Lumps and bumps during Lactation

As an International Board Certified Lactation Consultant (IBCLC), I receive many questions about breast care during lactation. These questions and concerns increase around the holidays especially. Parents have less time for self care and this can result in pain and sometimes infection.

First let's talk prevention. In those early days after birth, breastfeeding or pumping at least every 3 hours or more is necessary to maintain a healthy milk supply and prevent milk stasis, plugged ducts and help lower the chance of mastitis. Waiting longer often causes increased pain, firmness, tender lumps or hard areas in the breast and difficulties expressing the milk or nursing effectively. In addition examining your breasts once very 24 hours is great proactive move. You can assess them with your fingers in the shower. You are looking for any tender spots, or lumps. If you find them, massaging them at this early stage can help get that milk moving before it becomes a painful and harder to manage problem.

If you find yourself with trapped milk or plugged ducts there are varied techniques that can help. Think of your breasts as having an 8 lane highway of ducts near your chest wall that eventually narrows down to only several behind the nipple. The milk gets stuck at this narrowing area first and causes 'traffic' higher up in the breast. Begin massaging the lumps or marbles you feel behind your nipple area first. Then slowly move back, working on additional lumps or hard areas heading towards your chest wall last. Allowing the areas behind your nipple to flow will allow the milk higher up in the breast to flow. (If you start near your chest wall you will encounter that blockage and increase pressure near your nipple). Soaking your breast in warm water first can really help this process.

This massage should be followed by nursing, hand expression or pumping to remove the milk.

If you are nursing, you can try the dangle technique. You position yourself above your baby/child and dangle your breast into their mouth to nurse. Gravity, plus an effectively nursing child are your breast friend when you have a plugged duct. 

If your breast is very firm and you are not able to express milk effectively or nurse well, reach out to an IBCLC as soon as possible. Regular milk removal is needed to maintain your milk supply.

Be aware of the warning signs of mastitis. This condition may or may not require antibiotics. You may experience pain, redness, warmth, a fever of 100.4 or higher, body aches and malaise (fatigue and not feeling well). Call your MD if you have these symptoms. 

Remember to take care of yourself and your breasts during this busy time of year!