Breast pain can occur for many reasons. It is important to differentiate between breast and nipple pain, which is sometimes difficult as they commonly occur together. Nipple pain is a specific issue that is discussed separately.
Breasts become painful when they get backed up. The milk inside the lobules and ducts is not effectively being removed as quickly as it is being made. Usually it is a progression of symptoms, but severe infections can happen very quickly, so it is important to understand the differences. It is important to treat the underlying cause, which is usually inefficient milk removal, to prevent supply issues going forward.
This happens when your breasts suddenly start to produce transitional milk, usually after the first few days of breastfeeding. Not only is the milk volume increasing, there can also be swelling of the blood vessels and milk ducts, so the milk does not come out of your breasts easily. Your breasts can feel firm and look red and can be tender and warm to the touch. It is important to empty your breasts if this happens. Warm compresses, hand expressing, nursing (with a deep latch) and pumping are all helpful.
If your milk ducts become inflamed and swollen, milk can back up into your lobules, where the milk is made. Plugged ducts feel like hard, tender cords or lumps in your breasts. If only the tip of the duct is blocked, you can develop a blister-like collection of milk called a milk bleb. Blocked ducts mean less milk flow and therefore can decrease milk supply. Repeated or prolonged blockage can lead to infection. Use the same techniques used for engorgement to resolve the problem.
Infection or Mastitis
Nipple damage can lead to an infection in your breasts when yeast (candida) or bacteria (Staph) enters your blood stream through broken skin. Because of the increased blood flow to lactating breasts, infections (mastitis) can occur very quickly and become quite dangerous. It is important to contact your doctor immediately if you suspect mastitis. Mastitis makes your breasts feel warm and painful. They can swell and become red, and you can develop a fever. Your whole breast can be affected, or just one section. Each time you have mastitis, your milk supply is in danger of decreasing. Emptying your breasts, healing nipple damage, preventing further damage, and antibiotics are all important components of treatment, but prevention is key.