Blocked milk ducts, mastitis and breast abscess

Getting help for a blocked milk duct, mastitis and breast abscess

Your midwife, child and family health nurse or GP or the Australian Breastfeeding Association (ABA) can support you with breastfeeding your baby. They can also help you find a lactation consultant if you need one.

An ABA counsellor can also help – phone the National Breastfeeding Helpline on 1800 686 268 or use ABA LiveChat.

This article explains what to do about a blocked milk duct, mastitis and breast abscess. If you’re having other issues with breastfeeding, you could check out our articles on sore nipples and nipple infections, breast refusal and biting, how to increase supply and how to manage oversupply and engorgement.

Blocked milk duct

If a sore lump appears in your breast but you otherwise feel well, you might have a blocked milk duct. Try these tips straight away to ease the problem.

Before breastfeeding

Have a warm shower and massage the breast under water to break up the lump.
Use a warm compress – wrap a warm (not hot) heat pack in a soft cloth, and hold it to your breast for a few minutes. Gently massage to break up the lump.

When breastfeeding

Try taking your bra off to feed.
Feed frequently to drain the affected breast.
Try to trigger your let-down reflex by relaxing. Breathing exercises can help.
Check your baby’s attachment. Good attachment can help.
Vary breastfeeding positions to make sure your breast drains well.
Give your baby the affected breast first. Gently massage the lump towards the nipple using the flat part of your finger rather than your fingertip.
If your baby doesn’t clear the blockage by feeding, try expressing by hand. Expressing in the shower can help.

After breastfeeding
Place a cold pack or ice-pack wrapped in cloth on your breast to relieve pain and reduce inflammation.

If you can’t clear the blockage within 24 hours or you start to feel unwell (as if you’re coming down with the flu), see your GP – you might have mastitis.

Mastitis

Mastitis is an inflammation of the breast. Mastitis can be caused by a blocked milk duct that hasn’t been cleared.

You might have mastitis if your breast is inflamed, hot, sore, swollen or discoloured. On light skin, the discolouration might be pink or red or have shiny, silvery streaks. It might be harder to see discolouration on darker skin, but your breast will feel sore and warm.

Symptoms like fever, headache, muscle aches and chills can also be signs of mastitis.

If you think you have mastitis, follow the same steps as for a blocked milk duct. If your symptoms don’t improve, you might have an infection. Here’s what to do:

See your GP as soon as possible. You’ll probably be prescribed antibiotics to help with both the inflammation and the infection. You can keep breastfeeding while taking these.
Keep breastfeeding until your symptoms have cleared, because there’s a risk of developing a breast abscess if you stop. Try to drain the affected breast as much as possible.
Express your breastmilk if you’re too unwell to breastfeed or your baby won’t feed. Even if you have an infection, the breastmilk is still safe for your baby to drink.
Get plenty of rest.

You might also want to try the following steps:

Go to bed, rest and try to get someone to look after you and your baby.
Warm your sore breast with a warm cloth or shower for a few minutes before feeding. This helps trigger the let-down reflex, which can help clear blocked milk ducts and relieve pain.
Vary breastfeeding positions, so that your breast is being drained well. Sometimes mastitis can start from 1-2 ducts that aren’t being drained fully.
Apply ice-packs after the feed for comfort. A bag of frozen peas wrapped in a cloth can also work well.

It’s common for the milk supply in a breast with mastitis to drop a little. With frequent feeding during and after your illness, this will sort itself out quickly.

Mastitis can make you feel very sick, but you’ll get better quickly with the right treatment.

If your symptoms don’t improve after a few days of treatment, it’s a good idea to see your GP again.

Breast abscess

If mastitis isn’t treated quickly, a breast abscess can form.

A breast abscess is a build-up of pus in the breast. It usually makes the skin look discoloured and swollen. The affected area of your breast might feel hard and hurt if you touch it. You might not feel unwell.

If you think you have a breast abscess, see your GP as soon as possible. Your GP might refer you to a specialist. The specialist will usually use an ultrasound to confirm whether you have a breast abscess.

An abscess usually needs to be treated with antibiotics, and the pus needs to be drained with a special needle. You don’t normally need to be admitted to hospital.

If you’re being treated for a breast abscess, it’s important to keep breastfeeding to drain the affected breast. If you can’t breastfeed your baby on the affected breast, you’ll need to express from it. Your baby can feed from the other breast. It’s OK if milk leaks from where your abscess was drained.

Blocked milk ducts, mastitis and breast abscesses are most likely to happen in the first 3-6 months of breastfeeding. But these conditions can happen at any time during breastfeeding. It’s important to keep checking your breasts and making sure they’re emptied after feeds.

Avoiding mastitis and breast abscess

To avoid mastitis and complications like breast abscesses, empty your breasts regularly. You can do this by not skipping feeds or going a long time between feeds.

Also make sure that your bra isn’t too tight and your tops don’t dig into your breast. Watch out for tight baby carrier straps or seat belts too. Try not to wear a bra to bed, sleep on your stomach, or do anything else that puts pressure on your breasts.

If you notice any lumps or sore spots, treat them promptly so they don’t turn into mastitis.