Keeping Healthy Breastfeeding Breasts
Hulda Thorey talks about engorged breasts, blocked milk ducts and mastitis
New mums have enough to deal with without worrying about mastitis, a painful infection that develops in blocked milk ducts and is often accompanied by a fever. And because the condition is usually the result of poor breastfeeding technique, it is often new mums who suffer.
Statistics tell us that one in ten breastfeeding women will get mastitis, but fortunately there are steps you can take to prevent it - or more precisely, to prevent blocked milk ducts that provide the perfect environment for the infection to develop. The following steps are all about improving your breastfeeding technique, so it’s a win-win situation all around.
Preventing Blocked Milk Ducts
Milk ducts can become blocked if they are not emptied properly when baby feeds, and there are two main reasons for this: improper breastfeeding technique and engorgement, which can make it difficult for baby to latch on.
Improper Breastfeeding Techniques
Breastfeeding should be comfortable and your baby should feed well. Because newborns’ stomachs are very small, they do need to feed often and in small portions. But if your baby seems restless and your breasts still feel full after feeding, consider whether your breastfeeding position is correct and whether Baby is latching on properly. The video at this link provides excellent guidance but if you’re still having problems, ask for help from a midwife or lactation consultant.
Engorgement can happen in the first week after birth when the breasts start producing milk, sometimes faster than it can be taken up by Baby. Sometimes the problem is technique, but sometimes the problem is simply that the breasts are so engorged that the baby can’t latch on properly to suckle.
It is important to address the problem of engorgement, not least to ease the discomfort of having engorged breasts, but also because engorgement makes breastfeeding more tricky and the pressure of the milk build-up can block milk ducts or even damage the milk-producing cells.
Techniques for easing engorgement include:
- Apply warmth to your breasts or even take a warm shower or bath to soften them and encourage the “let-down” reflex.
- After feeding, or if your breasts are extremely engorged (e.g. as hard as your forehead), we recommend using ice packs or packs of frozen vegetables wrapped in cloth to cool your breasts and help slow milk production.
- Do some gentle breast massage, gently making small circles at first then brushing towards the nipple.
- Try expressing milk before feeding to soften the breast so that it is easier for Baby to latch onto it. Additionally, express milk after feeding if Baby has not emptied the breasts sufficiently. It can be a good idea to learn how to express milk by hand as this is less cumbersome and stressful than using a mechanical pump.
If You Find a Blocked Duct...
If, despite your best efforts, you do get a blocked milk duct (which might appear like a small pea-sized lump in your breast), try massaging the lump towards the nipple during feeding. This may take more than one feed. To help move things along, position Baby so his chin is towards the lump. “Chin direction” is where the most drainage takes place. A hot pack on the area before the feed may also help to soften the area. And if the lump does not go away or is getting red, it is best to get a midwife or lactation consultant to assist you in these efforts and to help evaluate whether you will need to see a doctor or get antibiotics.
If You Do Get Mastitis…
If you develop a very hard painful lump on your breast (usually triangular in shape and accompanied by a redness) and possibly a fever, it is likely that you have developed mastitis.
This must be examined by a qualified lactation consultant or a midwife to ensure that the right techniques are used and if the infection / fever is not quickly reversed, a doctor must be consulted, as the infection may lead to an abscess. It is possible that all that is needed is a correction in your breastfeeding technique and plenty of rest and fluids, but a doctor may also prescribe baby-friendly antibiotics.
Although it will feel like the last thing you want to do, breastfeeding is part of the cure. It will help clear the blockage, relieve the symptoms and prevent the mastitis from becoming more serious. The infection will not affect the baby although the milk may taste a little more salty for a while.
It has been mentioned now several times, and I apologise, but correct breastfeeding technique is important. If you are struggling, contact a lactation consultation for help. Although it may seem like a big effort to call in a lactation expert or go out to a clinic, achieving and enjoying a successful breastfeeding “career” may be just a small adjustment away. It really is worth sorting it out sooner rather than later.