This blog post will focus on first aid tips for engorged milk ducts. This is a very common issue for which we midwives are asked for help and support.
A milk duct blockage can occur at any time during breastfeeding, but most often in the first few months of breastfeeding. Some women experience this frequently, others only once.
In any case, it's very important that you react IMMEDIATELY to a blocked milk duct and counteract it to prevent it from developing into a mastitis. In this article, I'll explain the causes, symptoms, and treatment.
What does milk congestion mean?
When milk stasis occurs, the breast milk produced in the breast cannot drain completely. If left untreated, this can lead to mastitis (breast inflammation).
Germs can form in the accumulated milk, which then lead to an infection.
Causes of milk congestion
A milk duct blockage can have various causes, some of which you can't always influence yourself. I'd like to introduce you to a few typical causes to raise your awareness of the issue and, in the best case scenario, prevent the next one.
- Stress caused by various triggers (family disputes, too many visitors at once, lack of sleep and no relief, too much housework)
external interference and too many well-intentioned tips - longer breastfeeding breaks (your baby suddenly sleeps longer or skips feedings)
- ascending germs e.g. through sore nipples
- Getting a draft on the chest (cold)
(rather rarely) too tight nursing bra
Signs of milk congestion
Are you worried about a blocked duct, but don't know how to recognize it? Classic symptoms include:
- Chest pain
- Redness and swelling (please check your breast in the mirror to confirm the diagnosis)
- firm spots or knots palpable
- Feeling unwell like the beginning of a cold or flu
- also chills
Treatment of milk congestion
It's best to lie down in bed with your baby until your symptoms have completely subsided. During this phase, definitely leave your housework aside—it's not so important right now.
Please seek support until you heal. This could be your partner, grandparents, or simply people with whom you feel comfortable and whose company gives you peace and relaxation. Apart from that, the most important thing is to empty your breasts as thoroughly as possible!
Feed your baby as often as possible – ideally in a position where their lower jaw is facing the engorged area. This is because the baby's lower jaw and tongue are the most effective way to empty the breast. You may also want to adjust your position while breastfeeding, or your baby's position, accordingly. It's not dangerous for the baby to drink the engorged milk, even if you develop a fever.
To encourage your milk to flow, you can warm your breasts before breastfeeding, for example, with a hot shower, warm, moist compress, or a warmed breast milk pillow in the microwave or oven. These are filled with cherry stones or rapeseed, for example, which retain heat and release it back to your breast in measured amounts, thus promoting milk flow. The neck pillow (C-shaped) is ideal for placing around your breast before breastfeeding.
Home remedies for milk congestion and mastitis
Chilled white cabbage leaves
After breastfeeding, you can cool your breasts. Some colleagues recommend using chilled white cabbage leaves. They are lightly rolled out with a rolling pin and then placed on the breast until the cooling effect subsides. You can also use new leaves afterward, but always avoid the nipple.
White cabbage contains an enzyme that can reduce inflammation, and you can even get up with the cabbage leaves in your bra without any problems.
Quark wrap
I usually recommend quark wraps to affected women, which are great for reducing inflammation. It's best to spread the cool quark, not too thinly, between a layer of muslin diaper, and place this wrap on the reddened area of your breast for about 30 minutes after breastfeeding. You can repeat this several times a day. The protection of the muslin diaper makes it easier to shake out the wrap afterward without spreading the quark all over your house.
If you are in pain or have a fever and need medication, please discuss this with your midwife and/or doctor.
Relieve milk congestion by massaging
If your baby can't or won't drink enough, for example, because they're tired or full, you can also express the breast. This works best with the "Marmet technique." I can't give you detailed instructions on this at this point, but you can find information online.
This technique is also recommended if a blocked milk duct occurs during weaning. Relieving the blockage through breastfeeding or pumping would only unnecessarily stimulate milk production. If you're not comfortable with this technique, try using a manual breast pump and gentle suction to get the blocked milk flowing. In an emergency, you can also get a continuously adjustable electric breast pump from a pharmacy.
The important thing is that you only pump until you feel relief. Otherwise, you could end up in a vicious cycle if your baby continues to be unable to finish the abundant milk that's been produced again.
Help with a milk blockage caused by an excess of milk
If your engorgement is caused by excess milk and doesn't resolve quickly with your baby's growth spurt, you can try reducing your milk supply using natural remedies. However, you should always consult your midwife before doing this so you don't accidentally stop breastfeeding completely. Sometimes just eating a few sage drops can help reduce your milk supply.
Bacterial mastitis caused by milk congestion
If you develop bacterial mastitis, you'll need a prescription for an antibiotic. Don't worry, your doctor can prescribe a medication that will allow you to continue breastfeeding.
