Causes
Blocked ducts occur when the milk is stopped from flowing, making the area sore and swollen. If not treated this can lead to mastitis - where the mother feels ill and feverish.
Treatment
The basic treatment for a blocked duct or mastitis is to rest, feed or pump frequently (as normal, do not skip feeds or pumping sessions), and apply heat (before feeds) and ice (after feeds) to the affected area. If the mother doesn't feel any better within 24 hours then she should visit her doctor, who may prescribe antibiotics. Any advice to stop feeding on the affected side is incorrect and can make the problem significantly worse.
Heat from a warm wheat pack or similar will encourage the milk to start flowing through the duct. Paracetamol and Ibuprofen can be taken if tolerated. Cooling after feeding or pumping is also recommended, such as a cool wet washcloth, or a wrapped ice pack.
We used to recommend breast massage to the affected area, but we now believe that lymphatic drainage/massage is far better in treating mastitis. Lymphatic drainage/massage is very gentle as opposed to regular massage techniques. Therapeutic ultrasound, if available in your area, may also help to reduce inflammation (try your local Women's Health Physio to see if they offer this service). There is some limited evidence to support certain strains of probiotics (containing
I. salivarius and I. fermentum) in helping to treat and prevent mastitis.
To help prevent mastitis from reoccurring mothers should try to take things easy (I know, easier said than done), avoid going long stretches without breastfeeding, take care to wear bras that fit well, and ensure all antibiotic prescriptions are taken in full. If the blocked duct or mastitis reoccurs it is worth discussing possible causes with your midwife, a La Leche League Leader or a Lactation Consultant.
Recommended Websites
https://www.llli.org/breastfeeding-info/mastitis/
https://physicianguidetobreastfeeding.org/mythbusters/massage/
https://physicianguidetobreastfeeding.org/maternal-concerns/mastitis-and-associated-complications/
References:
https://www.aafp.org/afp/2008/0915/p727.html
https://physicianguidetobreastfeeding.org/wp-content/uploads/2021/08/PTtechniquesClinicalLactation2020.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4955247/
Disclaimer:
Information provided by Summer Warmth is not meant as a substitute for professional help from your health care professional. Please seek advice from your health care professional if you are having problems with breastfeeding or if you have continuing concerns.