Blocked Milk Ducts
When breast milk moves through the milk ducts toward the nipple for breastfeeding, flow can be impeded by inflammation and swelling within and around the ducts themselves. This inflammation can narrow the ducts, and cause a back-up of milk behind the "blockage" which can create the feeling of a lump or bump in the area or an area of fullness or firmness. The majority of blocked milk ducts will resolve on their own with conservative treatment within 24-48 hours, but some blocks may be persistent. Blocked milk ducts may be painful, red, warm and swollen on the surface area of the breast above the block. Occasionally a block may progress to mastitis which is an infection which may require antibiotics. You may have an infection if you develop a fever, chills, body aches or are feeling unwell.
Treatment of Blocked Milk Ducts
Treatment involves reducing the swelling within and around the duct, to allow the milk to flow again. Blocked milk ducts can have many causes, such as a high milk flow or an inefficient latch or suck, which then may result in nipple pain, and/or incomplete emptying of a part of the breast.
The physiotherapy approach to treatment of blocked milk duct includes:
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Manual lymphatic drainage massage, including self-massage techniques.
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Therapeutic ultrasound application to decrease pain, inflammation and swelling.
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Evaluation of postures and breastfeeding positions to prevent and treat muscle and joint pains.
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Screening and recommendations for torticollis and plagiocephaly (flat-head) which can impact successful feeding.
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Basic screening of latch and screening of baby for oro-fascial and body tension which may impact successful feeding.
Other Important Information
Due to scope of practice restrictions in Ontario, Registered (Licensed) Physiotherapists, are NOT permitted to address breastfeeding issues related to milk supply, feeding schedules, prescription of feeding supplements or prescription or evaluation of devices such as breast pumps or nipple shields. A certified Lactation Consultant is the best professional to help address and advise on these issues.
In Ontario, a physiotherapist must work in collaboration with either a physician, midwife or nurse practitioner who can diagnose a block milk duct and refer to physiotherapy for ultrasound treatment. A referral from a doctor, midwife or nurse practitioner is required for service.