Understanding Mastitis, Blocked Ducts, and Engorgement

Pelvic Floor

17 Jul

Author: Agnes Canadell

Breastfeeding is a rewarding experience, but it can also come with challenges such as mastitis, blocked ducts, and engorgement. Understanding these conditions, their symptoms, and effective treatment options, including physiotherapy techniques, can help manage and prevent these issues.

What is Mastitis and What Causes It?

Mastitis is a common condition that breastfeeding mothers might face. It involves inflammation (swelling and redness) of the breast tissue, which can lead to infection if not treated. Mastitis can cause significant pain and make breastfeeding very difficult.

Causes of Mastitis:

Too Much Milk (Hyperlactation):

When the body produces more milk than the baby needs, it can lead to swelling and blockages in the milk ducts.

Imbalance of Breast Bacteria (Mammary Dysbiosis):

The natural balance of bacteria in the breast can be disrupted by factors like genetics, certain medical conditions, or frequent use of breast pumps.

Inflammation and Injury (Inflammatory Mastitis):

Inflammation can be worsened by persistent blockages or rough handling of the breast, worsening the inflammation, which can cause more severe issues like infections or abscesses (pockets of pus). Common symptoms are redness, swelling and painful areas on the breast; fever, chills, and rapid heartbeat. Can cause systemic symptoms even without an infection.

Bacterial Mastitis :

Bacteria like Staphylococcus and Streptococcus can enter the breast, especially if there are cracks in the nipple, leading to infection and needing antibiotics or probiotics.

It presents with worsening redness and hardening in specific breast areas; fever and rapid heartbeat if severe. It requires antibiotics or probiotics; it is not contagious, and breastfeeding can continue. Basic handwashing and pump cleaning are sufficient; no need for routine sterilization.

Milk Stasis*:

Although not definitively proven, milk stasis (when milk isn’t moving properly through the ducts) is thought to contribute to the development of mastitis.

Mastitis can make breastfeeding very painful and can cause some mothers to stop breastfeeding earlier than they planned. Understanding the causes and symptoms can help in seeking timely treatment and continuing to breastfeed comfortably.

Symptoms:

- Swelling and redness in part of the breast

- Pain or burning sensation during breastfeeding

- systemic symptoms: Fever, chills, and rapid heartbeat

What are Blocked Ducts?

A blocked duct occurs when a milk duct in the breast becomes obstructed, preventing milk from flowing properly. This can cause a painful lump in the breast.

Causes:

- Infrequent feedings or missing feedings can lead to milk buildup.

- Tight clothing or bras that compress the breasts can restrict milk flow.

- Incomplete emptying of the breast during feeding can cause blockages

Symptoms:

- A tender, localized lump in the breast

- Redness and mild swelling around the lump

- Discomfort that may persist or worsen without treatment

What is Engorgement?

Engorgement happens when the breasts become overly full of milk, particularly common in the early days of breastfeeding as the milk supply adjusts to the baby’s needs. This condition makes the breasts feel very full, hard, and painful.

Causes:

- Increased milk production: Your body may produce more milk than your baby needs initially.

- Infrequent or inadequate breastfeeding: Not breastfeeding often enough or not draining the breasts fully.

- Sudden changes in feeding patterns can affect milk flow.

Symptoms:

- Swollen, firm, and painful breasts

- Skin that appears shiny and feels tight due to the swelling.

- Swelling can flatten the nipples, making it difficult for the baby to latch properly

These conditions can be uncomfortable and challenging but are manageable with the right strategies and support. Understanding the causes and symptoms is the first step toward effective treatment and prevention.

Treatment with Physiotherapy

Physiotherapy can play a crucial role in the treatment and prevention of mastitis, blocked ducts, and engorgement. Here are some effective physiotherapy techniques:

Therapeutic Ultrasound (TUS)

Therapeutic Ultrasound therapy uses high-frequency sound waves that penetrate deep into the breast tissue. This treatment has both thermal and mechanical effects, which can significantly aid in healing and provide relief from pain. It works generating heat, which helps to increase blood flow and reduce inflammation in the affected areas, and produces vibration, which helps break down blockages in the milk ducts, making it easier for milk to flow and reducing the build-up that causes pain and swelling.

The benefits of Ultrasound Therapy are:

Immediate Pain Relief: Many women experience significant relief from pain after just one session.
Reduction of Swelling: The heat generated by the ultrasound waves helps to reduce swelling and inflammation.
Improved Milk Flow: By breaking down the blockages in the milk ducts, ultrasound therapy helps to restore normal milk flow, which is essential for effective breastfeeding.
Non-Invasive: This therapy does not involve any medication, making it a safe option for breastfeeding mothers.
Quick Recovery: Most women find relief after just 1-3 sessions, making it a quick and efficient treatment option.

Lymphatic Massage/Drainage:

Lymphatic massage, also known as manual lymphatic drainage (MLD), is a gentle therapeutic massage technique that reduces swelling by assisting lymph fluid movement. It decreases interstitial fluid and softens fibrosis, making it useful for alleviating pain and edema resulting from an acute plug or microvascular injury.

Kinesiology Taping

Kinesiology taping involves applying elastic therapeutic tape to the skin. It provides support and stability to the breast tissue, reduces pain, and promotes lymphatic drainage. This technique, commonly used in sports medicine, can also benefit breastfeeding women by reducing breast pain and supporting lactating breasts.

Reverse-Pressure Softening

Reverse-pressure softening involves applying gentle pressure to soften the areola and surrounding tissue, which can improve latch by temporarily reducing localized edema. This technique can be performed before breastfeeding to facilitate easier milk flow and latch.

Neural Mobilization

Neural mobilization involves gentle movements to mobilize nerves, helping to alleviate pain related to nerve entrapment or hypersensitivity. This technique can address deep, chronic breast pain that may be due to nerve issues.

Education and Advice

Education and advice play a crucial role in managing and preventing breastfeeding issues like mastitis, blocked ducts, and engorgement. Here’s how the right guidance can make a difference:

Breastfeeding Positions: Proper positioning can help ensure effective milk flow and prevent blockages. Learning different positions can reduce discomfort and improve the overall breastfeeding experience.
Bra Fitting: Wearing a well-fitting bra supports the breasts properly, reducing the risk of compression and blockages. Avoiding tight or ill-fitting bras is essential for breast health.
Nipple Care: Proper nipple care, including the use of recommended products and creams, can prevent and heal cracks or sores, reducing the risk of infection and pain.
Handling of the Breast: Gentle and correct handling techniques can prevent trauma to the breast tissue, which is vital in avoiding inflammation and blockages.
Recommended Products and Creams: Using the right products can soothe and protect the skin, promoting healing and comfort during breastfeeding.
Stretching Exercises: Specific exercises can improve circulation and relieve tension in the chest and shoulder area, supporting overall breast health and comfort.

By incorporating these practices, mothers can significantly impact the healing process and prevent further episodes or the progression of these conditions to more serious presentations. Proper education and advice ensure a healthier and more comfortable breastfeeding journey.

Conclusion

Breastfeeding challenges like mastitis, blocked ducts, and engorgement can be effectively managed with the right knowledge and support. Physiotherapy offers several non-invasive techniques that can provide relief and promote healing. If you're experiencing any of these conditions, consider consulting a healthcare professional or a physiotherapist specializing in women's health to guide you through appropriate treatments and preventive measures. Taking care of your breast health is essential for both you and your baby's well-being.