Mastitis and Plugged Ducts
A plugged duct feels like a hard, tender lump in the breast, caused by milk failing to drain properly. If left untreated, it can develop into mastitis—an inflammation of breast tissue that may involve bacterial infection.
Symptoms of Mastitis
- Intense breast pain, redness, and swelling (often wedge-shaped).
- Breast feeling warm or hot to the touch.
- Fever (101°F or higher) and flu-like symptoms (chills, body aches, fatigue).
If you suspect infectious mastitis, contact your healthcare provider immediately, as antibiotics may be necessary.
Gentle Management Protocol (BAIT)
Recent guidelines for managing engorgement and plugged ducts recommend the BAIT approach, moving away from aggressive deep tissue massage which can worsen inflammation:
- Breast Rest: Feed on demand, but do not aggressively over-pump to "empty" the breast.
- Advil/Analgesics: Use anti-inflammatory medication (ibuprofen) to reduce swelling.
- Ice: Apply cold compresses between feeds. Heat can increase inflammation, so use cold to reduce swelling.
- Tylenol/Treatment: Use gentle lymphatic drainage massage (light, sweeping motions toward the collarbone) rather than deep pressure on the lump.
Nipple Soreness and Damage
Initial tenderness in the first week is common as your body adjusts. However, cracked, bleeding, or severely painful nipples indicate an issue, usually related to a shallow latch.
Remedies:
- Unlatch immediately if it pinches (break the suction gently with a clean finger in the corner of baby's mouth) and try again.
- Express a few drops of breastmilk and let it dry on the nipple; it has natural healing properties.
- Use purified lanolin or organic nipple balms.
- Consider silver nursing cups between feeds to protect from friction and promote a moist healing environment.
Low Milk Supply vs. Perceived Low Supply
Many mothers worry about supply, but true low supply is less common than perceived low supply. If your baby is having adequate wet/dirty diapers (6+ wet, 3+ dirty per day after day 5) and gaining weight along their curve, your supply is likely fine.
If true low supply is diagnosed by a pediatrician or IBCLC, strategies to increase it include:
- Increasing nursing frequency (breastmilk production relies on supply and demand).
- Pumping after feeds to stimulate more production.
- Skin-to-skin contact to boost oxytocin.
- Ensuring maternal hydration and adequate caloric intake.