Breast related concerns

If you are experiencing any of the following:

  • difficulty in breathing, very fast breathing or  shortness of breath
  • coughing up blood-stained sputum (a thick fluid produced in the lungs)
  • moderate or severe chest pain
  • collapse – unrousable (new mother does not wake up when you speak to them or seems very confused)
  • any of the signs of sepsis
  • Slurred speech or confusion
  • Extreme shivering or muscle pain
  • Passing no urine (in a day)
  • Severe breathlessness
  • It feels like you’re going to die
  • Skin mottled or discoloured

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

Please call your Midwife or GP if you have any of the following:

  • Unusual Nipple Discharge, Skin patches, or growths around the nipple/breast
  • A painful area to touch (often the upper outer area of the breast) which may also be painful to touch.
  • An ache within the whole breast and redness across the whole breast
  • A lumpy breast which feels hot to touch
  • ‘flu’ like symptoms- including raised temperature, shivering as well as feeling tearful and tired
  • If you have been treated for mastitis and completed a course of antibiotics and have addressed any breast drainage issues, but you continue to suffer pain and have ‘orange peel’ skin on your breast
  • Pain in the nipple or breast (burning, sharp or shooting pain) that can last up to one hour post feed
  • Sore, cracked nipples
  • Shiny, red or pink nipples
  • Itchy or flaky nipples

 

 

You need to contact a doctor or midwife today.

Please ring your Community Midwife, GP surgery or call NHS 111 - dial 111

If you do not have any of the signs or symptoms in the Red or Amber section then please continue to read the information tables in the following sections to access a full list of self care actions related to breast concerns.

Self care

Continue care at home. If you are still concerned about your breasts after reading the advice please contact your Community Midwife or call NHS 111 – dial 111

Mastitis

Mastitis is most common in breast feeding women but bottle feeding mothers can get it too.

Risk factors for mastitis:
  • Difficulty in latching the baby to the breast
  • Tight fitting clothing or bras or pressing on the breast with a finger whilst feeding (beyond the initial latching phase)
  • Irregular feeding at the breast or sudden changes in feeding frequency which leave the breasts over filled
Symptoms of mastitis:
  • Insufficient drainage may lead to milk leaking onto the breast tissue from a blocked duct. The body reacts by increasing the blood supply (leading to engorgement) and this produces inflammation and redness. The breast may also feel warmer to touch due to the increased blood supply.

  • Watch for:

    ·         a painful area to touch (often the upper outer area of the breast) which may also be painful to touch.

    ·         An ache within the whole breast and redness across the whole breast

    ·         A lumpy breast which feels hot to touch

    ·         ‘flu’ like symptoms (including raised temperature, shivering as well as feeling tearful and tired)

    ·         Excessive fullness in the breasts caused by sudden changes in feeding demand/pattern

    ·         Injury to the breast – being knocked or hurt by a toddler for example

Self care advice:
  • Check the positioning and attachment of baby at the breast. Attend a breastfeeding support group. Try feeding the baby in different positions.

  • Soak a cloth in warm water and place it on the breast to relieve the pain (a shower may have the same effect).

  • Rest and drink lots of fluids.

  • Take paracetamol or ibuprofen to reduce any pain or fever. If pain or temperature is not managed see amber section..

  • If you are breast feeding – continue to breast feed.

  • Start feeds with the sore breast first.

  • Express milk from your breast between feeds if the baby is not draining them sufficiently.

  • Massage the breasts to clear any blockages – stroke from the lumpy or sore area towards the areola/nipple to help the milk flow. This can be done during a feed or while expressing and may be beneficial before the feed commences

  • Check fit of clothing – especially bra. If this does not fit well then it may be beneficial to wear no bra until a proper fitting one can be obtained.

Bruised, sore or cracked nipples

Damage to the nipple usually occurs due to a poor latch or position at the breast. Giving advice to improve this may address the issue.

Problem Likely cause Self care
Nipple pain at the start of the feed Incorrect attachment and positioning Attend a Breast Feeding Support Group or seek support from a midwfie. Seek advice with correcting attachment and positioning from the national breastfeeding advice line 0300 100 0212
General nipple pain at the end of the feed Vasospasm- if the nipple turns white at the tip following a feed and is painful as the colour returns. Attend a Breeastfeeding Support Group for Specialist support. N.B. Labelatol can cause vasoconstriction in the nipple which may lead to this issue. If this might be the cause then talk to your GP to find alternative BP medication. Continue taking your prescribed medication until assessed by your GP.
Pin point pain in the nipple post feed White spot or Bleb (see below)  

White Spot or Bleb on the Nipple

These can look like a white ‘spot’ on the end of the nipple. It is a blocked nipple duct and can sometimes be relieved with gently rubbing it with a flannel under a warm flow of water (e.g.shower). The NCT web site has more support and information regarding this: Please click here.

Sucking blister

A blister on the end of the nipple is normally caused by incorrect positioning and attachment.

Thrush

Please click here.

Insufficient milk supply

Please click here.

Self Care

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Local Pharmacist

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health Visitors

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School Nurses

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GP (General Practitioner)

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

NHS 111

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

Accident and Emergency

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance
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