very painful left breast - what can i do?

[Mimile]

My left breast has been painful for the last 3 or 4 days, with a hard lumpy area on the outer side, extending to the armpit. I keep BF DD (4 weeks) on both sides, but while the rest of the breast soften as she goes, the hard area remains. It is quite painful, a little red, but not warm.
I also had a fever for the last 2 days, which I thought was the cold/flu (my DH had it last week).
Not sure what to do next. I take paracetamol every 4 hours and wear breast shells to collect "drips" (conventional breastpad irritate me too much). Could it be the pressure of the shell while lying on my side at night which blocked a duct? Is it likely to happen at this point.
Won't talk to HV as I've had issues with her (story posted elsewhere). She also runs my BF groups, which limits options...
Hope someone can advise!!

It could well be that the pressure of the shell has caused a blocked duct. A blocked duct is the most likely thing but mastitis is also a possibility or imminent. I wouldn't advise anyone to talk to their health visitor in this situation even if they were your best friend. You need to first off speak to someone trained in breastfeeding and then possibly a doctor as you may need antibiotics eventually.

Have you had a go trying to massage the breast to work on the hard area? Hot wet compress (or hot shower/bath) and then massage, feed, more massage. It can also help to try and feed in different positions so different ducts are drained differently. The area is hard because of a blockage most likely but also because of inflammation so it won't all disappear immediately.

I think the best thing is that you phone one the national breastfeeding helplines and speak to a trained counsellor. You can discuss with them all the things you can do at home and then discuss when you may need to see your doctor.
www.breastfeeding.nhs.uk/en/fe/page.asp?n1=4

Lansinoh breast pads are the best. They don't stick to your nips and are v comfortable. I never thought I'd be able to move away from the shells but these made it possible.

Take ibuprofen instead of paracetemol as they are anti-inflammatory.

thanks for your reply!
i've tried alternating postitions with little success (conventional, rugby ball and lying on my side). I am also on antibiotics for section scar infection (finished fluclox and still on metronidazole for a couple of days).
Also tried massaging with little result.
Will give the hot compress a go, and if nothing, will try to find someone / ring someone... hope it won t hamper BF or milk supply...

It sounds like a blocked duct but the fever is a bit worrying. I am not an expert though, and I think you should see/speak to someone asap about this, preferably a bf expert as Tamba says. There is a list of useful numbers on how breastfeeding works - see the column on the right.

Can you go shell-free for a while, particularly at night, and just lie on a towel?

The suggestion of massaging the lumpy area while you feed is a good one, and has sorted blocked ducts for me in the past, also some people suggest trying to position the baby so their chin is towards the lumpy part, as this drains the ducts more effectively. But I think you should discuss this with an expert as the possibility of mastitis is not something to take lightly.

sorry - x-posted with your message.

I know nothing about medicine but I do know that different abs interact with different infections, so it's possible that the c-section antibiotics may not be very effective against other infections.

I would ring someone anyway, whether or not the compress helps, as they can offer good advice on prevention and monitoring your fever etc. I don't want to scare you, but a friend ended up in hospital with blood poisoning, following an untreated breast infection. This was very unlucky, though, so I am sure you will be fine

When you are inflammed your breasts mistakenly think you are engorged so it can make a little difference to milk supply (as engorgement and fullness causes breasts to receive 'make less milk' signals). Ibuprofen is a good idea.
If you are on antibiotics already I suggest you take some probiotics (like lacto acidophilus capsules from the fridge in a health food shop) to help prevent thrush.

As you may have developed mastitis while ON antibiotics I think you should perhaps speak to your doctor and make an appointment to see your GP as they might need to tweak the dose before the course ends. It might not be advisable to come off antibiotics if you are showing clear symptoms while on them.