Support for breast feeding mothers – from clogged ducts to mastitis, with gentle guidance and timely care.
Breast milk provides all the nutrition your baby needs for the first six months of life and can give your baby most of their nutrition for the first year of their life and beyond.
Breast milk also helps to protect your baby against a range of infections. Breastfeeding is a learned skill and sometimes you need help and support to get it right. It doesn’t always come easily, but generally, with persistence, it does get easier.
Many mothers experience challenges such as breast pain, clogged ducts, mastitis, and abscess especially in the early postpartum period. These situations can be stressful, sometimes overwhelming, and often come with uncertainty about what is normal.
Our approach is gentle, practical, and timely. We assess your symptoms carefully, using clinical evaluation and ultrasound when needed, to understand what is happening within the breast.
Most conditions can be managed effectively with early recognition and appropriate care. When necessary, treatment is provided to relieve symptoms and prevent progression, while supporting continued breastfeeding whenever possible.
Breastfeeding support
After giving birth at FV Hospital, our lactation consultants visit daily to guide you through latching techniques and provide tools like nursing pillows or pumps for a confident, comfortable start. You will be guided step by step so you know what is happening, what to do, and when to seek help.
It’s the perfect food for your baby’s growth and development.
Protects babies against gastroenteritis and diarrhoea, ear and chest infections, allergies, diabetes, and other medical conditions.
Reduces the risk of Sudden Unexpected Death in Infancy including Sudden Infant Death Syndrome.
For you
It reduces the risk of bleeding after the birth.
May help you return to your pre-pregnancy weight.
Reduces your risk of developing breast and ovarian cancer and osteoporosis.
Convenient, free and there is very little preparation before each feed.
Breastfeeding gives you an opportunity to connect with your baby in a profound and deeply satisfying way. It is a physical and emotional bond that stays with you for many years afterwards.
Full breasts
Around the third or fourth day after your baby is born, your breasts start to produce lots of milk. This is known as the milk ‘coming in’.
During this time, your breasts may produce much more milk than your baby needs and they may feel full and uncomfortable. This will only last for a few days. Most women feel their breasts softening from around ten days to two weeks.
Your nipple and the dark area around it (the areola) may become full and firm and it may be difficult for your baby to attach properly to your breasts.
Your baby may not take all your milk from your breasts during feeds. After feeds, your breasts may still feel quite full and uncomfortable.
Some babies can be unsettled during this time and want to feed very frequently.
Your baby might have lots of loose, greenish bowel motions.
All of this is normal.
Feed your baby while your breasts are full
Good positioning and attachment is important – ask your midwife for help with this if you need it.
Hand express some milk before you attach your baby to your breasts. This will soften the areola and make it easier for your baby to attach. Ask your midwife to teach you how to hand express.
Offer one breast per feed. Don’t swap sides unless the first breast feels very soft after the baby finishes feeding from it.
If your baby wants a top-up feed within an hour, feed again from the same breast.
If the baby is still hungry after the first breast is ‘finished’, then you can offer the second breast.
If your baby only feeds from one breast at a feed and the other breast is uncomfortably full, express a small amount of milk for comfort.
Change sides each time you begin a new feed.
If your breasts are very uncomfortable between feeds, you may need to express a small amount of milk to relieve the fullness. You can also stimulate some milk to flow by:
Placing a warm pack on the breast for a few minutes
Having a warm shower or bath.
Let some milk drip from one side into a towel or container while feeding from the other breast.
Wear a supportive bra but make sure it doesn’t dig in. Some women feel more comfortable without a bra at this time.
Cold packs after feeds for a few minutes may help to relieve swelling and discomfort. A covered cold pack or a packet of frozen vegetables can be used for this.
Paracetamol may be taken for pain relief if required. Follow instructions on the packet.
Offer both breasts at each feed again, but continue to let the baby finish the first side before offering the second.
Low Milk Supply
Most mothers produce enough milk for their babies. Your milk supply is considered low when there is not enough breast milk being produced to meet your baby’s growth needs.
Many mothers worry about their milk supply, especially in the early stages of breastfeeding. In fact, women who have stopped breastfeeding will most commonly say it was because they ‘didn’t have enough milk’. However, most mothers do produce enough milk for their babies.
If the breast milk supply is genuinely low it is usually a temporary situation and can be improved with appropriate support. If you are concerned about your supply it is important to seek advice from our lactation consultant or FV Breast Care Specialist.
