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Tips & Guides

What to do when you have blocked milk ducts (engorgement) and mastitis?

Knowing the different symptoms and taking appropriate measures

Common symptoms of breast trouble are lumps or swelling that hurt, and mastitis.
Please follow the instructions of an expert, such as doctors, midwives, and lactation consultants, as breast problems can lead to breast milk insufficiency and poor weight gain in your baby.

Lumps and swelling

If you find lumps or swelling, try to breastfeed using the appropriate positioning and latch on, and breastfeed frequently. Another way to take care of lumps and swelling is to express breastmilk after and between breastfeedings. Expressing breastmilk often helps, even when the lump causes a burning pain. There is a possibility that a lump in the mammary gland will become mastitis if it is left untreated. Additionally, if your baby suddenly stops wanting breastmilk, it may be a warning of mastitis.

Mastitis

Mastitis is a breast disease accompanied by pain, fever (38.5 degrees C and above) and engorgement, chills, flu-like body pain and systemic symptoms.
Mastitis is said to be most common 2-3 weeks postpartum, but it can develop at any time during the breastfeeding period.
Mastitis is divided into 2 types, one with a bacterial infection and the other without.

1.Congestive mastitis
Stagnation mastitis (noninfectious mastitis) causes breast inflammation without bacterial infection. It is usually accompanied by redness, engorgement, lumps, a burning sensation in one breast, and sometimes a mild systemic fever. If you have these symptoms, try to breastfeed using the appropriate positioning and latch on to cope with the disruption of breastmilk.

2.Acute purulent mastitis
If symptoms don’t improve within 24 hours of the start of the symptoms in (1) and you have flu-like symptoms such as fever, chills and body pain, you may be infected by this bacterial form of mastitis. If the symptoms are severe, a course of antibiotics may be recommended, but in any case, see a specialist and obtain advice.

Differentiating between blocked milk ducts and mastitis:

1) Firm lump on breasts that hurts when you touch it, no fever: You may have a blocked milk duct

2) Firm and tender lump on your breasts, feverish and/or flu-like symptoms: You may have a breast infection (mastitis)

Blocked milk ducts and mastitis happen when the milk doesn't drain from the breast adequately and it occurs when:

- There are persistent problems with baby latching on

- Baby feeds rather often or missing feeds

- You feed from one breasts more often than the other

- There is pressure on your breast from tight fitting clothes and restrictive bra

What should you do when you have blocked milk ducts or mastitis? 

An infection needs to be treated immediately with anti-biotic treament and you need to contact your health care providers with no delay.

You should continue nursing and nurse even more frequently, especially on the affected side! You need to get lots of rest and care for your breasts with heat and gentle massage. 

Some self-care tips:

  • Wear a nursing bra.
  • Avoid underwire bras.
  • Avoid constrictive and tight clothing. If you're wearing a bra, you should get one size bigger. 
  • If you wear a regular bra, flip it under, not over your breast while nursing.
  • Make sure the baby's positioning is correct and they are latching on properly
  • Change baby's feeding position throughout the day, at least once during each feed. 
  • Allow baby to finish feeding on one breast before switching to another
  • Rest and nurse often

How to prevent mastitis?

Treat blocked milk ducts carefully as it may lead to mastitis. To avoid mastitis:

  • Nurse regularly
  • Pump out the milk from your breast if baby missed feeding
  • Always keep your hands clean before touching your breasts
  • Change bra pads frequently

What can I do when I have a blocked milk duct? How do I unclog it?

You can gently massage the area in a circular motion starting behind the lump, working toward the nipple. After feeding: If the duct has not cleared during the feed, hand express or pump after your baby has finished feeding to ensure your breast is adequately drained. It may take several feeds to clear the blockage.

What causes blocked milk ducts? How do I prevent it?

There are several reasons that cause clogged milk ducts. It can be due to an overabundance of milk supply, excessive pressure on the breasts tissues due to an over tight underwire bra and insufficient drainage of your milk ducts. The most common reason is the insufficient drainage of milk ducts, which is a result of inconsistent feeding cycles and feeding positions of newborn. A normal feeding cycle occurs every 3-4 hours and it is important to follow this cycle to prevent blocked milk ducts.

Another tip to prevent blocked milk ducts is rotating the positions of latching your baby. Think of it this way - the milk ducts of your breasts are located at the top, bottom, right and left of your breasts. The 'Cradle / Cross Cradle' positioning of baby latches directly onto the right and left of the milk ducts, and the suckling movement puts pressure on the right and left milk ducts. The top and bottom milk ducts in this case, are not properly drained of the milk. Whereas, the 'Football' hold of the baby latches onto the top and bottom milk ducts and suckling position puts pressure on the top and bottom milk ducts and in this case, the right and left milk ducts are not properly drained. So, the best way to properly drained all areas of the milk ducts is to rotate the feeding positions with both 'Cradle/Cross-cradle' and 'Football' hold to ensure all parts of the milk ducts are covered. 

Talk to lactation consultants or your health care providers to learn more about breastfeeding!

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