Thrush

Thrush is a yeast infection that can grow in baby’s mouth, and on mother’s nipples. Thrush can cause white or yellow looking patches in the baby’s mouth. On nipples thrush can cause itching or burning nipples, shooting pains in the breast, red and shiny spots and pain deep down in the breast. If you or your baby develops thrush, it is important that you both get treated to avoid passing thrush back and forth between you. Contact your care provider for information on how to treat thrush. Be sure to wash anything that comes into contact with the infection in hot water. Pacifiers and bottle nipples can be boiled, and toys can be soaked in a tub of hot soapy water. Be sure to wash all bra and other clothing items that come into contact with your nipples in hot water.

Milk that is pumped while you or you baby is infected with thrush can be fed while you’ both being treated. Once treatment stops all milk pumped during the infection must be discarded.

Mastitis

Mastitis is breast inflammation, and sometimes infection. Mastitis can be caused by a plugged duct that was not treated, or by not breastfeeding frequently enough. Mastitis is more common in the first few weeks postpartum, but can happen anytime during lactation.  Do not stop breastfeeding if you have symptoms of mastitis. Abruptly halting breastfeeding can lead to further complications, including abscesses in the breast.

Preventing Mastitis
Breastfeed frequently, and pump often while you are away from your baby.
Avoid sleeping on your stomach for long periods of time.
Avoid wearing tight fitting clothes, or underwire bras, as these can push on milk ducts, and cause a blockage, which can lead to mastitis.
If your breasts start to feel full or engorged, try to encourage your baby to nurse. You do not need to wait to offer the breast until your baby shows feeding cues.
Stress, fatigue, and weakened immunity also puts you at risk for developing mastitis so try to take care of yourself, and get adequate rest and nutrition.

Symptoms of Mastitis
If you develop the following symptoms and do not feel better after treatment for 12-24 hours, contact your doctor, as some cases do require antibiotics.
A fever of 101F or greater.
Flu like symptoms that continue to worsen quickly.
Pain, heat and swelling in one or both breasts.
Red streaks on one or both breasts, from the nipple outwards.

Side Effects in Your Milk From Mastitis
Expressed milk may have lumps in it, or be stringy. This milk is fine for baby to consume.
Milk may have a saltier taste because of increased sodium. This is temporary and will go back to normal when mastitis has been treated.
Milk may contain pus or blood. This milk is safe for baby to consume while you are being treated for mastitis.  

Treating Mastitis
Getting into bed with your baby for as long as possible during your illness, and breastfeeding frequently.
Increase your fluid intake.
Apply heat, and gentle compress to the affected breast before breastfeeding.
Use a cold compress after breastfeeding to reduce inflammation.
Fill a large basin with warm water, and lean over it, submerging your breasts in the water.
Vary the position you breastfeed in, to ensure all milk ducts are being sufficiently emptied.

After mastitis has been cleared up, it is common for the area to still be red, and have a bruised feeling for up to a week after.

Contact your doctor immediately if:
Symptoms worsen suddenly, or you have a temperature spike.
You have mastitis symptoms in both breasts.
You have broken skin on your breast/nipple with sign of infection.
There is blood or pus in your expressed breastmilk.

Plugged Milk Duct

A plugged milk duct is an area on your breast where milk flow is obstructed. A plugged duct usually develops gradually, and only affects one breast. Do not stop breastfeeding if you develop a plugged duct. Abruptly stopping breastfeeding can put you at risk for developing mastitis and breast abscesses.

Preventing Plugged Milk Ducts
Breastfeed frequently, and ensure you are fully emptying the breast at each feeding.
Hand express, or pump when you cannot breastfeed your baby.
Avoid clothing and bras that are tight fitting because they can put pressure on your breasts and cause a blockage.

Symptoms of a Plugged Milk Duct
You may notice a hard lump on one breast that feels tender, hot or swollen. This lump may feel worse before breastfeeding, and better afterwards. Sometimes your breast will feel tender, and swollen without an obvious location of a plug. Breastfeeding on the affected breast may be painful at letdown. You may develop a low-grade fever of 101F or less. If your symptoms worsen quickly, and your fever spikes, you may have developed mastitis from a plugged duct.

Treating a Plugged Milk Duct
Breastfeed as often as possible on the affected breast. Use your hand to massage the area while breastfeeding.
Use a warm compress on the affected breast before nursing.
Breastfeed by dangling your breasts over baby to utilize gravity.
Take a hot shower and massage the plugged duct. You can also use a large toothed comb to help massage the duct.
Always massage the milk duct from the outside in towards the nipple.
Pump or hand express after breastfeeding.
Rest and drink lots of fluids.

Side Effects in Expressed Milk During a Plugged Milk Duct
Milk may appear stringy. Baby can still consume stringy breastmilk.
Milk output from the affected breast may decrease slightly. This is temporary and will improve once the plugged duct is removed.

Milk Blisters

A milk blister is a blocked nipple pore (sometimes also called a bleb).  Typically, when a milk blister occurs it is because a tiny bit of milk gets backed up behind a milk duct. This can happen because of oversupply, yeast infections, or for no reason at all. Milk blisters occur on the nipple itself, and look like white or yellow dots that are very painful while nursing. To treat a milk blister, apply a moist warm compress to the area immediately before breastfeeding. Using an Epsom salt soak a few times a day can help heal the milk blister too. Once the area is moist, you can also use a clean finger to try and break the blister to open up the milk duct. After the blister heals, it is helpful to continue the warm compresses and soaks to ward off a recurrence. If the blister becomes infected, starts oozing, or you start running a fever, contact a health professional.
To treat a recurring milk blister you can massage the entire breast with grapefruit seed extract. To make a massage oil, use a few drops of grapefruit seed extract mixed with some olive oil.