My baby feeds too often: Babies naturally feed frequently (normally 8 to 12 times in 24 hours), and in the early days babies can be very unsettled. This does not mean that there is not enough milk. In fact, frequent feeding is necessary to establish a good breast milk supply.
My breasts feel soft: When your milk supply adjusts to your baby’s needs your breasts may not feel as full (this may occur anywhere between 3 to 12 weeks following birth). As long as your baby continues to feed well, your breasts will produce enough milk for your baby.
My baby has suddenly started to feed more frequently: Your baby may want to feed more during a ‘growth spurt’, but this increased feeding over a couple of days will help you to increase your supply.
My baby only feeds for a short time: This is no cause for concern as long as your baby continues to grow. After two or three months your baby becomes more efficient at feeding and therefore will take less time at the breast.
Your baby should be back to birth weight by approximately two weeks of age and gaining an average of 150 grams or more per week for the first three months of life.
After the first week following birth, your baby should:
Wake for feeds by themselves
Settle between most feeds
Have at least 6 to 8 soaked nappies (4 to 5 heavy disposable nappies) in 24 hours
Pass a soft yellow stool (poo) at least once a day.
Your baby is not attaching well at the breast. This may also cause nipple pain and damage.
Your baby does not feed often enough. Nearly all babies need to feed at least 8 to 12 times in 24 hours.
Your baby does not feed effectively at the breast.
You have started using formula milk as well as breastfeeding.
You have had breast surgery that is affecting your milk supply.
You have recently had mastitis.
You are taking oral contraceptive pills containing oestrogen.
You smoke cigarettes.
Some medications, including over-the-counter and herbal preparations such as cold/flu tablets, may reduce your milk supply.
Rarely, there may be reduced or no milk production because of a medical condition. This occurs in less than five per cent of mothers.
The key to increasing your milk supply is frequent stimulation and emptying of the breasts. This may take some time and it is important that you seek advice and support from a lactation consultant, your maternal and child health nurse or other health care professional skilled in breastfeeding management.
Hold your baby skin-to-skin at the breast (baby dressed in a nappy only, so that there is direct skin contact between you and your baby). This will help to keep your baby awake and also to increase the release of hormones involved in breast milk production.
Breastfeed frequently, two to three hourly – a total of at least eight feeds in 24 hours. Your baby may need to be woken for some feeds, or may wake to feed even more often.
Make sure that attachment is good and that your baby is both sucking and swallowing (you may need to seek help with this).
Switch feed; offer each breast twice. When you notice your baby is becoming tired or not swallowing very frequently anymore, take your baby off that breast and ‘switch’ to the next side. Repeat on both breasts. This will ensure your baby is draining the breast more efficiently.
Express after breastfeeds to provide further stimulation to your breasts and to ensure that your breasts are well drained. This will help increase your milk supply.
If your baby is sleepy at the breast and not feeding well you may need to cut short the feed and use the time to express each breast twice, for example, five minutes left side, five minutes right side and then repeat. The expressed breast milk should then be fed to your baby.
When breastfeeding or expressing, compress or massage your breasts to assist with milk flow and drainage.
If you need to give your baby extra milk, give expressed breast milk separately and before any infant formula. Seek advice from a lactation consultant or our Breast Care Specialist before commencing infant formula.
Sometimes prescription medicines are used to assist with increasing milk supply; these are available from your doctor.
Talk to FV Lactation Consultant about strategies to manage feeding and expressing while you are increasing your milk supply. Often it takes about one hour to feed and express. Then you and your baby can rest between feeds.
Clogged Ducts
Blocked milk ducts are common and may cause localised pain or firmness in the breast.
Occasionally, a nursing mother can develop a blockage inside her breast that stops some of her milk from flowing to her baby. Sometimes this blockage (called a plugged duct) can cause the breast tissue to become infected. Signs and symptoms of plugged ducts include:
A tender area or painful lump in your breast.
Skin redness.
A full feeling over a large portion of the breast that stays firm even after nursing.
A milk duct may become plugged for several reasons, including:
Your baby does not completely empty your breast during each feeding. This can cause milk to build up. It may happen if:
Your baby is not given enough time to nurse.
Your baby is not latched on properly.
You miss a feeding.
Feedings are too far apart.
Your clothing puts too much pressure on the breast tissue, especially underwire bras or bras that fit too tightly. A front or backpack style infant carrier can also cause problems if the straps are too tight.
You have dried milk secretions on the tip of the nipple or a clogged nipple pore that blocks your milk flow.
