Breast engorgement

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Breast engorgement
ICD-9 676.24

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Breast engorgement occurs in the mammary glands when too much breast milk is contained within them. It is caused by insufficient breastfeeding and/or blocked milk ducts. When engorged the breasts may swell, throb, and cause mild to extreme pain.

Engorgement may lead to mastitis (inflammation of the breast) and untreated engorgement puts pressure on the milk ducts, often causing a plugged duct. The woman will often feel a lump in one part of the breast, and the skin in that area may be red and/or warm. If it continues unchecked, the plugged duct can become a breast infection, at which point she may have fever or flu-like symptoms.

Treatment

Though it may seem natural to decrease breastfeeding, it is important to continue to reduce the levels of milk. It is, in fact, generally beneficial to breastfeed very often to keep the breasts relatively empty (a lactating breast is never really empty).

Treatment for engorgement, plugged ducts, and infections all include frequent nursing to empty the breast. Application of wet heat and gentle massage (from the part(s) of the breast that are engorged or lumpy towards the nipple) right before nursing often helps, as well. Nursing with the baby's chin (the "moving part" of the baby's mouth) pointed towards the worst-affected part can also help clear it up.

If the problem has developed to the point of mastitis, care to eat and drink enough and well enough can help. Bed rest and frequent nursing (no longer than 2 hours from the beginning of one feeding to the beginning of the next) are important. An untreated (or ineffectively treated) breast infection can develop into a breast abscess, which may require surgical draining. A breast infection that continues for more than 24 hours or gets severe should be reported to the woman's doctor; she may need antibiotics.

A very serious type of breast cancer called inflammatory breast cancer presents with similar signs/symptoms as mastitis - including a swollen breast. Inflammatory breast cancer has occurred in women who are breast feeding. It is the most aggressive type of breast cancer with the highest mortality rate, and it is usually not recognized via mammography or ultrasound.

Antibiotics are often prescribed for mastitis or a breast abscess. If the condition is not relieved after 2 weeks of antibiotic therapy, the physician should rule out inflammatory breast cancer.

References


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