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Postpartum Breast Issues

Sore Nipples, Plugged Ducts, Mastitis & Thrush


Nipple sores: breakdown in the skin of the nipple, usually from sensitive skin or improper latching.

  • Symptoms include visible sores like blisters or scabs on nipple and sharp pain during latching.
  • How to take care of nipple sores
    • Make sure your baby is latching completely on the breast (most of your aerola should be covered)
    • Make sure you break the suction/latch properly before taking your baby from the breast.  Place 1 finger in the side of the baby’s mouth to break the suction and keep your finger between the baby’s gums until the nipple is completely out of the mouth.
    • If your baby slides down to the end of the nipple while nursing, break the latch and relatch.
    • After nursing, express a small amount of your breastmilk onto the nipple and rub it in-let air dry.  You milk has hormones that will help you create new cells.
    • You can use products like lanolin creams (lasinoh) or gel pads (soothies) to help protect the skin between feedings.
    • Breast shells can be use to prevent clothing from rubbing against your nipple.


Plugged ducts:  breast milk that does not completely release or empty from the breast and sits in the ducts.

  • Symptoms include a hard area of the breast that may be warm and tender to the touch.
  • How to take care of plugged ducts
    • Continue breastfeeding/pumping: although the milk will contain bacteria it is not harmful to your baby. 
    • Place warm/moist heat to the area for 5 to 10 minutes prior to nursing or pumping. 
    • Latch baby on the breast with the plugged duct first (the baby will drink the largest volume from the 1st breast)
    • Make sure the baby is latching completely to the nipple
    • Latch the baby with it’s chin facing the side of the plugged duct
    • Massage the area toward the nipple to help the milk release while nursing
    • If the area is still firm after nursing, hand express or pump breast to completely release the milk.
    • Once the milk is completely released, you can use cool packs for comfort.


Mastitis: an infection in the breast, usually from bacteria growing in milk that has been sitting the ducts or from sores on the nipple allowing bacteria to enter the breast.

  • Symptoms of plugged duct with hard areas that are red and hot to the touch and also ‘flu-like’ symptoms: fever, body ache and/or chills.
    • Continue with all of the above directions for plugged ducts.
    • Take your antibiotic on time and finish the prescription
    • Take Tylenol for fever or Motrin (up to 600mg every 6 hours) for both breast pain & fever.
    • If the infection does not improve, return to the office for further evaluation.


Yeast/Thrush: a fungal infection in the breast

  • Symptoms include nipple pain, redness and/or itching. You may have shooting pain in the breast during of after nursing.  Your baby may have white spots on the tongue that do not rub off.  These infections may occur after taking antibiotics.
  • How to take care of breasts
    • Continue breastfeeding/pumping
    • Air dry your nipples
    • Change your breast pads regularly to prevent a moisture on the nipple
    • Avoid plastic lined pads that may hold moisture in
    • Wash your bras in hot water and pump parts in hot water or dishwasher (if safe)
    • You may need a prescription for an antifungal cream to rub onto you nipples after breastfeeding.
    • You baby should be treated with nystatin drops after each feeding to prevent passing the infection back to your breasts: contact your baby’s pediatrician for a prescription.


By Cyndi Ayoub, WHNP

August 28, 2010