It's also possible that a milk stagnation will occur several times during your breastfeeding period. However, the better you take care of yourself now (bed rest!!) and cool your breasts and care for yourself after breastfeeding or other emptying, the more likely you are to get the milk stagnation under control quickly and once and for all.
Since milk congestion can sometimes be caused by minor injuries to the nipple, or by exposure to cold or drafts, I'd like to recommend these as a last recommendation. Stressed nipples recover particularly well in direct exposure to air. The silk and the special knitting technique ensure good air circulation and transport fluid away from the body. The absorbent wool layer protects the underwear.
Always seek medical advice
Important note: This article contains only general information and should not be used for self-diagnosis or treatment. It is not a substitute for a consultation with a doctor.
Treating milk congestion: When should I see a doctor?
If all measures have not been successful and after 24-48 hours neither the hardening nor the pain and fever (> 38.4 °C) have subsided, you should consult a doctor.
Symptoms such as chills and headaches and body aches also indicate a smooth transition to a serious chest infection.
Preventing milk congestion – this is how it works
- You should take good care of yourself and your breasts throughout the entire breastfeeding period.
Feel free to change your baby's breastfeeding position so that all segments of the breast are emptied properly. - Always plan enough rest breaks for yourself, ideally with your baby. Make sure you have enough food and drink. Mothers often forget to take good care of themselves.
- Avoid wearing bras that are too tight or other clothing that creates pressure in the chest area.
- Breastfeed your baby frequently enough, ensuring you have ample physical contact with your baby. If you experience breastfeeding difficulties, seek immediate help from your midwife or a lactation consultant.
- If necessary, you can wake a sleepy baby to breastfeed. Alternatively, empty the breast by hand (“Marmet technique”) or with a pump until the pressure subsides.
There are also some women who are prone to clumping milk fat, which causes repeated episodes of engorgement. These women often benefit from taking lecithin. Due to its emulsifying properties, lecithin can help prevent clumping of fat and thus ensure a smooth flow of milk. - It is best to discuss the next steps and the appropriate dosage with your midwife or lactation consultant.
Milk stasis during pregnancy
Can you get mastitis during pregnancy?
Yes, that is also possible, but only very rarely the case.
During pregnancy, make sure you stop wearing underwire bras, which put too much pressure on your growing breasts.
Furthermore, you should not actively express colostrum unless discussed with your midwife. There are a few indications for this practice, such as gestational diabetes, to provide the baby with nourishment immediately after birth and prevent a drastic drop in blood sugar.
If you have already experienced a milk blockage during pregnancy, follow the same tips as after the birth and contact your midwife.
A self-treated breast engorgement should disappear after one to two days, at least the more serious symptoms like fever and body aches. Redness and pain may persist for a few more days.
You can experience milk stasis throughout breastfeeding, but most commonly in the first few weeks after birth. In rare cases, it can even occur during pregnancy.
In the case of mastitis, which can develop from a blocked milk duct, germs multiply in the blocked milk and can cause an infection.
A milk blockage does not usually disappear on its own, but rather through regular breastfeeding with correct attachment technique, massage, pumping or expressing and plenty of rest.
If all the measures presented here do not lead to the milk blockage being resolved, you should see a doctor or alternatively ask your midwife or lactation consultant for help.
You should continue to breastfeed your baby every 2 to 3 hours at night, too. If necessary, you can wake your baby to do this. If that doesn't work, you can express some milk or pump briefly until the tension subsides. Furthermore, warm your breasts before breastfeeding and cool them afterward, if necessary. Feel free to change your breastfeeding position here as well.
During the acute phase, urgently ask your partner for support or get help from loved ones for the night. It's essential that you sleep/rest during breaks between breastfeeding. If you manage the engorgement well when it first starts, it can subside very quickly.
This varies greatly from individual to individual. With fever and body aches, this is certainly a given, and you'll probably feel the need to do it anyway. Otherwise, it's better to stay in bed with your baby a little longer at first until you've regained your strength and the milk ducts have cleared. Urgently ask those around you for support. You'll usually feel significantly better after one or two days of bed rest, and you'll be able to gradually increase your physical activity again.
Yes. Some mothers prefer to control the suction on their now-sensitive breasts themselves. A continuously adjustable breast pump is ideal for this. You can borrow one from the pharmacy in an emergency.
If your baby doesn't want to drink the excess breast milk right away, you can freeze it in breast milk bags for later.
With engorgement, the breasts become sore and tense. Often, you can feel lumpy and hardened areas in the breast. Sometimes these may also feel warm and red.
Retterspitz has anti-inflammatory and pain-relieving effects. Furthermore, Retterspitz has a cooling and decongestant effect.
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