Breast pain in lactating mothers

The number of new mothers who breastfeed has increased dramatically over the last three decades. There is a concern that the present related medical service may be inadequate. Breast pain is the most common complaint among lactating mothers who seek medical help. This study aimed to investigate this problem.

Medical records of women who presented with breast pain to a private clinic run by a doctor who was trained as an International Lactation Consultant were reviewed over a period of 6 months in 2015. Most patients were self-referred after chatting online. Assessment included characteristics and duration of pain, treatment prior to consultation, feeding practices, mother's diet, and breast examination. Any site of blockage was identified and relieved. Those with persistent pain were given antibiotics. When there were signs of abscess or abscess that could not be drained, they were referred to a breast surgeon.

A total of 69 patients were seen of whom 45 had been breastfeeding for more than 1 month. Pain was experienced for longer than 7 days in 22 women. Antifungal or antibacterial treatment had been unsuccessful in 31 women prior to consultation. The diagnoses were engorgement in five women, blocked duct in 35, mastitis in 13, breast abscess in six, poor positioning and latch in seven, nipple cracks in two, and skin infection in one. Oral antibiotics were prescribed to 21 patients and local antifungal treatment was given to one patient only.

Blocked duct was the most common cause of breast pain in lactating mothers. Without prompt relief it is possible that it will progress to mastitis/breast abscess or the mother may discontinue breastfeeding. This may be a suitable time for Hong Kong to set up one or more public full-time breastfeeding clinics to provide a better service to lactating mothers and to facilitate professional training and research.