Prevention is the best treatment
- Feed frequently – over 24 hours. Delaying a feed is not physiological. Feed baby when he opens one eye, change nappy when he finishes feeding.
- Sleep without a bra. Cotton singlet or T shirt soaks up milk but topless best
- Ensure decent fitting bra during day time e.g. sports bra
- Remove bra before feeding baby
- Hand-expression and feed baby from affected breast first
- Massage and express breast in direction of nipple
- Alternate feeding positions
- Comfort measures including warmth (helps oxytocin let-down), cold packs (reduce oedema)
- Anti-inflammatory medication – Ibuprofen 400 mg qid for pain Reassure mother of safety of this medication
- Bed rest and reassurance – encourage mother to co-sleep as the physiological norm. Give her a SAFE SLEEP 7 PRINTOUT (LA LECHE LEAGUE)
- Recommend contact with lactation consultant / ABA / La Leche League.