The difference between engorged breasts and mastitis

While engorged breasts and mastitis may present with similar symptoms, the two conditions are not the same.

What causes engorged breasts?

This typically happens around day four after delivery (slightly longer after a Caesarian birth). It can be very uncomfortable, as your breasts may become full and heavy, and excruciatingly tender to the touch. In some instances, they become rock-hard, hot, and sore. This is what is commonly known as ‘milk coming in’.

Six ways to treat engorged breasts

1. Feed your baby on demand, as normal, and don’t be tempted to express your milk to make them emptier and softer – all you’ll do is encourage more milk to be produced and your breasts will become more engorged.
2. Ask your pharmacist, clinic sister, or doctor to recommend anti-inflammatory medication that’s safe while breastfeeding– this will ease the engorgement.
3. Applying hot towels just before feeding time also helps the milk to flow more easily, so that your baby can have an effective feed and an adequate supply of milk.
4. After feeding, gently massage some arnica cream or oil onto your sore and swollen breasts.
5. Place ice packs and cabbage leaves onto your breasts in between feeds to ease the pain and inflammation. Persevere … it will get better.
6. As your body adjusts to producing just the right amount of milk for your baby, the engorgement will lessen. This usually occurs within three to four days.

What causes mastitis?

Mastitis is an inflammation (not necessarily an infection) of the breast. It is most commonly caused by engorged breasts and/or a blocked milk duct. In some cases, bacteria (staphylococcus aureus) or a fungus (candida albicans) from your baby’s mouth or throat can enter your breasts via the nipple and can cause mastitis.

Blocked milk ducts commonly occur, especially in the first month of breastfeeding, when your breasts can still be swollen and sore. You can usually feel the actual spot where the blockage is, because it’s sore, and if you look, you may see a red and inflamed area.

Four ways to treat mastitis

1. This usually only occurs in one breast and is more prevalent before a feed when your breasts are full – feeding usually gives you some relief.
2. You may also feel a bit feverish and have a headache. Treat the area as you would if your breasts are engorged (see above).
3. If the mastitis is caused by bacteria, your doctor may prescribe antibiotics.
4. If the red and tender area does not lessen after a feed, and if the entire area does not settle down within a few days, and you’re feeling feverish and unwell, it is best to seek medical advice in case you have a breast abscess, which will need to be surgically drained.