Breast engorgement, plugged ducts and mastitis causes and treatment.

Breast engorgement

You may experience breast engorgement where your breasts become overly full (swollen), hard and painful.

Signs and symptoms

  • Swollen breasts
  • Tender, warm and throbbing breasts
  • Reddened breasts
  • Taut, shiny and transparent skin on breasts
  • Low-grade fever
  • Flattened nipples


  • Day three or four when the milk volume increases
  • If feedings are missed
  • If baby is not sucking and latched correctly and not emptying the breast fully
  • If mom and baby are separated
  • Long night sleeps or missed night feeds


  • Breastfeed your baby early and often after birth.
  • Breastfeed your baby frequently on demand (eight or more times in 24 hours).
  • Feed baby every two to three hours day and night at first, then learn to watch baby’s cues.
  • Make sure your baby is latched on and positioned correctly.
  • Wake a sleepy baby to breastfeed every two to three hours during the day. If baby is growing well, she may go a little longer at night.
  • If you are separated from your baby, begin hand expression as soon as possible after birth, preferably within one hour. Your baby may be able to take drops of your colostrum. After the first 24 hours, continue to hand express and use an effective and efficient pump to establish a good milk supply and pump often (eight or more times in 24 hours).
  • Avoid any unnecessary supplementation.


  • Use Advil or Motrin (ibuprofen) to maintain comfort and decrease pain.
  • Use cold compresses between feeds to reduce swelling and discomfort. Do not place the ice pack directly onto the skin.
  • Some women report improved comfort when raw cabbage leaves are applied to the breasts. Once the discomfort goes away, stop using cabbage leaves as they can decrease your milk supply.
  • Hand express a little prior to breastfeeding to help soften the dark area on your breast or nipple (areola) so your baby can latch more easily.

Plugged ducts

If you have a red sore area in your breast, you may have a plugged duct. A plugged duct can happen if milk builds up in a milk duct and does not flow. Pressure builds up behind the duct and can cause soreness in the surrounding area.

Plugged ducts can become infected. With continued nursing and massage of the area, plugged ducts usually clear up in one to two days. Find ways to relieve plugged ducts.


If you develop a fever greater than 38˚C, feel as though you are getting the flu or your breast is red and sore, you may have mastitis. Continue to breastfeed.

Mastitis is an infection of the breast tissue and/or milk ducts. It may come on suddenly and make you feel sick with chills and aches. The breast may feel firm, swollen, hot and painful and may appear red or have red streaking.

If you think you have mastitis, contact your health care provider or call HealthLink BC at 8-1-1 immediately. Find ways to treat mastitis.