Mastitis vs Blocked or Plugged Ducts

Mastitis is inflammation of the breast mostly caused by a blockage. This may or may not be associated with infection, whether bacterial or fungal. Mastitis usually occurs in breastfeeding mothers. In these instances, the breast milk being produced behind a blockage seeps into the surrounding tissue which then causes an inflammatory response. However, mastitis can occur even in women who are not breastfeeding or pregnant, and can even occur in small babies. 

Nobody knows exactly why some women get mastitis. Bacteria may gain access to the breast through a crack or sore in the nipple, but women without sore nipples also get mastitis. Mastitis needs to be differentiated from a blocked or plugged milk duct. A blocked duct does not need to be treated with antibiotics, whereas mastitis often requires treatment with antibiotics. 

Blocked or Plugged Ducts

A plugged duct presents as a painful, swollen, firm mass in the breast, often with overlying reddening of the skin, similar to mastitis, though not usually as intense.

Blocked ducts will almost always resolve spontaneously within 24 to 48 hours after onset. During the time the block is present, the baby may be fussy when nursing on that side, as milk flow may be slower than usual.

Blocked ducts can be made to resolve more quickly by:

  • Continuing breastfeeding on the affected side.

  • Draining the affected area better. One way of doing this is to position the baby so his chin “points” to the area of hardness. Thus, if the blocked duct is in the outer lower area of your breast (about 4 o’clock), the football position would be best.

  • Using breast compression while the baby is feeding.

  • Heat on the affected area (hot water bottle) also helps.

  • The mother trying to rest. (Not always easy, but take the baby into bed with you).

  • Therapeutic ultrasound

If a blocked duct has not settled within 48 hours (unusual), therapeutic ultrasound often works. This can be arranged at PhysioWorks.

If ultrasound is going to work, one treatment will improve your symptoms and a second one will finish the job in most cases.  Ultrasound also helps prevent recurrent blocked duct which always occurs in the same place.

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Mastitis

Mastitis, though, is usually associated with fever and more intense pain and redness of the breast. As you can imagine, it is not always easy to differentiate mild mastitis from a severely blocked duct. A blocked duct can lead to mastitis.

In order to make a diagnosis of mastitis, there must be an area of hardness, pain, redness and swelling in the breast. The absence of such an area in the breast means that the mother does not have mastitis. Flu-like symptoms or fever alone are not enough to make the diagnosis of mastitis.

As with almost all breastfeeding problems, a poor latch, and thus, poor draining of the breast sets up the situation where mastitis can occur.

Mastitis Treatment

  • Always consult your doctor for assessment.

  • Continue breastfeeding, unless it is just too painful to do so. If you cannot continue breastfeeding, express your milk as best you can in the meantime, and restart breastfeeding as soon as you can. Continuing breastfeeding helps mastitis to resolve more rapidly. There is no danger to the baby.

  • Heat (hot water bottle) applied to the affected area helps fight off the infection.

  • Rest helps fight off infection.

  • Try Ultrasound treatment if your symptoms last beyond 48 hours.

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    Last updated 10-May-2016 10:36 AM

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