What causes breast redness, swelling and pain during lactation?

Women are prone to breast diseases during lactation due to various reasons such as not paying attention to hygiene and incorrect breastfeeding methods. Breast pain is common during lactation. Many women find that their breasts are red, swollen and painful during lactation, which is most likely caused by mastitis. Next, let’s analyze in detail what causes redness, swelling and pain in the breasts during breastfeeding?

The clinical manifestations of acute mastitis can be divided into three stages or phases.

Stage 1: milk stasis and lump stage or redness and swelling stage. The main symptom is sudden swelling, hardness, and pain in a certain part of the breast, usually the upper outer or upper inner quadrant, with unclear boundaries and obvious tenderness. At this stage, the inflammation inside the breast is at the cellulitis stage and no abscess has yet formed. The color of the breast skin is normal, slightly red, or slightly warm. Sudden high fever, chills, pain, swelling, local bright redness, which quickly turns to pus and ruptures, often accompanied by chest tightness, headache, loss of appetite, etc. If the nipples are cracked, you will feel a pain like a needle prick in the nipples when breastfeeding, and one or two small pus spots or very small cracks may be seen on the surface of the nipples.

Stage 2: abscess formation stage. If the cellulitis stage fails to dissipate in time, the inflammation will continue to develop, tissue necrosis, and abscess formation are inevitable. The lump gradually grows larger and harder, and the pain becomes more severe, often throbbing or even persistent, and the local skin of the breast becomes red and burning. The patient has a persistent high fever, thirst, nausea and anorexia, and swollen lymph nodes in the ipsilateral axillary. After 2 to 3 days of redness, swelling, heat and pain, the center of the lump gradually becomes soft and fluctuating, the center becomes red, swollen and shiny, the skin becomes thinner, and large areas of surrounding skin become bright red. Pus will be sucked out during the puncture. At this stage, the abscess has formed and the opportunity for conservative treatment has passed.

Stage three: late stage of abscess ulceration. When an abscess matures, it may rupture on its own or be drained surgically. If the drainage is unobstructed, the local swelling and pain will be reduced, the body temperature will return to normal, and after changing the dressing, the wound will gradually heal in about a month. If the pus does not drain smoothly after ulceration, the swelling does not go away, the pain does not decrease, and the fever does not subside, it means that the drainage is not smooth. If it is not healed for a long time, it will turn into chronic mastitis and form a milk fistula, that is, milk and pus will flow out mixedly.