Localised breast inflammation – a new look at ‘blocked ducts’

In healthy, lactating breasts - milk flows easily through the milk ducts inside the breast and out numerous tiny openings in the nipple. Sometimes the surrounding breast tissue around these milk ducts can become inflamed, leading to the difficulties with milk flow.

This is commonly referred to as a ‘blocked duct’ but breast inflammation is the now recognised as the most accurate description.

This inflammation may present as:

• An area of the breast that is swollen/lumpy
• Redness of the skin on the breast
• Tender area of the breast to touch
• Pain when breastfeeding or experiencing a milk let down
• Breast/s feeling full/heavy and not softening well after feeds

Why has this inflammation happened?

Breast inflammation can happen at any point in your breastfeeding journey, and sometimes appear quite suddenly without knowing the exact cause.

But there are some common reasons was inflammation can occur including:

• Your baby isn’t attaching well and/or isn’t removing breastmilk well
• Oversupply of breastmilk
• Baby sleeps overnight/long breaks between feeds
• External pressure on the breast (tight bras, baby carrier straps/sleeping on side or stomach)
• Skipping breastfeeds

How do I treat breast inflammation?

• Start treatment as soon as you notice signs of inflammation in your breast/s.
• When possible, take any restrictive clothing/bras off before feeding
• Breastfeed on demand – whenever your baby wants to feed, let them feed.
• Offer the breast as often as you can to help frequent milk movement and removal
• Check your breastfeeding attachment and make sure your baby is feeding well
• If your baby isn’t attaching well (or often enough) you may need to use a hospital grade electric breast pump
• Use cool compresses after feeds to bring comfort and help relieve inflammation

Breast massage – does it help?

Until recently, one of the most common tips to help clear a ‘blocked duct’ was firm, purposeful hand massage of the ‘lump’ towards the nipple while feeding or expressing breastmilk. This was based on the belief of a physical ‘blockage’ in the milk duct preventing the free flow of breastmilk.

However, we now know that localised breast inflammation in the area surrounding the milk ducts is the main reason why milk flow may be impacted. For this reason, firm massage against inflamed tissue may actually cause further inflammation and deep tissue damage.

Consequently, it is now recommended that firm massage be avoided in treatment of breast inflammation. Some research articles suggest gentle massage/free movement of the breasts is of some benefit in milk movement and comfort.

This gentle massage should be done in combination with other treatment techniques.

Mastitis

In cases where localised breast inflammation isn’t treated quickly – it can become mastitis.

You may have mastitis is your breast is swollen, painful and/or hot to touch or discoloured. You may also experience a fever or flu-like symptoms. Muscle aches, chills, headaches and nausea are common symptoms of mastitis.

If you think you have mastitis, it is important that you follow the same treatment techniques as listed for inflammation and ensure frequent, effective removal of milk from the breast.

If your symptoms are not improving quickly (within 12-24 hours) and/or you develop a high temperature, you’ll need medical attention. You will likely need a course of antibiotics for several days to help clear the infection/inflammation.

Written by Keryn Thompson, RM & IBCLC (L-301766)

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