowing when to call your provider can help you feel confident. 

Engorgement

It’s normal for your breasts to feel full a few days after birth. But engorgement is more than fullness — breasts can feel swollen, hot and painful, and nipples may flatten, making it harder for your baby to latch. 

What helps: Nurse often (8–12 times every 24 hours), don’t skip feedings, try warm compresses or a shower before nursing to get milk flowing, then use cold packs afterward to ease swelling. Massage and hand expression can soften the areola before latching. A supportive, non-underwire bra may also help. 

Plugged Ducts

A plugged duct feels like a sore, hard lump. It happens when milk doesn’t drain completely.

What helps: Try warm compresses, massage toward the nipple, nursing first on the affected side and switching up positions so your baby’s chin points toward the plug. Rest, fluids and avoiding tight bras or sleeping on your stomach also make a difference.

If the lump doesn’t clear in several days or you develop a fever of 100.4°F or higher along with flu-like symptoms, call your provider — a plugged duct can turn into mastitis. 

Mastitis

Mastitis is a breast infection. It usually causes a red, hot, painful area plus fever above 100.4 F and flu-like symptoms such as chills, fatigue and body aches. Sometimes it develops from a plugged duct, or when bacteria enter through a cracked nipple.

What to do: Don’t wait for it to pass. Call your provider right away — you’ll likely need antibiotics that are safe while breastfeeding. Keep nursing, as your milk isn’t harmful to your baby. Be sure to complete the full course (usually 7–10 days) to keep the infection from returning.

Thrush

Thrush is a yeast infection that can affect both you and your baby. It often causes burning or stabbing breast pain that continues after feedings. Other signs include itchy, red or flaky nipples; white patches in your baby’s mouth; or a diaper rash that won’t go away.

What to do: Call your provider. Both you and your baby should be treated at the same time, usually for two weeks, even if symptoms ease sooner. To prevent reinfection, boil nipples, pacifiers and toys daily, replace them weekly and wash bras and towels in hot water. Keep your breasts dry between feeds.

Breast pain during nursing is common, but you don’t have to push through it. Engorgement and plugged ducts often improve with home care. Mastitis and thrush need medical treatment, but both are very treatable. If you notice a fever, worsening pain or symptoms that don’t improve, call your provider. You’ll feel better faster — and get back to focusing on your baby.