Breast Health While Breastfeeding: Understanding Lumps and Knowing When to Seek Help

Breastfeeding is natural, but it can also bring some unexpected changes, including the appearance of lumps in your breasts. While most lumps are harmless and related to breastfeeding, it’s important to know what’s normal and when it might be time to consult a healthcare provider. Let’s explore why lumps may form, how to tell if they’re breastfeeding-related, and when they could signal something more serious, like an infection or, in rare cases, breast cancer.

Why Lumps Occur During Breastfeeding

It’s not unusual to feel lumps in your breasts while nursing, and there are a few common reasons for this:

1. Engorgement: When your breasts are producing more milk than your baby is drinking, they can become overly full, swollen, and feel lumpy. This is usually temporary and improves once feeding gets into a regular rhythm.
2. Clogged Milk Ducts: Clogged milk ducts are caused by inflammation of the surrounding tissue. Use only gentle massage, nurse your baby on demand, and apply cold rather than heat to help reduce inflammation and help clogged ducts resolve.
3. Galactocele (Milk-Filled Cyst): This is a milk-filled cyst that develops when a milk duct is blocked, causing milk to collect. Galactoceles are usually benign and are not harmful. They may feel soft or firm and are often painless.

Telling the Difference Between Normal Lumps and Those That Need Attention

Many lumps that occur during breastfeeding are normal and related to milk production, but some require closer attention. Here’s how to know when it’s time to seek help:

1. Mastitis (Breast Infection)

• Symptoms: A lump may feel hot and painful and be accompanied by redness, swelling, and a fever. The skin around the lump may appear inflamed, and you might experience flu-like symptoms.
• What it means: Mastitis is most often caused by significant inflammation of the breast tissue. Increased pumping and nursing can worsen inflammation, so focus on feeding your baby on demand. Non-steroidal anti-inflammatory drugs (NSAIDs) and applying ice can help reduce swelling, inflammation, and pain caused by mastitis. Avoid heat and deep massage as they can worsen inflammation. In some cases, bacteria can enter the breast through cracked nipples, leading to bacterial infection. Bacterial mastitis requires antibiotic treatment.

2. Breast Abscess

• Symptoms: If mastitis is left untreated, it can lead to the formation of an abscess, which is a painful collection of pus within the breast. A lump that feels hard and is filled with fluid, accompanied by severe pain, redness, and swelling, could be an abscess.
• What it means: A breast abscess often requires medical intervention, such as drainage or antibiotics, so it’s crucial to seek medical help promptly if you suspect this.

3. Breast Cancer

• Symptoms: Although rare, it is possible to develop breast cancer while breastfeeding. A cancerous lump may feel hard, have irregular edges, and not move when pressed. It is usually painless, but it’s important to remember that not all breast cancers feel the same. You should also look out for dimpling of the skin, changes in the appearance of the nipple, or a lump in the underarm.
• What it means: If you find a lump that doesn’t go away after a few days or weeks, even after trying remedies for clogged ducts or mastitis, it’s important to get it checked by a healthcare provider. They may recommend a mammogram, ultrasound, or biopsy to determine the nature of the lump.

When to See a doctor

It’s always better to err on the side of caution when it comes to your breast health while breastfeeding. Here are some general guidelines for when to seek medical advice:

• The lump doesn’t improve with home care (tips given above) within a few days.
• The lump is growing or disappears after a week or two.
• You experience severe pain, fever, or flu-like symptoms, which could indicate an infection.
• You notice any unusual changes in the breast, such as dimpling of the skin, nipple retraction, or skin changes that don’t resolve.
• The lump feels hard, immovable, or irregular and persists for over two weeks, even after treatment for clogged ducts or mastitis.

Tips for Maintaining Breast Health While Breastfeeding

• Don’t skip nursing or pumping sessions: Regularly removing milk can help prevent engorgement and clogged ducts by keeping the milk flowing.
• Ensure your breast pump flanges are the right size: A poorly fitting flange can reduce your pump’s effectiveness and lead to clogged ducts.
  Ensure your baby’s latch is comfortable and effective: Latch problems can lead to clogged ducts and even mastitis. If you’re experiencing pain with latching or are concerned that your baby isn’t transferring milk effectively, seek help from an IBCLC.
• Wear a comfortable bra: Tight bras can put pressure on the breasts and increase the risk of blocked ducts.
• Stay hydrated and nourished: Drinking plenty of water and eating well supports both your milk supply and your overall health.

Final Thoughts

It’s perfectly normal to experience lumps in your breasts while breastfeeding, and most of the time, they’re related to natural processes like milk production or clogged ducts. However, listening to your body and seeking medical advice is important if something doesn’t feel right. Whether it’s an infection, an abscess, or a rare case of breast cancer, early detection and treatment can make all the difference. Don’t hesitate to contact your healthcare provider if you’re unsure—your peace of mind and well-being are worth it.

Breastfeeding is a journey; staying mindful of your breast health can help ensure you and your baby enjoy this special time together.

 

Co-written by: Tracy Corey, RN, IBCLC, CFM, and Jacque Ordner BSN, RN, IBCLC, RLC.