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A blocked milk duct or breastfeeding mastitis - how to tell the difference

You can get a blocked milk duct when milk is not sufficiently removed from the breast.

a blocked milk duct or mastitis

Mastitis (breast infection) in breastfeeding women is often the result of a plugged milk duct.

You can also get mastitis when bacteria enter the breast tissue through a crack in the nipple.

Often mastitis is so painful for the breastfeeding mother that she wants to stop breastfeeding all together.

About 20% of women from Western countries will develop mastitis.

This usually occurs in the first 2-3 weeks post partum, but it can also happen later on, for example, when you start weaning. Mastitis can develop very sudden and most of the time it affects just one of the breasts.



Mastitis symptoms

A blocked milk duct is not the same as mastitis but a blocked duct may become mastitis if not taken care of. How do you know you have a blocked duct or mastitis?

Symptoms of a blocked duct:

  • The infected breast is tender or painful
  • There may be swelling and redness in the area
  • Sometimes you feel a lump in your breast
  • The problem is local, only affects the breast
  • Body temperature will not be higher than 101.37°F (38.5°C)

Symptoms of Mastitis:

  • Pain, redness and swelling
  • Affects the whole system like with a bad flu
  • Fever of 101.3°F (38.5°C) F or higher
  • Will most of the time need treatment with antibiotics


Causes of a blocked milk duct

  • Engorgement (This is the overfilling of the breasts with milk that can be very painful)
  • Inadequate milk removal. (incorrect positioning or latching on, anatomical problems of baby's mouth, use of nipple shields.)
  • Anything that puts pressure on the breast tissue.(restrictive clothing, sleeping on your stomach , heavy diaper bag)
  • Irregular or missed feedings. (Milk stasis is more likely to happen when you miss a feed)
  • Busy work schedule
  • Painful or cracked nipples (This can be very painful and mother stops feeding before her baby empties the breast.)
  • Your baby has a sore mouth and refuses to drink. (This can happen when a new tooth is ready to erupt or with mouth thrush in babies.)


Causes of Mastitis

  • Blocked duct and all the previous mentioned factors that can lead to blocked ducts.
  • Nipple cracks allowing bacteria to enter the breast.
  • If a mother is stressed, has lack of sleep and is not eating well she has a higher risk of infections like mastitis
  • Bacteria from the mother's own hands touching her nipples while latching on her baby. Hand disinfection before breastfeeding has proven to reduce the chance of developing mastitis.


How to treat a blocked duct?

This position allows a baby to
empty all mom's milk ducts.
emptying blocked milk duct

  • Frequently nursing your baby in different positions is the most effective way to empty the swollen and painful breast.
  • By using a warm shower or a warm compress on the painful area. Massaging the breast beginning just before the painful spot towards the nipple. This will help to unblock the ducts so the milk can run freely.
  • By using a breast pump if nursing is too painful. A breast pump can be useful to take the pressure of in the beginning or to empty the breast completely after nursing. Another possibility is manually expelling milk from the breast.
  • Take a pain relieving medicine like acetaminophen or ibuprofen.
  • Apply a cold ice pack after breastfeeding.


Mastitis treatment

  • The recommended treatment for mastitis is usually focused on clearing blocked ducts and engorgement. Frequent breastfeeding and varying the feeding position will help the blood flow in the affected area and clear the blocked milk duct. Always try to start feeding the baby on the affected side.
  • As with a blocked duct apply heat and massage before nursing. It also helps to lean over a big bowl with warm water and soak the breasts in their 3 times a day, preferably before nursing.
  • Plenty of rest and fluid will boost your immune system.
  • If a fever persists for more than 24 hours and you are very sick you should contact a doctor because you may need a course of antibiotics to fight the infection.

Most breast infections are caused by the bacteria staphylococcus aureus and are treated with penicillins such as flucloxacillin and dicloxacillin. Treatment with antibiotics does not harm the breast-feeding baby and breastfeeding can continue normally.

For some mothers nursing is very painful at this stage. Though stopping breastfeeding at this point will increase your chance of developing a breast abscess that may then need surgical drainage.


Getting help

While most health providers have knowledge of the appropriate treatment for blocked milk ducts and mastitis there are still doctors thatmay advise you not to feed from the infected breast or not to breastfeed at all. If given this advice, get a second opinion or contact a lactation consultant in the area.

Lactation consultants can be extremely helpful with breastfeeding difficulties such as treating and preventing mastitis.

Do not put yourself at risk of complications and unnecessary deprive your baby from all the nutritional and immunological benefits provided by breast milk.



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