Blocked milk ducts, mastitis and breast abscess

Getting help for mastitis and blocked milk ducts

If you’d like some help with breastfeeding, support services are available. Your midwife, child and family health nurse, 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.

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 probably have a blocked milk duct. Try these tips straight away to ease the problem.

Before breastfeeding

Have a hot shower, and massage the breast under water to help break up the lump.
Use a warm compress to help soften the lump – try a warmed (not hot) heat pack, wrapped in a soft cloth and held to your breast for a few minutes.
Check that your bra isn’t too tight. You might even want to take it off during feeds.

When breastfeeding

Feed frequently to empty the affected breast.
Give your baby the affected breast first. Gently massage the lump towards the nipple.
Check your baby’s position and attachment. Make sure your feeding position allows the milk to flow ‘downhill’ from the blockage to your nipple.
If your baby doesn’t clear the blockage by feeding, try expressing by hand.

After breastfeeding
Place an ice-pack or chilled cabbage leaf on your breast to relieve pain after a feed.

If you can’t clear the blockage within 12 hours, or you start to feel unwell (as if you’re coming down with the flu), see your GP – you might have mastitis.

Mastitis

It can be normal to have swollen breasts in the first few weeks of breastfeeding. But if you have an inflamed, sore, swollen or red breast, or if you have the chills or feel like you have the flu, you might have mastitis.

If you think you might have mastitis, follow the same steps as for a blocked milk duct. You should also do the following:

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 breastfeeding during this time.
Express your breastmilk if you’re too sick to breastfeed right now. 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 hot shower before feeding. This helps trigger the let-down reflex, which can help clear blocked milk ducts and relieve pain.
Vary breastfeeding positions, so that all your milk ducts are being emptied. Sometimes mastitis can start from one or two ducts that aren’t being emptied fully.
Apply ice-packs after the feed.

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.

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

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 red and swollen, and it feels warm and tender to touch.

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 needs to be treated with antibiotics, and the pus needs to be drained with a special needle.

If you’re being treated for a breast abscess, it’s important to keep breastfeeding to empty the affected breast. If breastfeeding is causing you any pain or discomfort, you might need to express from the affected breast. Your baby can feed from the other breast.

Avoiding mastitis and breast abscess

To avoid mastitis, and complications like breast abscesses, make sure that your breasts don’t get overfull. You can do this by not skipping feeds or going a long time between feeds.

Also make sure that your clothing doesn’t dig into your breast, and watch out for tight baby carrier straps or seat belts. Try not to 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.

Staying fit and healthy also helps ward off mastitis.