Up to 49 per cent of women have trouble breastfeeding on the day of delivery. This reduces to 15 per cent a week later. Women are now likely first exposed to breastfeeding when they try it themselves as compared to women in previous generations who learned to breastfeed by watching women in their family breastfeed.
There are many factors that can influence breastfeeding and attachment early on; poor attachment and difficulty feeding is more likely to happen with your first baby, if you have had a caesarean section, or have flat or inverted nipples. The position you hold the baby in, the way baby reacts, and your anxiety levels can also influence breastfeeding.
Problems with breastfeeding can range from difficulty or painful attachment to engorgement, blocked ducts, and mastitis. It can be painful, debilitating and stressful.
Blocked ducts and mastitis
Excessive compression of the ducts and restriction in milk flow can result in blocked ducts. The compression does not need to be strong at all for the ducts to get compressed. The restricted milk can then ‘settle’ and block the ducts. Any obstruction to normal breast drainage including bruising or swelling, hurried feeds or poor positioning, poor attachment, nipple soreness, poor bra design and finger compression, can block the ducts. The breast milk produced behind these blockages seeps into the surrounding tissue which then causes an inflammatory response. When these blocked ducts are not cleared you may develop mastitis causing infection of the breast tissue.
Signs and symptoms
There can be tenderness, swelling, a hard lump can be felt, and sometimes a red flare over the affected area of the breast.Some can experience flu-like symptoms – feeling hot and cold with aching joints.If left untreated, mastitis may become a breast abscess. We find blocked ducts often occur more with weather changes, Friday afternoons, public holidays and when there is family coming to visit!
Treatment for blocked ducts and mastitis
- Your breast milk is safe for your baby even if you have mastitis, so continue to breastfeed or express from the affected breast.
- Drink plenty of water throughout the day.
- Rest as much as possible. Get help with household chores from partner, family and friends.
- Physiotherapy treatment consisting of Therapeutic Ultrasound, and effleurage or draining massage to clear the ducts.
- Kinesotape and Tubigrip to provide support for oedematous breast tissue and improve blood and lymph circulation. If addressed early enough this may clear the duct and prevent infection.
A blocked duct can become mastitis within hours. If you can’t clear a blockage yourself within 12 hours, seek help! If antibiotics are prescribed by your doctor, take as directed. It is safe to continue to breastfeed when taking these antibiotics
What do I do if I have problems breastfeeding?
- Try feeding in variety of positions - cradle hold, football hold or side-lying.
- Try to fully drain the blocked breast at each feed either by feeding or expressing.
- Express the lumpy blocked area whilst in the shower and follow up with a feed.
- If the blockage doesn’t clear within 12 hours, seek help from your physio, GP or obstetrician.
Physiotherapy can help mothers who are breastfeeding
- Therapeutic Ultrasound and massage to unblock the ducts (usually up to three treatments are advised).
- Advice on positioning and posture during breastfeeding
It’s important to bring your baby with you for treatment if possible as the baby helps clear the blockage once the ultrasound and massage have loosened it.
Feel free to call Back In Motion Bacchus Marsh Physio to discuss whether physiotherapy could help you.
Author
Adeline Antony - Physiotherapist at Back In Motion Melton and Back In Motion Bacchus Mars