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Engorgement, mastitis + thrush: What they are and how to treat them

We all have unique breastfeeding journeys and unexpected problems can pop up along the way.

breastfeeding complications

We all have unique breastfeeding journeys and unexpected problems can pop up along the way. Some problems, like engorgement, may occur in the first few days after giving birth, while others, like mastitis, can happen much later on.

Any time that you experience pain while nursing or pumping, whether it be your first time breastfeeding or your 300th time, it's important to be seen by a lactation professional as soon as possible. They can help you get a prompt diagnosis and start a treatment plan.


Here are common breastfeeding-related problems that can come on as a surprise include engorgement, plugged milk ducts, mastitis and thrush.

What is engorgement?

Engorgement is when your breasts are overly full of milk.

Swollen breasts due to engorgement can cause pain and interfere with your baby's ability to latch. Engorgement is common during the first few days after giving birth when one's milk "comes in," but can also occur later on if a feeding or pumping session is skipped, as well as during the process of weaning.

How to treat engorgement

One of the best treatments for engorgement within the first week after giving birth is to empty your breasts by nursing or pumping frequently. Applying heat with warm compresses and massaging your breasts prior to breastfeeding can also be helpful.

Other tricks to help with engorgement include applying cold packs to your breasts for 15 to 20 minutes after each feeding, wearing a comfortable bra, and spending as much time as you can flat on your back (a good excuse to be able to get extra rest!).

Untreated engorgement can lead to additional problems, including plugged milk ducts and mastitis. So, if you try these techniques and are still struggling, reach out to your provider or a lactation professional for help.

What is a plugged milk duct?

A plugged (or clogged) milk duct occurs when drainage from a milk duct is blocked. Plugged milk ducts can develop if your breasts are not totally emptied after a nursing or pumping session. Localized pain, tenderness and swelling, or a lumpy feeling in the area of the blockage occur. Pain associated with a blocked duct typically worsens while breastfeeding and resolves afterward. Your baby may also be fussier than normal while feeding if you have a plugged duct due to slow milk flow from the affected breast.

How to treat plugged milk ducts

Treatments for plugged ducts include frequent feeding on the affected side, pumping after feeding to promote total emptying of the breast, and trying out different nursing positions that may help clear the blockage.

Other treatments are similar to the remedies for engorgement: wear a comfortable bra, apply heat and massage your breast prior to feeding, and cold packs and rest after feeding to help to decrease pain and inflammation.

What is mastitis?

Mastitis is an inflammation of breast tissue that causes pain, swelling, warmth and redness. Fever, chills, and flu-like symptoms are also common.

The two main causes of mastitis are plugged milk ducts and nipple cracks or abrasions that can cause bacteria to enter the breast. Other risk factors for mastitis include poor breastfeeding technique or latch, wearing a bra that is too tight and having previously had mastitis in the past (though some mothers develop mastitis in the absence of any of these risk factors).

All possible cases of mastitis should be evaluated by a lactation or medical professional as soon as possible.

How to treat mastitis

You will likely be encouraged to continue to breastfeed from the affected side, making sure that one's breasts are fully emptied out after each feeding. Using warm compresses and breast massage prior to feeding can also help.

Over-the-counter pain relievers, such as ibuprofen, are commonly used for mastitis-associated pain and discomfort. Other tips for moms with mastitis include focusing on getting rest between feeding and pumping sessions, increasing fluid intake, starting each breastfeeding session on the affected side, and applying cold packs to the affected area between feedings.

If a mother with mastitis gets very ill or has a significant worsening of symptoms over a 12 to 24-hour period, antibiotics may be needed to clear a bacterial infection.

What is thrush?

Thrush is a fungal (yeast) infection of the nipple area that can cause significant pain and discomfort. Symptoms of thrush include a sudden onset of intense nipple pain while nursing (does not improve with changing latch or technique), an itching or burning sensation of the nipples, or a pink or red, flaky rash around the nipples.

Symptoms of thrush in a baby include white patches visible in the mouth or on the tongue, feeding refusal or pain while eating, and a diaper rash that does not respond to the application of common diaper rash creams or ointments. Some babies with thrush have no symptoms at all.

Risk factors for thrush include nipple cracks and abrasions, leaving damp nursing pads on for too long, antibiotic use during pregnancy or labor, having a recent vaginal yeast infection, and diabetes.

How to treat thrush

Treatment for nipple thrush includes treating both mother and baby at the same time. Oral nystatin is the most common treatment for babies with thrush, while moms are usually treated with topical antifungal creams. Severe cases of thrush may require treatment with an oral antifungal, such as Diflucan (fluconazole).

Alternative treatments for mothers with breast thrush include probiotics and grapefruit seed extract. However, these should be taken under the guidance of a medical professional.

Moms with thrush should continue breastfeeding and pumping during treatment to prevent a decrease in milk supply. Mothers and babies should be treated for at least one week after all symptoms resolve to avoid reinfection.

Other ways to prevent reinfection include frequent hand washing, changing nursing pads as soon as they become damp, rinsing your nipples after every breastfeeding and letting them dry before applying antifungal cream, and making sure that all pump parts, bottle nipples, and pacifiers are boiled after every use to kill any remaining yeast.


You've got this, mama!

Although the breastfeeding complications discussed above can cause some discomfort, they are relatively common, treatable and should not interfere with your ability to breastfeed your baby long term. If concerning symptoms pop up, it's essential not to ignore them and to seek help and guidance as soon as possible. Most importantly, please remember that you can (and should) continue to breastfeed while being treated for any of these conditions.

