Mastitis vs. Blocked Duct and what to do about it

Mastitis is a bacterial infection of the breast that usually occurs in breastfeeding mothers.

Mastitis needs to be differentiated from a plugged or blocked duct, because the plugged or blocked duct does not need treatment with antibiotics, whereas mastitis often, but not always, does require treatment with antibiotics. A blocked duct presents as a painful, swollen, firm mass in the breast. The skin overlying the blocked duct is often quite red, similar to what happens during mastitis, but less intense. Mastitis is usually also associated with fever and more intense pain as well. However, it is not always easy to distinguish between a mild mastitis and a severe blocked duct. A blocked duct, can, apparently, go on to become mastitis. In France, physicians also recognize something they call lymphangite that is fever associated with skin which is hot and red, but there is no underlying painful mass. They do not believe this requires treatment with antibiotics.

Blocked Ducts
Blocked ducts will almost always resolve spontaneously within 24 to 48 hours after onset, even without any treatment at all. 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 outside, lower area of your breast (about 4 o'clock), the football hold would be best.

-Using breast compression while the baby is feeding, getting your hand around the blocked duct and using steady pressure.

-Applying heat to the affected area (with a heating pad or hot water bottle, but be careful not to injure your skin by using too much heat for too long a period of time).


-Trying to rest. (Not always easy, but take the baby to bed with you.)

By Vincent Iannelli, M.D., http://pediatrics.about.com/od/breastfeeding/a/mastitis.htm