If you think you may have a plugged milk duct, it’s important to take care of it right away so you can stop a breast infection from developing. Here are some ways to prevent infection:
Breastfeed at least every 1½ to 3 hours. Keep to a regular schedule. This will help drain the breast and clear out the plugged duct as well as give you a chance to bond with your baby.
Begin each feeding on the side with the plugged duct because the baby empties the first side most effectively.
If possible, increase the length of time you feed your baby, up to 20 minutes per side, and use both breasts at each feeding.
Apply moist, warm heat to the plugged duct area for 10-15 minutes before nursing.
Massage the breast just above the sore area while nursing.
Vary your nursing position from time to time to relieve the pressure on your nipples. Try sitting up, lying down, and switching between using the football hold, cradle hold, and cross-cradle hold.
Make sure your baby is properly positioned.
Remove tight clothing or baby carriers. Find a well-fitting bra and use a carrier that does not squeeze the breast tissue.
Be sure to get enough rest. Sleep when the baby sleeps. Get help with household chores or leave them undone until you feel better.
Increase your fluid intake to about 8 to 10 glasses in a 24-hour period and eat a healthy, balanced diet.
Look for dried milk secretions or a clogged pore on the nipple. Soak the visible plug in warm water. Then gently try to express the plug by hand.
If needed, take acetaminophen (Panadol) or ibuprofen (Advil) to help relieve the pain.
If these suggestions do not relieve your discomfort or you have any questions, check with our Lactation Consultant.
Mastitis
Mastitis is when your breast gets inflamed because of nipple damage or if a plugged duct becomes infected. Mastitis is quite common.
Sometimes mastitis is mild and sometimes it is severe. You might have:
Tenderness, reddened areas of your breast
Uncomfortable or painful breast lumps.
Sometimes mastitis feels like getting the flu. You might:
Feel unwell
Feel hot and cold with a fever
Have general body aches
Have headaches.
If you feel unwell or your breast is red, you should see your doctor as soon as possible.
If your doctor gives you antibiotics, follow the instructions. It is safe to breastfeed when you take these antibiotics
After you start taking the antibiotics, if you don’t start to feel better after 48hrs you might need to go back to the doctor.
You might need other tests. If you have severe mastitis, the doctor might check if there is a particular bacteria causing your mastitis. This can help them use the right antibiotics.
You can keep breastfeeding
Your breastmilk is safe for your baby even if you have mastitis.
You can keep breastfeeding or expressing from both breasts. This will help your milk supply.
It is important to care for yourself and your breasts at the first signs of mastitis.
Breastfeeding frequently helps
Some babies want to feed more frequently when you have mastitis. Try to feed to what your baby wants.
Some babies might not want to feed from the breast with mastitis for a while. Keep offering and expressing your milk. Your baby should start to feed from both breasts soon.
A cool pack wrapped in a cloth and placed on your breast after feeding or expressing can help reduce inflammation.
You can put a warm cloth on the affected area to encourage the milk flow before feeding or expressing. If your milk is flowing okay, you don’t need to use warmth.
You can help improve milk flow
You can very gently stroke the breast with mastitis to help improve milk flow. You can do this during feeding or expressing, or in the bath or shower.
Between feeds, you can very gently stroke the affected area towards your armpit. This helps to reduce fluid build-up in your breasts.
Do NOT try pumping to relieve pressure
Pain relief
A cool pack can be good for pain relief.
You can take paracetamol or ibuprofen to help with pain. It is safe to take these while breastfeeding.
Looking after yourself
Drink enough water so you are not thirsty.
Rest when you can.
Ask your partner, family or friends for help with household tasks.
Looking after your baby
Check your baby is having the usual number of wet and dirty nappies.
Looking after your breasts
Wear comfortable non-restrictive clothing.
Avoid pressure on your breasts.
Don’t use strong pressure from your hands and fingers during feeding or expressing.
Feeding to prevent mastitis
You should breastfeed frequently. Young babies often need to feed 8–12 times in 24 hours, or more.
Don’t miss or delay feeds.
Offer both breasts for each feed. If your baby doesn’t take the second breast, offer it first next time.
Wake your baby for a feed if your breasts start to feel too full.
Ask your nurse, midwife or breastfeeding counsellor to check your baby is attaching and feeding well.
Avoid giving your baby formula or other fluids unless advised by your nurse, midwife or doctor.
Expressing to prevent mastitis
If your breasts still feel full after a feed, express just enough milk for comfort.
If your baby doesn’t want to feed yet, express just enough milk for comfort.
If you’re using a breast pump, check the breast shield size is not causing any problems for your nipple or breast.
Ask our Lactation Consultant if you think your breast pump is causing problems.