As much as I love fall, it always feels like the season when my family's routine gets kicked into overdrive. With our oldest in (homeschool) kindergarten, my youngest on the brink of entering her twos, work, housework and *all the things* filling my day, it's hard not to feel a little overwhelmed sometimes. Did I mention we're still in a pandemic? (Yeah, it's a lot.) And while I try to take a positive view as much as I can, now more than ever I definitely jump at the chance to take anything off my busy plate.

One thing first in line at the chopping block? Cooking. To be fair, I like cooking. I cooked most of our meals long before I had ever even heard of social distancing. But there's something about the pandemic that suddenly made cooking every single meal feel exponentially more draining.

Enter Daily Harvest. They deliver nourishing, delicious food right to your door. Daily Harvest's mix of smoothies, bowls, flatbreads, snacks and more provide a balanced, whole food options that are as satisfying as they are nutritious. But my favorite part? When we're ready to eat, I simply pull the food from the freezer and it's ready in minutes—without any chopping, measuring or searching for a recipe. Even better, they're incredibly tasty, meaning I'm not struggling to get my girls to dig in. Not cooking has never felt so good.

Here are my 8 favorite products that are helping to lighten my load right now:

Mulberry + Dragonfruit Oat Bowl

Mulberry + Dragonfruit Oat Bowl

One thing that actually helps break up the monotony of quarantine? Trying and introducing new ingredients to my family. I love this overnight oat bowl (add milk the night before and let it set in your fridge overnight—easy-peasy!) because not only does it not compromise on nutrition, but it also helps me bring new whole fruits, vegetables and superfoods to the table with ease.

Mint + Cacao Smoothie

Mint + Cacao Smoothie

I kid you not, these taste exactly like a mint chocolate chip milkshake. (Just ask my 4-year-old, who is constantly stealing sips from my glass.) What she doesn't know? She's actually getting organic banana, spinach and chlorella with every sip. #momwin

Kabocha + Sage Flatbread

Kabocha + Sage Flatbread

Our family's eating habits have been leaning more plant-forward this year, which often means a lot of veggie washing, peeling and chopping every time I cook. That's why these flatbreads are my new best friend come lunchtime. This Kabocha + Sage Flatbread is made with a gluten-free cauliflower crust topped with kabocha squash, fennel and sage for a taste of fall in every bite. (Missing the cheese? You can add it before baking for more of a pizza feel.)

Kale + Sweet Potato Flatbread

Kale + Sweet Potato Flatbread

There's something about the combination of sweet potato crust topped with red cabbage, organic greens and an herby-cilantro sauce that is so delicious… like surprisingly delicious. I polished off this bad boy in seconds! And unlike other "veggie" crusts I've tried, these are actually clean (AKA no fillers, preservations, partially-hydrogenated oil or artificial anything). Plus, it couldn't be easier to throw in the oven between conference calls and homeschool lessons.

Cacao + Avocado Smoothie

Cacao + Avocado Smoothie

Any time I get to serve a breakfast that tastes like chocolate, it's a good day. (That goes double when it's *my* breakfast.) This rich, chocolatey smoothie is packed with organic zucchini, avocado, pumpkin seeds and pea protein for a nourishing mix of healthy fats and muscle-building protein so I can carry that baby all day long. And did I mention the chocolate?

Vanilla Bean + Apple Chia Bowl

Vanilla Bean + Apple Chia Bowl

Maybe it's just me, but after a long week of cooking, the last thing I want to do on Saturday morning is...wake up and cook. That's why these one-step breakfasts are saving my weekend. I simply add our favorite milk the night before and store the bowl in the fridge overnight. Come morning, I have a nutritious chia bowl that powers me through even the busiest day of errands. It's also Instagram-ready, which makes me feel like I'm out brunching (even if I can't remember the last time I was in a restaurant).

Cacao Nib + Vanilla Bites

Cacao Nib + Vanilla Bites

My kids have turned into snack monsters during quarantine, and I'm often struggling to find a wholesome option (that doesn't require a lot of extra cooking or else I resort to something ultra-refined and shelf-stable). These bites are the hero I never knew I needed. For one, they taste like cookie dough, but they're actually packed with chickpeas, pumpkin, dates and flax seed (among other whole ingredients). But unlike actual cookie dough, I don't have to go anywhere near my mixer to whip them up—all I have to do is pull the container out of the freezer, let them defrost a bit and we can all enjoy a treat.

Cauliflower Rice + Pesto Harvest Bowl

Cauliflower Rice + Pesto Harvest Bowl

Sometimes I have a little more time to cook, but I still want a quick, stress-free solution. (Especially because it always feels like I just cleaned up from the last meal.) I love these Harvest Bowls because they warm up in under five minutes on the stove top (or microwave!) but pack tons of flavor. The Cauliflower Rice + Pesto bowl is one of my favorites, with basil, olive oil and nutritional yeast for a hearty dish reminiscent of a mouth-watering Italian meal. When I'm feeling extra fancy, I add leftover grilled chicken or a fried egg.

Strawberry + Rich, Rippled Berry Compote Scoops

Strawberry + Rich, Rippled Berry Compote Scoops

Who doesn't want to end the day with a little something sweet? This creamy and decadent frozen treat from Daily Harvest is swirled with sweet berries and tropical dragonfruit for an antioxidant burst you'll feel good about—but that your kiddos will just think is ice cream. Go ahead, take credit for being the best mom ever.

Want to try it yourself? You can get $25 off your first box of Daily Harvest with code MOTHERLY.

This article was sponsored by Daily Harvest. Thank you for supporting the brands that support Motherly and mamas

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