# swollen, tender breasts at 4 days postpartum



## queen b (Jun 8, 2007)

hi all,

my baby is 4 days old and my milk came in the night before last. yesterday i was super engorged, but today is much better. except that on the side of my left breast i feel extremely tender. it's actually quite painful. is this definitely a sign of a clogged duct or infection? or is it normal at this juncture to be extremely tender and sore.

thanks!


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## kai28 (Sep 9, 2008)

I can't really say. But I did spend a lot of time wondering if my breasts were normal after my milk came in - they were very tender & sore. My baby started sleeping thru the night at 5 weeks, and since then every morning my breasts have been sore. The left more than the right as my left is slightly larger.

If you think it could be a clogged duct, try warm compresses before feeding/pumping & then massage either while feeding/pumping. And check how your bra fits- perhaps there is something causing pressure/restricted blood/milk flow? I don't know.


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## Llyra (Jan 16, 2005)

I can't say for sure in your particular case, obviously. I can say that when my milk came in with the twins, my breasts were so tender and sore that even putting on a shirt reduced me to tears. At one point, both kiddos were sound asleep and wouldn't wake up, and I was so full that I was desperate, I was unable to get anything out with a pump, and I wound up talking DD1 (weaned!) into attempting to nurse, to try and relieve the situation a bit.

But in that case, the entire breast was engorged, not just one part. What you're describing sounds more like a plugged duct.

Things that can help with engorgement: warm compresses before a feed, to make milk flow more easily and thus facilitate emptying the breast. cold compresses after a feed or between feeds, to relieve pain and swelling. a nice warm shower-- sometimes the warm water flowing over your breasts will induce the milk to let down, and you'll leak a bit and feel less engorged. You can also pump a tiny bit to try and relieve the fullness. But don't pump much-- you'll only tell your breasts to make even more milk thus aggravating the engorgement.

Sometimes baby will refuse to latch to an engorged breast, or seem to really struggle to latch, or only achieve a very shallow, ineffective latch-- the breast may be too hard for baby to effectively nurse. You can help that by using warm compresses before a feed, and by perhaps expressing or pumping a small amount to soften the breast, right before trying to latch baby.

You can tell a plugged duct by noticing how your breasts feel right after baby has a good vigorous feed. If the whole breasts softens up, and feels emptier, then it's probably just normal engorgement. If however only part of the breasts seems to soften, and there's a quadrant that stays fuller and harder even than it was before the feed, then you may be dealing with a clogged duct. If you do have a clogged duct, you'll need to be vigilant about emptying the breast. If baby is sleepy and won't nurse, you may need to try pumping or hand-expressing. Try massaging the clog, applying heat, and nursing as frequently as baby is able and willing. Watch out for fever or other signs of mastitis.

And take heart-- for me, the tender soreness subsided after only a day or two, and my supply evened out a lot more, and things were so much easier.


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## spughy (Jun 28, 2005)

There are two stages of engorgement. The first (primary engorgement), which lasts for a couple of days as the milk "comes in", involves a lot of extra blood and fluid to ALL the breast tissue plus filled alveoli and milk ducts. The extra fluid disappears over a few days, and secondary engorgement happens any time simply when you haven't nursed for a bit.

I think for many women, primary engorgement does result in very tender breasts. Unless they're tender in a very localized way - like just one spot or a couple of spots, but distinctly *spots* - I would wait a couple of days before doing anything. But, if the tenderness is very localized, it is a good sign that it is a plugged duct.


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