Blocked milk ducts or breast inflammation, mastitis and breast abscess

Getting help for a blocked milk duct or localised breast inflammation, mastitis or 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 or localised breast inflammation, 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 or localised breast inflammation

Milk ducts are tiny tubes in the breast. When you’re breastfeeding, milk flows through the ducts to the nipple.

If a sore lump or swollen, tender area appears in your breast but you otherwise feel well, you might have a blocked milk duct or localised breast inflammation.

You might hear the term ‘blocked milk duct’. But ‘localised breast inflammation’ is a better way to describe what’s happening. The ducts aren’t necessarily blocked, but they and the tissue around them might be inflamed. This can stop your milk from flowing well.

Try these tips straight away to ease the problem.

Before breastfeeding
Help your milk flow by encouraging your let-down reflex:

Have a warm shower. Gently stroke your breast towards your nipple while you’re in the shower.
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 stroke your breast towards your nipple after using the compress.
Try to relax. Breathing exercises can help.

When breastfeeding

Feed your baby whenever your baby wants a feed. Feed from both breasts.
Try taking off your bra to feed.
Check your baby’s attachment. Good attachment can help.
Vary breastfeeding positions to make sure milk flows from all areas of your breasts.
If your baby doesn’t feed well, try expressing by hand. Expressing in the shower can help too.

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

If you still have localised breast inflammation after 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 generalised inflammation of the breast. Mastitis can be caused by localised breast inflammation that isn’t treated quickly.

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 localised breast inflammation. 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 need 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 remove as much milk as possible from the affected breast.
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.
Vary breastfeeding positions, so that your milk flows from all areas of your breasts.
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. Your milk supply will sort itself out quickly if you keep feeding according to your baby’s needs during and after the mastitis.

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 so the milk can continue flowing from 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.

Localised breast inflammation, mastitis and breast abscesses are most likely to happen in the first 6-8 weeks of breastfeeding. But these conditions can happen at any time during breastfeeding. It’s important to keep checking your breasts and trying to remove as much milk as possible from them.

Avoiding mastitis and breast abscess

To avoid mastitis and complications like breast abscesses, keep removing as much milk as possible from your breasts:

Feed your baby according to their needs.
Don’t skip feeds or go a long time between feeds.
Make sure your baby is properly attached to the breast.
Vary breastfeeding positions.

The following tips can also help you to avoid mastitis and breast abscesses:

Make sure that your bra isn’t too tight and your tops don’t dig into your breasts.
Avoid tight baby carrier straps or seat belts.
Try not to wear a bra to bed or sleep on your stomach.
Avoid anything that puts pressure on your breasts.
Treat lumps or sore spots promptly.