New recommendations for mastitis and clogged milk ducts

There is constant new research and new understanding of various conditions in various fields. This also applies to breastfeeding. As a rule, the recommendations change gradually, and they will therefore not always be equally well marked.

But in 2022 there was a marked shift in international recommendations regarding the treatment and understanding of mastitis and blocked milk ducts.

In the past, the recommendation for mastitis and clogged milk ducts has been frequent breastfeeding and thorough emptying. Some have recommended massage and heat.

❗️ In the new recommendations, it is the opposite:

If blocked milk ducts or mastitis are suspected, the breast should be kept at rest.

NB! This must not be misunderstood to mean that you should not breastfeed or pump at all. An important part of the treatment is to express milk. The point is not to overdo the stimulation.

The recommendations are as follows:

🔹breastfeed as normal on demand from the child*

🔹use cold compresses for about 10-20 minutes between breastfeedings to reduce swelling in the breast tissue

🔹take anti-inflammatory / painkillers if needed

🔹DO NOT massage the breast

🔹warm compresses on the breast just before breastfeeding can facilitate the expulsion of milk

If you suspect mastitis, this will be the first choice as treatment for 12-24 hours (5).

Contact a doctor before this if during this 24-hour period you become much worse, develop a high fever, nausea, vomiting or experience more chest pain. You may then need antibiotics.

*If the child is ill and/or does not feed as often or as effectively as usual - or if you are away from the child - then you should hand-milk or pump approximately as often as the child would feed if everything were normal. It's not always easy, but try to get about as much milk as the baby would.

In order for the new recommendations to be easier to understand, we can imagine that clogged milk ducts and mastitis are like a queue in all the lanes on the motorway:

Breastfeeding (or pumping) more often than usual, and thus increasing milk production, is the same as adding extra cars to the queue and creating more congestion. If we instead take it easy and don't add more cars, the queue will eventually dissolve.

In the same way, massage is not the first thing we think of as treatment if we have sprained our ankle or have inflammation in a shoulder:

Instead, we keep the painful area calm and cool it down, both to relieve pain and to prevent the inflammation from increasing. The same applies to a breast with inflammation.

Mastitis

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