Breast pain and fever during lactation

Pregnant women who are breastfeeding need to feed their babies with breast milk, which places high demands on the breasts. Some mothers need to feed their babies with formula milk because they do not have enough breast milk, while some mothers have enough milk and can continue to breastfeed. Some mothers find that their breasts are sore and hot during breastfeeding. Let’s find out what causes breast pain and fever during breastfeeding?

Lactational mastitis is a common breast disease in breastfeeding mothers. Bacterial invasion and infection, nipple cracks, milk congestion and blocked milk ducts can all induce mastitis. The specific causes of the disease are:

1. Bacterial infection

Mastitis during lactation is most often acute mastitis, the main pathogen of which is Staphylococcus aureus and less commonly Streptococcus. There are four ways that bacterial infections can enter the body:

(1) Direct invasion through the milk duct: This is a direct route for bacteria to invade the milk, which is prone to infection due to milk congestion and retention. Because retained milk is easy to decompose, the decomposition products are acidic, which not only irritates the mammary ducts but also serves as a good culture medium for bacterial reproduction.

(2) Entering through small wounds or cracks on the nipples: If there are wounds or cracks on the mother's nipples, these places are easy for bacteria to enter, invading the breast interstitium through the lymphatic vessels and forming cellulitis.

(3) Other parts of the body: Pathogens that infect other parts of the mother's body during the postpartum period can circulate through the blood and cause breast infection.

(4) Retrograde ductal infection: Another route of infection is that pathogens in the baby's body (such as oral and nasopharyngeal infections) directly invade the mammary lobules along the mammary ducts during breastfeeding, grow and multiply in the stagnant milk, and cause breast infection.

2. Nipple cleft

When the nipple is injured and cracked, or the nipple is chapped, these methods can lead to mastitis.

(1) Nipple cracks: This is usually caused by incorrect breastfeeding posture, the baby not sucking the nipple and most of the areola in the mouth, and breastfeeding on one side for too long.

(2) Poor nipple care: Pregnant mothers neglect nipple care and fail to clean their nipples regularly, which causes the epithelial tissue to become fragile and the nipple skin epidermis to become weak and easily damaged. Since it is the first time for a new mother to breastfeed, the nipple skin has weak resistance and is easily damaged by the baby's sucking, causing milk congestion and bacterial invasion, leading to mastitis.

(3) Breast trauma: If the nipple is injured, it is easy to damage the tissue, for example: a sudden impact or being kicked by an older child.

3. Milk stasis

(1) The milk is not completely sucked out: First-time mothers have no experience in breastfeeding and have a lot of milk. The baby often cannot suck out all the milk, causing excess milk to accumulate in the glandular lobules, which is conducive to the growth and reproduction of bacteria.

(2) Nipple hypoplasia: If primiparas do not clean their nipples regularly during pregnancy, the epithelium will become fragile. If the baby sucks for too long, the nipple epidermis will become soft and prone to cracking. When cracking occurs, the baby's sucking will cause severe pain to the mother, affecting adequate breastfeeding. The breasts will not be easily emptied, and milk will easily accumulate. In addition, if the nipples are underdeveloped, short, flat, small, or inverted, milk is more likely to accumulate.

(3) Breasts are too full: During lactation, breast milk is not discharged smoothly and accumulates in the breasts, leading to mastitis. For example, if the breasts are large, they tend to droop, making it more difficult for the milk in the lower part to flow out.

4. Milk duct obstruction

(1) It is common in secondary milk stasis. The main causes are incomplete emptying of the breast, irregular and frequent breastfeeding, and local pressure on the breast. Milk stasis is also common in people with nipple hypoplasia (such as inverted nipples), which affects breastfeeding.

(2) For first-time mothers, their breast milk contains a large amount of exfoliated epithelial cells, which can easily cause blockage of the milk ducts and aggravate milk congestion. Milk stasis reduces the vitality of breast tissue, creating conditions for the growth and reproduction of invading bacteria. If it is not cleared in time, mastitis will occur.