Blocked Milk Duct and Mastitis

Evidence 

https://www.racgp.org.au/afp/2016/august/overcoming-challenges-faced-by-breastfeeding-mothe 

Lisa H Amir, Anita Bearzatto 

Some women develop recurrent blocked ducts – lumps occurring within the breast, but without fever or the systemic symptoms of mastitis. These are usually caused by poor drainage of milk, and it is worthwhile spending time to address the possible causes (e.g. tight clothing, pressure from a hand or a seat belt, sleeping on the stomach). Blocked ducts may occur after longer than usual breaks between breastfeeding, or expression or excessive arm exercise.  

In mastitis, a segment of the breast is red, swollen and tender, and there is concurrent fever, myalgia, shaking, headache and nausea. If recognised very early, mastitis can be managed by increasing milk drainage from the breast (e.g. increasing feeds and/or expressing), applying heat before a feed and cold packs after a feed. Very gentle massage of the affected area during feeding may help.  

Education 

What is a Blocked Milk Duct? 

A blocked milk duct happens when the milk can't flow through one of the tiny tubes (ducts) in the breast that carry milk to the nipple. This can cause a small, hard lump in the breast that might feel sore or tender. The area around the lump might also look red or swollen. 

This blockage usually occurs when milk isn't removed from the breast completely during feeding, or if there's too much pressure on the breast, like from a tight bra.  

How to Clear a Milk Duct 

If you have a blocked milk duct, it's important to clear it so the milk can flow freely again. Here are some steps you can try: 

• Continue feeding your baby from both breasts, especially the one with the blockage. This helps to move the milk and can clear the duct. 

• Make sure you are using the correct size breast pump attachment – called a Flange, it comes in all different sizes and it’s important to have the correct size so it’s comfortable and you can express the most milk. If you are unsure if you have the correct size speak with the lactation consultant on the Neonatal ward. 

• Gently massage the area where the duct is blocked while you’re breastfeeding or pumping. Use your fingers to press and move the lump toward the nipple. 

• Apply a warm, damp cloth to the affected area before feeding or pumping. The warmth can help loosen the blockage and get the milk flowing. 

• If you are directly feeding, try a different position to ensure the baby is draining all parts of your breast. Sometimes a change in position can help clear the blockage. Speak to your lactation consultant or nurse on the ward to help you and your baby find the safest position.  

• Make sure to get plenty of rest and drink lots of water. This helps your body heal and keeps your milk supply strong. 

• Avoid tight bras or clothes that put pressure on your breasts, as this can make the blockage worse. 

If the blockage doesn’t clear in a day or two, or if you start feeling sick, it's important to see a doctor as a blocked duct that doesn’t clear may lead to an infection called mastitis. 

What is Mastitis? 

Mastitis is an infection in the breast that can happen when a blocked milk duct isn’t cleared. It causes the breast to become red, swollen, and very painful. Mastitis can also make you feel sick, like you have the flu, with a fever, chills, and tiredness. 

This infection happens when milk gets trapped in the breast, creating a good place for bacteria to grow. The bacteria can enter through a cracked nipple or skin and cause an infection. 

Signs of Mastitis: 

• A red, swollen area on your breast that feels hot and sore. 

• Flu-like symptoms, such as fever and chills. 

• Feeling very tired or weak. 

What to Do: 

• It might be painful, but it’s important to keep feeding your baby. This helps to clear the infection. 

• Make sure to rest as much as possible and drink plenty of water. 

• If you think you have mastitis, see a doctor right away. You might need antibiotics to help clear the infection.

Empowerment 

Dealing with a blocked milk duct or mastitis can be incredibly challenging, both physically and emotionally. Remember, it's okay to feel frustrated or overwhelmed—your body is working hard to nourish your baby, and this is just a bump in the road. You’re not alone in this journey; many mothers have faced the same difficulties and come through stronger. 

By expressing regularly and emptying the breast fully you will reduce the risk of having blocked milk ducts or mastitis. Take things one step at a time. Rest when you can, stay hydrated, and don’t hesitate to seek support from healthcare providers or lactation consultants. They can offer the guidance you need to feel better and continue your breastfeeding journey. 

The Australian Breastfeeding Association (ABA) also runs the National Breastfeeding Helpline. This 24/7 free service is available on 1800 686 268, online or in person at a support group.  

Useful Links 

Australian Breastfeeding Association  

https://www.breastfeeding.asn.au/ 

Royal Women’s Hospital - Breastfeeding fact sheets 

www.thewomens.org.au/health-information/breastfeeding 

Health Direct 

https://www.healthdirect.gov.au/mastitis 

Raising Children Australia  

https://raisingchildren.net.au/newborns/breastfeeding-bottle-feeding/breastfeeding-challenges/blocked-duct-mastitis-abscess 

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