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blocked duct vs mastitis | do I have a blocked duct | mastitis or blocked duct

How to Properly Distinguish between a Blocked Duct or Mastitis?

This is such a common question for mums, especially first-time mums who notice a change in their breast. Maybe you’ve heard of other women having a blocked duct or even experiencing mastitis. Given the statistics for mastitis are up to 40% of women experiencing it (and plenty higher than that for a blocked duct) it’s incredible to think how little value is placed on educating women about these issues before they begin breastfeeding. Many of the clients we see at the Melbourne Mastitis Clinic fall into this category of simply not knowing what is going on in their breast and we pop up in their google search for answers.

There are different features to determine if you have a blocked duct or mastitis and this can be confusing, especially when mastitis can begin with a blocked duct. So let’s go through them and work out what the differences are with blocked ducts and mastitis, what relieves a blocked duct and how to get help if you do happen to have a blocked duct or mastitis.

What is the main cause of mastitis?

Mastitis is a misunderstood condition that is often stated as an infection and this is only partly true.  Did you know there are actually 2 types of mastitis!  When you understand the causes of each type of mastitis, the treatment for each also makes sense.

By definition, mastitis in an inflammation of the breast tissue, this is true for both infective mastitis and inflammatory mastitis – our two types of mastitis. 

Infectious Mastitis

As the name states clearly, this type of mastitis is an infection, a bacterial one. Most often bacteria enters the inside of the breast via damage to the nipple. This can be due to a poor latch, common in the early days of breastfeeding, tongue tie issues with baby, and sometimes even for an ill-fitting flange on a breast pump. Antibiotics should form a part of the treatment for bacterial mastitis. This form is not usually caused by a blocked duct, but by bacterial entry through broken skin as already stated.

Milk Stasis

The second type of mastitis, known as inflammatory mastitis, occurs following milk stasis (when the milk doesn’t move along through the duct). Milk stasis is commonly the cause for blocked ducts as the milk sits stagnant inside the breast too long, and forms a “glob”.  This can develop into mastitis when not unclogged due to an increase in pressure building up behind the clog, causing milk to seep into breast tissue outside the duct, in turn causing an inflammatory reaction

Please note: due to a protein in the milk, called a ‘cytokine’, when there is an inflammatory mastitis episode, the cytokines are responsible for the whole-body reactions that are often described as flu-like aches & pains, fever. Yes! Fever occurs in inflammatory mastitis, that is mastitis without a bacterial infection!

So, regardless of what type of mastitis you have the symptoms are much the same: 

  • Fever 
  • Aches and pain 
  • Red, hot breast 
  • feeling unwell 

but then with an infection, most of the symptoms are worse and you may also experience fainting, dizziness, vomiting. Seek medical advice if you suspect an infection. 

How to relieve mastitis symptoms?

The important thing to begin with is to realise that mastitis is not IN the milk itself. This is a common misconception and it has come about because women are told that to relieve mastitis they should drain the breast. This is a useful action but will not relieve the mastitis itself. To relieve the actual mastitis you need to move along the fluid congestion that is the lump. Please understand that this lumpiness will not drain from the breast via the nipple. We teach women about this fact everyday to provide useful techniques to ease the congestion. These techniques are for infectious or inflammatory mastitis.

You can also use heat or cold depending on what feels best for you, OTC pain-relief that your pharmacist says in safe for you, rest, and stay hydrated. Your body needs to heal so treat it kindly.

What Does Mastitis Look Like Compared to a Blocked Duct?

There are symptoms that differ between mastitis and a blocked duct (also called a plugged duct or clogged duct).

  1. Colour of the skin – Mastitis is more of a bright pink to red hot colour whereas blocked ducts usually present either with no colour change or a very pale pink.
  2. Temperature of the skin – mastitis is very warm to hot in contrast to a more gentle increase in warmth for a blocked duct
  3. Pain – although a blocked duct can feel painful, mastitis is truly awful when it comes to pain
  4. Fever – Fever is very common with mastitis and even up to 40C with an infection. A blocked duct may have a slight fever but not really pushing 38C

What Causes a Blocked Duct?

A blocked duct occurs due to milk stasis (think stagnant pond). Reasons this can occur can be:

  • too long between feeds/pump sessions
  • tight seam in a bra or top compressing a duct
  • nipple damage may cause a blockage right at the nipple surface called a ‘bleb
  • finger or thumb pressure on the breast that compresses a duct whilst trying to direct the breast for the baby
  • scar tissue in the area that creates a connective tissue restriction creating a vulnerability for a duct to become blocked

How To Relieve Blocked Duct Symptoms 

To relieve a blocked duct you want to think about the clog being a fatty mass. So heat can be beneficial to work at softening the blockage as well as any vibrating tool/toy you may have. By using massage towards the nipple and the above strategies, then feed or pump and see if the blocked duct clears.  You may notice a stringy type of product leave though the nipple, this is the clog. Sometimes mums notice that baby begins to cough when a clog clears and this can be a stringy section of the clog tickling baby’s gag reflex. This is not harmful for baby, they will soon swallow it and it will be gone.

How to Get Help if you Suffer from Mastitis or Blocked Duct 

For both a blocked duct and mastitis, ultrasound therapy can be a useful tool to jiggle the area of congestion at a micro level. We utilise it in our clinic and then apply the appropriate manual therapy, massage strategy to work at clearing the blocked milk duct or mastitis. These techniques are different for each of mastitis or a blocked milk duct.

We also have virtual consults available which is especially useful given the lack of educated health professionals in this field of work. You can check out our virtual consults here.

You can also call 03 9859 5059 or book online via the button below.

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