Tips to manage mastitis and blocked ducts during breastfeeding

If you have mastitis and blocked ducts, you should not stop breastfeeding or expressing it, as this could worsen matters.

Here are some tips to help you manage the condition:

  1. Massage the breast gently before and during a feed to stimulate the milk flow. Avoid deep tissue massage as this may cause trauma to the breast tissue.

  2. Perform hand expression to remove small amounts of milk before latching to help transfer the milk effectively.

  3. Feed on demand, and do not aim to "empty" breasts. Overfeeding or "pumping to empty" may lead to hyperlactation (oversupply) and can worsen tissue swelling and inflammation. After a feed, small amounts of milk can be expressed for comfort until the milk supply has been regulated to meet the infant's needs.

  4. Vary the feeding positions while breastfeeding to drain the milk effectively.

  5. Take pain relief or anti-inflammatory medications such as ibuprofen to relieve any pain and inflammation.

  6. Apply cold compresses between a feed or expressing session to help reduce swelling and pain.

  7. Take sunflower or soy lecithin supplements of five to 10 grammes daily to reduce inflammation in the ducts.

  8. Increase your fluid intake and take fever medication (antipyretics) if you have a fever.

When to seek medical help for masitis and blocked ducts

A mother should seek assistance from a lactation consultant if she cannot resolve the blockage and mastitis by herself after several feeds, expressing of breast milk and application of cold compresses. Further medical assistance may be required in some cases.

  • In the case of a milk blister (nipple bleb), massaging the nipple and feeding the baby can help to burst the blister. If the nipple bleb is painful, oral lecithin (fats that are essential to cells in the body) may be taken, and a topical steroid cream application may be used to reduce inflammation on the surface of the nipple. This can be wiped off with a tissue or towel before feeding the infant. Don’t burst the bleb using a needle as it may cause trauma and further narrowing of the milk duct. 

  • If bacteria mastitis is suspected, accompanied with worsening inflammation, pain, and fever for more than 24 hours, seek medical help.The doctor may need to prescribe antibiotics. The antibiotics which target the common organism causing mastitis include cloxacillin, amoxicillin-clavulanic acid, cephalexin and clindamycin. These are compatible with breastfeeding. 

  • If an abscess develops, fine needle aspiration under ultrasound guidance or surgical incision and drainage by a breast surgeon may be required.

Why you should continue to breastfeed even with mastitis and blocked ducts

Ms Pang says it is vital for a woman to continue breastfeeding her baby after developing blocked ducts or mastitis.

Sudden cessation of breastfeeding is not advisable in the presence of blocked ducts and mastitis,” Ms Pang explains. “This can increase the risk of a breast abscess developing.”

However, a breastfeeding woman who suffers from blocked ducts or mastitis and plans to stop breastfeeding is encouraged to gradually wean her baby off breastfeeding to prevent the recurrence of these conditions. But weaning off breast milk should be carried out only after the blockage and mastitis has been resolved.

For tips on how to prevent mastitis and blocked ducts, read page 1.

Ref: I23

Other articles you may be interested in:

Care After Delivery (Postpartum Care)

Tips to Care for Your Baby (Newborn to 18 Months)

Health Checks for Mums (From Birth to 18 Months)

Health Screenings for Babies (Newborns to 18 Months)

Baby Growth (Newborn to 18 Months)