Postnatal health: breast and nipple care
Your breasts will be bigger and heavier than usual, so you'll find a good-quality, well-fitting cotton maternity bra both convenient and comfortable. Have several so you can wear a clean one every day.
If you're using breast pads to prevent leaking milk from staining your clothes, avoid those that are lined or backed with plastic. Change pads after each feed and whenever they're wet.
Cleaning and washing breast and nipple
Wash your breasts and nipples every day. It's best not to use soap because it strips away the natural oils that protect the skin from drying and cracking, and can make a sore or cracked nipple worse. There's no need to wash your nipples before or after each feed, but before you fasten or put on your bra after feeding, let your nipples dry in the air. You should always wash your hands before handling your breasts to prevent infection.
Engorgement of breast
Three or four days after you've given birth, your breasts will fill with milk. They'll become larger and heavier, and feel tender and warm when you touch them. They can get too full - this is known as engorgement. Engorgement usually only lasts a day or two, but it can be uncomfortable and may happen again.
To ease engorged breasts, express some milk with your hands or by feeding your baby - you'll probably have to express a small amount of milk first so that he can latch on (see also Breastfeeding tips). It also helps to bathe your breasts with warm water or cover them with warm towels, and to stroke them gently but firmly towards the nipple. Engorgement can come back at any time during breastfeeding, particularly if your breasts are never properly emptied or if your baby misses a feed.
In the early weeks of breastfeeding you can get a blocked milk duct. This can be caused by engorgement, or it can result from a bra that's too tight, or dried secretions on the nipple tip blocking a nipple opening. If you get a blockage, your breast will feel tender and lumpy and your skin may redden.
To clear a blocked duct, start feeds with your affected breast and gently massage it just above the sore area while you feed to ease the milk gently towards the nipple. If the blockage doesn't clear, don't offer the breast to your baby and check with your doctor. Your breast may become infected, resulting in an abscess, which is painful, but not disastrous.
Sore and cracked nipples
When you begin breastfeeding, your nipples may feel slightly tender for the first minute or so of suckling. This tenderness is quite normal, and it usually disappears after a few days. Sore and cracked nipples, though, are a common problem in the early weeks and can turn what should be a pleasure into something of an ordeal. Cracked nipples are very painful and if the problem continues, infection can develop.
The main causes of sore and cracked nipples are your baby not latching on properly and not being careful enough when taking your baby off your breast. Taking care to start and finish feeding properly can prevent these problems, and is essential if nipples are to heal after they have become sore or cracked. To help avoid cracked nipples, apply a drop of baby lotion to your breast pad, but wash it off before you feed.
If a nipple is cracked, you may need to keep your baby off that breast for up to 72 hours and express milk to prevent it getting engorged. Cracked nipples heal quickly when they are exposed to the air so, if possible, go topless or bra-less occasionally, especially when you are resting, in order to let the air circulate over them.
The first signs of mastitis (breast infection) are swelling, tenderness, and reddening of the affected area. You'll also have flu-like symptoms, including a fever, chills, aches, headaches, and perhaps nausea and vomiting. If the infection is not treated, a painful pus-filled cavity called a breast abscess may develop.
If you think you've developed an infection, see your doctor. If it's treated promptly with antibiotics, mastitis usually improves within a day or so. The infection only affects breast tissue, not your milk, so you can't give it to your baby.
Get more on this subject…