Breastfeeding should be a joyful experience, but problems such as engorgement, blocked milk ducts and mastitis can turn it into a painful and stressful activity. So what is the difference between these conditions and how can physio help?




For all you NEW mums out there, an engorged breast can occur between 2-5 days after delivery, as your milk ‘comes in’. It’s normal for your breasts to become larger, heavier and a little sore as you begin producing greater quantities of milk. Some of the fullness is due to extra blood and lymph fluid within the breast tissue. This should usually subside within a few days to a week. Occasionally prolonged swelling can compress the milk ducts and restrict milk flow. This causes hardening of the breast tissue and can feel painful and lumpy, not to mention causing difficulties for the baby obtain a good latch.


Blocked milk ducts


Blocked milk ducts can occur at any time and for a variety of reasons, usually related to restricted milk flow. A blockage in the milk duct causes the milk to build up in the duct and can lead to the surrounding tissue becoming swollen, sore and forming a hard lump. This is often quite tender to touch.




Mastitis is the inflammation of the breast tissue as a result of a blocked milk duct. The milk collects behind the blockage and can be forced into the breast tissue, causing an inflammatory response and possibly infection or fever. If the symptoms are not addressed within 24-48 hours you may start to feel unwell, achy and feverish. We don’t want it to get to that!




Lactation consultants and midwives are absolutely invaluable to provide breastfeeding mums with trouble-shooting advice regarding the cause for their restricted milk flow. They also provide hands-on treatment like massage and hand expressing. Physiotherapy can work alongside these services using therapeutic ultrasound, lymphatic drainage massage and taping. Whilst the midwife’s treatment aims to unblock the duct and restoring milk flow, physiotherapy treatment aims to reduce the surrounding swelling and inflammation to aid flow.


Therapeutic ultrasound uses ultrasonic sound waves to cause vibration at a cellular level. This vibration causes heat and aids with localised blood flow, leading to the removal of excess swelling and inflammation and thereby restoring milk flow. Specialised lymphatic drainage massage and Kinesio-taping can further help remove swelling and inflammation. Many women find it a useful adjunct to their own massage and hot compresses, and in many cases it can prevent the escalation of a blocked duct into full-blown mastitis. On average, they find that 3 treatment sessions are enough to help clear the blockage and return to happy, pain-free breastfeeding.


You could have a blocked milk duct or mastitis if you notice:

  • A hard or painful lump or wedge in your breast
  • Redness or warmness to touch on your breast or
  • If you feel feverish and unwell.

Physiotherapy may be able to help you!


My Body can provide experienced assessment and treatment of blocked milk ducts and mastitis. We know it’s hard to get out of the flat with a new baby, that’s why we will come to you! Contact us to make a booking or find out more.

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