Q&A: I'm 22 weeks pregnant and experiencing extreme breast pain. Can I do anything about it?

by Dr. Gerard M. DiLeo

I am 22 weeks pregnant and for the past 4 months I have been having extreme breast pain. My nipples get very hard, turn purple and white, while my breast turns purple like a huge bruise.

The pain wakes me up in the middle of the night and happens many times during the day, sometimes as much as once an hour all day long. It sends burning pains from my nipple straight through to my back, the nipple stays very erect, and it hurts up to a half hour at a time. What is causing this and what can I do about it?

That does sound painful. From what you describe, you may be experiencing engorgement early in your pregnancy. Engorgement usually occurs when your breast milk "comes" in a few days after your baby's birth. (Before your milk comes in, your breast produces colostrum, or foremilk.) Engorgement during pregnancy is uncommon, but possible.

The pain around your nipples is probably a result both of increased sensitivity and small amounts of microscopic engorgement near the drainage ducts going to the nipple. But you may have engorgement in other areas of your breast as well. Severe engorgement can lead to mastitis, an infection of the breast tissue.

Definitely put in a call to your health care provider right away. He or she may be able to give you some at-home remedies or suggest setting up an appointment to evaluate your condition. You should also consider contacting a lactation consultant either by looking up one in your area through the International Lactation Consultant Association or your local La Leche League support person.

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