By: Courtney Miller, RN, BSN, IBCLC
Breastfeeding is an incredible journey, but sometimes things don’t go as smoothly as we’d like. Engorgement, clogged ducts, and mastitis can all cause discomfort and frustration, but understanding these issues—and how to treat them—can help keep your breastfeeding journey on track. Let’s break it all down and explore effective strategies for relief.
Engorgement: When Your Breasts Feel Like Overfilled Balloons
Your breasts are working hard during breastfeeding! They’re constantly filling, emptying, responding to hormones, and adjusting to your baby’s needs. But sometimes, things don’t flow as they should, leading to engorgement.
What Causes Engorgement?
Increased milk supply after birth
Missed or delayed feedings
Weaning too quickly
Poor latch or inefficient milk removal
Excess fluids given during labor or postpartum – IV fluids can contribute to swelling in the breast tissue, making engorgement worse as the body works to reabsorb the extra fluid.
Engorgement can feel like painful swelling, tightness, and even warmth in the breasts. In some cases, it’s not just excess milk causing the discomfort—it can also be due to fluid retention.
How to Relieve Engorgement
Breast Gymnastics & Therapeutic Breast Massage
Developed by IBCLC Maya Bolman, these gentle techniques help move excess fluid and milk within the breast.
Unlike deep tissue massage (which can actually make things worse), use light pressure—about the same as rubbing lotion on your skin.
Therapeutic breast massage can be especially beneficial if you received a lot of fluids during labor, as it helps move excess fluid from the breast tissue back toward the lymph nodes in your armpits for reabsorption.
Reverse Pressure Softening
If the swelling is making it difficult for your baby to latch, gently massage fluid away from the nipple, back into the lymphatic system for reabsorption.
Cold Therapy & Ibuprofen
Ice packs or cool compresses can reduce inflammation.
Ibuprofen (if approved by your doctor) can also help with swelling and pain.
Clogged Ducts: When Milk Gets Stuck
What Is a Clogged Duct?
Milk ducts are tiny tubes that carry milk from the glandular tissue to the nipple. A clog happens when inflammation narrows these ducts, making it harder for milk to flow. It can feel like a painful lump, and the skin might look red or feel warm.
Think of it like traffic—when a four-lane highway suddenly shrinks to one lane, everything backs up! We need to reduce inflammation so the “lanes” can open again.
What Causes Clogged Ducts?
Skipping a feeding or pumping session
Wearing a too-tight bra
Poor latch or ineffective milk removal
How to Clear a Clogged Duct
Breast Massage & Gymnastics
Just like with engorgement, focus on gentle movements.
Moving the fluid back into the lymphatic system can help reduce swelling and improve milk flow.
Dangle Feeding
Try breastfeeding while leaning over your baby on all fours, letting gravity help the milk flow downward.
This can also help if you have mastitis and your breasts are too tender for massage.
Sunflower Lecithin & Diet Adjustments
If you frequently get clogs, consider adding sunflower lecithin to your routine. It contains choline, which helps keep milk ducts “silky” and prevents fat from sticking.
Want a natural source? Try whole eggs, tofu, broccoli, beans, shiitake mushrooms, and peanut butter.
Consult an IBCLC
Recurring clogs? A lactation consultant (LC) can check for latch issues, pumping problems, and flange fit to prevent future clogs.
Mastitis: When Things Get Serious
If engorgement or a clogged duct isn’t addressed, it can turn into mastitis—an inflammation of the breast tissue.
How Do You Know If You Have Mastitis?
Breast tenderness or pain (like a deep bruise)
Red streaks on the skin
Fever and flu-like symptoms
Milk tasting salty (some babies may refuse to nurse)
What Causes Mastitis?
Mastitis can be caused by:
A clogged duct that wasn’t cleared
Bacteria entering through a cracked nipple
Do You Need Antibiotics?
Not always! New research from the Academy of Breastfeeding Medicine suggests that most mastitis cases don’t require antibiotics. Instead, targeting the inflammation is key.
What to Do If You Have Mastitis
Keep Nursing or Pumping
It’s safe to continue breastfeeding, even with mastitis.
Stopping suddenly can make things worse.
Rest & Hydrate
Your body needs energy to fight the inflammation.
Monitor Your Symptoms
If you have a fever for more than 24 hours or your symptoms don’t improve, call your OB or primary care provider.
Check Your Nipple Health
If mastitis started due to cracked nipples, see an LC to correct any latch issues.
Optimize Pumping Settings
If you pump, ensure your flange size and suction settings are correct.
Preventing Future Mastitis
Ensure complete breast emptying
Improve latch and/or flange size
Reduce body inflammation (hydration, balanced diet, and rest)
Final Thoughts
Breastfeeding can be challenging, but with the right techniques and support, you can navigate engorgement, clogged ducts, and mastitis successfully. If you experience recurring issues, don’t hesitate to seek help from a lactation consultant. They can guide you through latch improvements, pumping adjustments, and personalized care.
Have you experienced any of these challenges? Share your experience or ask questions in the comments!
💛 Need more breastfeeding support? Reach out to our team for personalized care!
Comments