Breastfeeding is the ideal food, exclusively, for the baby during the first six months of life, but sometimes it is not easy and problems often arise.
Lumps in the breast are common and it is important to know how to prevent them and how to treat them in the event that they appear to avoid possible complications.
Why do breast lumps appear?
Lumps in the chest usually correspond to obstructions . Milk circulates through ducts (called milk ducts) within the breast. When one of these ducts becomes blocked, it causes milk to accumulate.
This causes a hard lump to appear in one area of the chest, which is accompanied by pain and sometimes redness. They can appear due to an incorrect emptying of the breast (very common in the first days of the baby’s life, when there is a bad grip or if they spend too much time between feedings), by pressure (for example when wearing a very tight bra or sleeping supported on a specific chest area) or infection .
What to do if they appear?
Applying heat is controversial and, although it used to be recommended before feeding to improve milk flow, we could make the infection worse. Current recommendations are to apply cold between feedings to reduce inflammation.
It is convenient to put the baby to breastfeed frequently and to do it in that position in which his chin is oriented to the obstructed area , as it is the one that will empty the best. For example, if we notice the hard lump on the side of the chest, near the armpit (the area where obstructions most often appear), the position in rugby will help that area drain.
In addition, we can perform circular massages and towards the nipple both before feeding and during (with care so that the baby does not disengage).
If the pain is very severe, the mother can take painkillers (paracetamol or ibuprofen). To check the compatibility of any medication with breastfeeding, visit the website www.e-lactancia.org.
The usual thing is that the obstructions disappear in 2 or 3 days and it is not uncommon to notice that they decrease after taking and increase again after a few hours.
How to prevent them?
Although sometimes it is inevitable that they occur, we can take some precautions to try to avoid them. What I consider most important, and that any nursing mother should bear in mind (not only to prevent obstructions), is that breastfeeding should be on demand , it does not have schedules.
The breast should be offered frequently and whenever the baby asks for it. Although it seems like a lot, the usual thing is for newborns to take between 8 and 12 feedings a day. We must also bear in mind that they are the ones who decide when they have finished the feeding (they let go or fall asleep), we must let them empty one breast well before offering them the second (which many times they will not want and it is not necessary for them to suckle from the 2 in each shot).
Another advice that I usually give mothers in the first days of their babies’ life is to vary the positions as much as possible, so that all areas of the chest are well emptied. Wearing a nursing bra of the appropriate size, which does not constrict, is also important to avoid obstructions.
When to suspect mastitis?
Mastitis is an inflammation of the breast, which can sometimes be due to an infection. Sometimes an obstruction does not result can lead to mastitis. We will suspect a breast infection if, in addition to noticing a painful lump in the breast, and having the area hot and red, general symptoms such as malaise, fever, chills or headache appear .
It is essential in this case to carry out a correct emptying of the breast, we can apply cold to reduce inflammation and take analgesics and antipyretics. It is likely that we will also need antibiotic treatment that a doctor will have to prescribe. Most antibiotics are compatible with breastfeeding and it is recommended to continue breastfeeding despite mastitis.
Other causes of breast lumps during breastfeeding
Although the most likely cause of a breast lump during breastfeeding is an obstruction for one of the reasons mentioned above, there are other reasons why lumps may appear in the breast, such as a galactocele, an abscess or a tumor ( benign or malignant).
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The galactocele is a milk cyst. The fat content of the milk accumulates outside the ducts, resulting in a lump. It is more likely to appear during weaning and is a benign lesion. Unlike obstruction, this lump does not change its size after feedings nor is it painful; the area is not reddened. To diagnose it, the gynecologist will likely perform an ultrasound. Galactoceles can disappear spontaneously but in some cases it may be necessary for the gynecologist to puncture it to empty it.
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Breast abscess is a complication of mastitis when it does not resolve properly. We will notice a painful lump in the chest that moves when we touch it, the area will be red or bruised, shiny and “tense.” There is not always a fever. The gynecologist will have to empty this pus, either by aspirating with a needle (fine needle aspiration) or through a small surgical incision.
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Hamartoma, fibroadenoma or lactational adenoma are benign tumors that can appear during lactation and should be evaluated by a gynecologist.
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Although fortunately it is rare, the appearance of a breast lump could also correspond to breast cancer . Therefore, when faced with a persistent breast lump, we must contact a specialist .
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