The birth of a new baby is an exciting and challenging time. With that tiny bundle comes many new challenges, which may include learning the art of breastfeeding. Breastfeeding may not run smoothly, and some women experience discomfort, damage to the nipples, and in some cases a blocked milk duct.
What is a blocked milk duct?
The ducts inside the breast carry milk from deep within the breast to the nipple openings, to allow breast feeding. Sometimes these ducts can develop a clog or blockage of milk that results in a tender or painful lump or firm area in the breast. You will be able to feel this lump in your breast like a marble under the skin. The skin around the lump may also be red and warm.
A blocked duct can occur at any time, and sometimes where there is a change in your feeding routine e.g. if your baby sleeps through the night and doesn’t wake for feeding.
Blocked ducts will usually resolve without special treatment within 24 to 48 hours after starting. During the time the block is present, the baby may be fussy when breastfeeding on that side because the milk flow will be slower than usual.
Is it Mastitis?
Mastitis is an inflammation of the breast which is usually caused by a blocked milk duct that hasn’t cleared, and an infection can occur. This has similar symptoms of a blocked duct and occurs with a fever and flu like symptoms (joint aches, fatigue). Mastitis requires a doctor’s visit and can require antibiotics which can impact breastfeeding.
Fast treatment of a blocked duct can help prevent Mastitis from occurring or blocked ducts from worsening.
What can I do?
- Continue breastfeeding on that side as much as you are able. Using a pump to express milk can also be very helpful if bub is refusing.
- Promote breast drainage by:
- Ensuring the best possible latch during feeding
- Feeding the baby in such a position that the baby’s chin “points” to the blocked duct. Thus, if the blocked duct is in the bottom outside area of the breast (7 o’clock), then feeding the baby in the football position may be helpful.
- Gentle massage to keep the milk flowing – while breast feeding gently stroke with firm pressure towards your nipple along the path of the block to assist the milk to drain
- Ice: The blocked duct can feel tender and sore so placing ice on the breast can ease the discomfort
- Heat: The use of heat on the breast 10-15minutes prior to breast feeding can help ease milk movement. A hot shower can also help relieve pain.
- Loose clothing is preferable for comfort and to avoid breast compression
What if it’s not resolving?
Most blocked milk ducts resolve in 24-48 hours – however sometimes they do not. This needs to be addressed as if the duct remains blocked this can lead to mastitis and often the GP will prescribe a course of antibiotics.
If you develop a blocked duct a helpful option is therapeutic ultrasound by a physiotherapist in the first 24 hours to assist in clearing the block.
What is an Ultrasound?
Ultrasound uses sound waves which cause vibrations deep in the tissues gently increasing heat and friction. The warming effect e ncourages increased blood supply and soft tissue healing.
This can be used to help clear a block and is beneficial in preventing recurrent blocks from occurring in the same place in the breast.
How does it work?
The ultrasound is applied gently over the area of the blocked duct gently moving towards the nipple. You will feel a gentle warmth, and the treatment is not painful.
The ultrasound is applied for 5 minutes at a dose of 2 watts/cm₂ and only 1-2 sessions are normally required on subsequent days.
Following the treatment, you should attempt to breast feed on the affected side after 20 minutes and continue to breast feed on this side. You can also express milk if needed instead.
What if it doesn’t settle?
If following two treatments on two consecutive days have not helped resolve the blocked duct, further sessions are unlikely to be beneficial.
At this stage you should visit your local doctor to be re-evaluated and potentially start a course of antibiotics.
If you are experiencing a blocked breast duct you can always pop into the Healthy Body Company for some guidance and treatment to help get you and bub back to breastfeeding worry free!
There is lots of help available for new mums who may have questions regarding returning to exercise, abdominal separation or muscular pain after bringing a new baby home. To see how we can help, follow the link below.
Cooper, B. & Kowalsky, D. (2006). Physical therapy interventions for treatment of blocked milk ducts in lactating women. Journal of Women’s Health Physical Therapy; 30(2):26
International breastfeeding centre. https://ibconline.ca/information-sheets/blocked-ducts-mastitis/. Jacobs, A., Abou-Dakn, M., Becker, K., Both, D., Gatermann, S., Gresens, R., Groß, M., Jochum, F., Kühnert, M., Rouw, E., Scheele, M., Strauss, A., Strempel, A., Vetter, K., Wöckel, A., & Geburtshilfe, F. (2013). S3-Guidelines for the Treatment of Inflammatory Breast Disease during the Lactation Period. Thieme; 73(12): 1202-1208. DOI: 10.1055/s-0033-1360115