Mention the word ‘mastitis’ to a breastfeeding mother and she may shudder with fear! Mastitis is usually caused by a blocked milk duct which has become inflamed. The mum may develop a fever as well as noticing the breast to be hard and sore, and often accompanied by a red patch on the skin. It’s possible to have a blocked duct without it turning into mastitis, as long as it is treated promptly, so getting onto treatment early if you notice any lumpy areas on the breast is a good idea.

So what causes the blockage in the first place? Inadequate drainage of the breast is the main reason blocked ducts and mastitis form, but this may be for a variety of reasons. In the early weeks, it’s most likely caused by incorrect attachment of the baby to the breast, usually when the latch is too shallow and bubs is not taking enough of the breast tissue into his mouth. The other reason the breast may not be draining well, is if a feed is skipped or your baby sleeps longer than usual between feeds or starting to sleep longer overnight.

Mums with an oversupply may also have problems with blockages if they aren’t managing their supply well. Have a chat to a lactation consultant if you have too much milk, as they can talk you through a feeding plan to help control your breastmilk production.

If you have a blocked duct, what do you do?

The first thing is to drain the breast frequently, so that usually means breastfeeding as much as possible. You may even favour the sore side for a few feeds in a row to see if that clears it.  If the milk isn’t flowing well, apply heat before the feed, massage the lumpy area towards the nipple while feeding and apply ice packs afterwards to try to reduce the swelling in the inflamed area. If you are not directly breastfeeding, or if your baby won’t take the mastitic breast (some babies find it tastes salty and may refuse, or if the flow is affected), follow all these steps while expressing with a breast pump.

A few other ideas include changing bubs’ breastfeeding position so his chin is pointed towards the lump, or trying the all-fours position, which looks quite comical but is a great way to allow gravity to unblock your ducts. To do this, place your baby on the bed and hover over him on all fours to feed with your breast dangling down. For stubborn blockages, some mums have had success with ultrasound therapy – seek out a physio specifically trained in breast-related issues.

If the blockage does turn into mastitis, and you feel flu-like symptoms, see your health professional for antibiotic treatment.

Patients of St Vincent’s Private Hospital Melbourne can call our Breastfeeding Clinic to speak to a lactation consultant, this is a free service to patients who gave birth at the hospital.

For more info on blocked ducts and mastitis, see the Australian Breastfeeding Association website