Getting help for a blocked milk duct, 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, mastitis and a 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.

What is a blocked milk duct (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.

Blocked milk duct or localised breast inflammation?

Most people use the term ‘blocked milk duct’, but ‘localised breast inflammation’ is the proper way to describe what’s happening. The ducts aren’t necessarily blocked, but they and the tissue around them might be congested and inflamed. This can narrow the duct and stop your milk from flowing well.

Try these tips straight away to ease the problem.

Before breastfeeding

• Apply a warm (but not hot) pack or cloth to the affected area. This can help with milk flow. Remove before starting the feed.
• Gently stroke your breast. This can encourage your let-down reflex.
• Take a moment to slow down, get comfortable and relax your body. Breathing exercises can help.

When breastfeeding

• Feed your baby whenever they want a feed. Feed from both breasts.
• Try taking off your bra to feed. This can take pressure off your breasts, which might help with milk flow.
• Check your baby’s attachment. Good attachment can help.
• Vary breastfeeding positions. This can help the milk flow 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.
• Don’t use a warm pack after feeding.
• Take time to rest.

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.

What is mastitis?

Mastitis is generalised inflammation of the breast. It can be caused by localised breast inflammation that isn’t treated quickly.

Mastitis symptoms

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.

Mastitis treatment

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

• See your GP if you have symptoms lasting more than 24 hours. You might need antibiotics to help with both the inflammation and the infection. You can keep breastfeeding while taking these.
• Keep breastfeeding from the affected breast until your symptoms have cleared. There’s a risk of developing a breast abscess if you stop. Feed from the other breast too.
• Vary breastfeeding positions to help milk flow from all areas of your breasts.
• Express your breastmilk by hand 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.
• Apply ice-packs after the feed for comfort. A bag of frozen peas wrapped in a cloth can also work well.
• If you have pain or discomfort, consider taking paracetamol or ibuprofen in the recommended dose and frequency.
• Get plenty of rest. Try to get someone to look after you and your baby if you can.

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

You might notice a small drop in milk supply in the breast with mastitis. Your milk supply will sort itself out quickly if you keep feeding according to your baby’s needs during and after the mastitis.

If your symptoms don’t improve after 2 days of treatment, it’s a good idea to see your GP again.

What is a breast abscess?

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

Signs of a breast abscess

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 it might hurt if you touch it. You might not feel unwell.

Treatment for a breast abscess

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 removing milk from them.

Avoiding mastitis and breast abscess

To avoid mastitis and complications like breast abscesses, keep removing milk 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.
• Check your breasts for areas that are discoloured or tender after feeding.

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 localised breast inflammation promptly.