Breast Engorgement and Lumps in the Armpit After Delivery - Obstetrics and Gynecology

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Breast engorgement and the presence of lumps in the armpit after delivery can be concerning for new mothers, especially when they are trying to establish breastfeeding. Engorgement occurs when the breasts become overly full with milk, leading to swelling, discomfort, and sometimes pain. This condition is common in the early days of breastfeeding, particularly when the milk supply is being established.
When a mother experiences engorgement, it can lead to a few complications, including blocked milk ducts or mastitis, which is an infection of the breast tissue. Blocked ducts can occur when milk is not adequately removed from the breast, leading to localized swelling and tenderness. If left untreated, this can progress to mastitis, which may present with symptoms such as fever, chills, and flu-like symptoms, in addition to breast pain.

The lump you are feeling in your armpit, which is about the size of a ping pong ball, could be related to several factors. It may be a swollen lymph node, which can occur due to the body’s response to infection or inflammation in the breast tissue. The lymphatic system plays a crucial role in the immune response, and when there is an issue in the breast, the lymph nodes in the armpit can become enlarged as they filter out pathogens and debris.

Here are some steps you can take to manage engorgement and the lump in your armpit:
1. Continue Breastfeeding or Pumping: It is essential to keep the milk flowing to prevent further engorgement. If your baby is not nursing effectively, continue to use the electric breast pump to express milk. This will help relieve pressure and prevent blocked ducts.

2. Warm Compresses: Applying warm compresses to your breasts before nursing or pumping can help stimulate milk flow and relieve discomfort. After feeding, cold compresses can help reduce swelling.

3. Massage: Gently massaging the breast while nursing or pumping can help to clear any blocked ducts. Focus on the area of engorgement and work towards the nipple.

4. Positioning: Ensure that your baby is latching correctly. Sometimes, changing nursing positions can help drain different areas of the breast more effectively.

5. Hydration and Nutrition: While you mentioned reducing fluid intake, it is crucial to stay well-hydrated and maintain a balanced diet to support milk production.

6. Monitor the Lump: Keep an eye on the lump in your armpit. If it becomes increasingly painful, does not improve, or if you develop other symptoms such as fever, it is essential to seek medical attention. A healthcare provider may perform an examination and possibly imaging studies to determine the cause of the lump.

7. Consult a Lactation Consultant: If you continue to have difficulties with breastfeeding or engorgement, consider consulting a lactation consultant. They can provide personalized support and strategies to help you establish a successful breastfeeding routine.

In summary, while engorgement is a common issue for new mothers, it is essential to address it promptly to prevent complications. The lump in your armpit may be related to the engorgement or an immune response, and monitoring it closely is important. If you have any concerns or if symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.