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Engorgement, Blocked Ducts and Mastitis

6 min read

Engorgement, Blocked Ducts and Mastitis

Breastfeeding, Milk Making, Life-Giving, Leaky, Ever-changing boobs.

Love them or hate them, breasts are wonderful, unique things created to feed and nourish our wee babies' minds and bodies and protect them from nasty bugs.

Our breasts are actually amazing and go through a rollercoaster of their own throughout pregnancy and breastfeeding - even weaning from breastfeeding can wreak a little havoc on your poor bosom. It’s widely known that breastfeeding has huge health benefits for not only our babies but for us Mummys too – including some studies finding a reduction in the risk of getting:

  • Breast and Ovarian Cancer
  • Type 2 Diabetes
  • Rheumatoid Arthritis
  • Cardiovascular Disease - High Blood Pressure & Cholesterol 

While all this is fantastic, there can still be times where breastfeeding is not so kind to us and our breasts. Engorgement, Blocked Ducts and Mastitis – some Mums cringe just hearing the words if they've been there before. So what are they? How do we identify and treat them, and most importantly, how can we try to avoid them?


Engorgement can be very normal, but can also be extremely tender and sometimes painful – then, if left untreated it can lead to blocked milk ducts which then can have a flow-on effect, leading to an infection called Mastitis.

Engorgement, in a nutshell, is an oversupply of breast milk that has not been drained from the breasts. This condition is usually temporary and very common in the early stages when your breast milk ‘comes in.'

Engorgement normally subsides as your breast milk supply ‘regulates’ and settles but can seem pretty alarming the first couple of times until you get the hang of your milk flow and release it as much as your sore breast needs.

Engorgement makes breasts feel rock hard and tender to the touch, you may experience leaking, redness, slight throbbing and pain when you are engorged. Engorged breasts also look and feel huge (many selfies were taken in the presence of engorged breasts.)

To manage engorgement, ensure your breasts are drained sufficiently and frequently, usually feeding frequently and on-demand can suffice – but sometimes you may need to hand or manually express a little – just enough to get comfortable is key, or even use an electric pump if you have one on hand.

Warm flannels on your affected breast or breasts and hot showers can help a little milk naturally flow from the breast – just enough to get relief and prevent blocked ducts.

An electric breast pump or even just a handheld manual pump can be super useful to quickly relieve engorgement and mean there is some extra milk you can put away for the baby later.

While engorgement itself is completely normal and most mums experience it – if not dealt with effectively it may lead to blocked ducts or a breast infection - which can be much more painful.

What are blocked ducts?

Blocked milk ducts occur when milk isn't sufficiently draining from your aching breast. A blocked milk duct can be incredibly tender to touch and make the whole breast tissue ache. When the milk duct can not drain properly, milk gets backed up behind it and causes pressure like water trying to break out of a dam. This can result in a raised bump or breast abscess in your chest that you can actually find and feel. This may be painful to touch, but if you're gentle, you can slowly massage it out as much as you can.

At this stage, a blocked milk duct has no adverse effects on mama's health - however, you may notice that your baby is fussier when feeding on the affected breast. This is because the milk may be flowing at a slower rate and frustrating your hungry baby. It's important that you are continuing to breastfeed from this breast though to help shift the blockage and it's even recommended to start the baby's feed on this breast to properly drain it to the best of your and your baby's ability. The taste of the blocked milk is not unpleasant and won't affect your baby negatively, so make sure you keep trying to dislodge it by gently massaging the lump or sore area while feeding your baby. Using a breast pump while massaging can also help if the baby isn't interested in eating (and you can save the milk for later).

Just like with engorgement, you can treat milk ducts at home with a warm shower, regular massaging and warm compresses to get that milk duct opening to give and release the tension. Don't give up! If it's not working, the next step is to talk to your doctor or a lactation consultant.

A blocked duct is nothing to ignore because if you leave it, milk will continue to back up behind it (imagine the bursting of the dam). If you start experiencing heat in the area of the blocked duct, a fever or a general dip in your health - the blocked duct might have progressed to a breast infection called Mastitis.

What is Mastitis?

Alright, mama, here's where we get real. Mastitis is a fairly serious infection that can require urgent medical attention and progress quite rapidly. (Note: do not ignore)

While mastitis primarily affects breastfeeding women, it actually can affect non-breastfeeding women and even men. It is an inflammation of the breast tissue that can get incredibly painful (you will want to avoid this stage of mastitis by acting early.) Symptoms of mastitis include warmth in the area, redness, fever, chills, sickness and pain or burning sensations while breastfeeding. Feeling particularly run-down or experiencing flu-like symptoms in conjunction with breast pain is a big giveaway.

So pay attention to your breasts AND your health.

What causes Mastitis, and how can we prevent it?

Mastitis is usually caused by the progression of engorgement, blocked ducts and then they dive into an infection when the previous conditions could not be rectified. It can also be caused by bacteria from your baby's mouth or your skin's surface entering your breast through cracked nipples or a milk duct.

If you get mastitis, while you should never ignore it, don't panic. It's very common and as long as you get some advice, it is fairly simple to rectify. If you're in a lot of pain or are just concerned about it from the suspected onset of it - call your doctor as soon as you can as infections are not great news, in general, no matter where you get them.

Getting mastitis isn't the end of the world, it doesn't mean that you have to wean your baby early or anything dire in most cases. A lactation consultant can put your mind at ease and most cases of mastitis don't get serious and can be easily treated by baby-safe antibiotics.

Treatment for mastitis can range from at-home methods like warm compresses and showers, self-massage and other suggestions your doctor may give you - but to stop the infection, antibiotics are the most common and effective treatment.

In order to prevent mastitis, pay attention to your breasts when they start feeling strange or if engorgement / blocked ducts are lasting for a while and seek medical advice or help early. Express milk regularly, by breastfeeding or with a pump to reduce as much swelling as possible. You can also avoid anything that can stifle your milk flow - like tight bras, seatbelts right across your boob or bags with handles that flatten or put pressure on your breasts.

Your breasts are one of your most valuable assets.

It's important to take care of them, especially if you're concerned about any of these three breast conditions. Avoid wearing tight-fitting clothes that restrict milk supply and flow while the affected area calms down and life returns to some kind of normal when it comes to your ever-changing breasts. Taking good care of them means that you can be sure your baby (and you) are experiencing a comfortable and safe feeding experience for both of you.

For more health information on mastitis, make sure to talk to your midwife, consultant or doctor who have a huge amount of help to offer.

Happy feeding!

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