Lactostasis in a nursing mother: symptoms and treatment
Lactostasis is a retention of milk in the excretory ducts of the breast of a nursing mother. One or several ducts can be blocked. Most often, this condition is observed in women who are breastfeeding for the first time. Lactostasis develops mainly 10-14 days after childbirth.
Although every woman's breast has its own anatomical features, its internal structure is identical for all representatives of the beautiful half of humanity. Inside the breast is glandular tissue, which is divided into lobes. There are about 15-20 of them. Each of these large lobes is divided into smaller lobules that pass into the excretory ducts leading to the nipple. When in any of the ducts there is an obstacle to the normal flow of milk, this provokes the development of lactostasis. It begins due to the fact that the mammary gland cannot be emptied completely.
- Causes of lactostasis
- How to understand that you have lactostasis and not mastitis?
- Risk factors for the development of lactostasis
- 10 tips to avoid lactostasis
- How to express milk correctly with lactostasis?
- Is there a specific treatment for lactostasis?
- Answers to popular questions about lactostasis
The development of lactostasis can be provoked by an incorrect feeding technique of a child, a violation of the feeding regime, and poor-quality expression of milk. Stress favors milk stagnation, as well as hypothermia of the breast. The quality of the bra worn by a nursing mother is also important. If the breast is constantly pinched and tightened, then the blockage of the mammary glands cannot be avoided.
By itself, lactostasis is not dangerous for either a woman or a baby. However, if you do not get rid of it in time, it can lead to serious complications.
Treatment should be started as soon as possible. Lack of adequate therapy for 3-4 days will lead to the fact that the woman will develop mastitis. Its purulent form requires surgical intervention. The fact is that with a long stay of milk in the mammary gland, fermentation processes are started in it. This leads to the accumulation of serous exudate and the development of initially non-suppurative inflammation. But in such conditions, pathogenic bacteria begin to multiply very quickly. As their number increases, the inflammatory process will intensify, capturing all new areas of healthy tissue. After a short time, suppuration will join.
Lactostasis is not terrible for those women who carefully monitor the standing of their own breasts, feed the baby correctly, and empty the mammary gland in a high-quality and timely manner.
Causes of lactostasis
Lactostasis develops due to a violation of the outflow of milk from the mammary glands.
Most often, this is caused by non-compliance with the feeding technique and poor-quality expression of breast milk:
- Too little time is allowed for feeding. The fact is that not every baby is able to satisfy the nutritional needs of his own body in a short time. Feeding time should be selected on an individual basis. If a woman takes the breast away from the baby too early, as soon as he stops sucking vigorously and willingly, this will lead to insufficient emptying of the breast, because there is too much milk in it. As a result, lactostasis will develop.
During the feeding process, do not press on the breast with your hand.
- If a woman lays a baby to the breast too rarely, this can lead to the fact that too much milk will accumulate in the mammary gland. The belief of some mothers that it is necessary to wait until the baby is very hungry is incorrect. The baby will drink as much milk as his body needs: no more and no less. The unfinished excess will remain in the milk ducts, leading to congestion.
- If a woman takes the wrong position during the feeding process, or holds the baby incorrectly, this can also lead to lactostasis.
- Expressing too much milk will cause more milk to be produced than the baby can consume.
- Too early refusal of breastfeeding can provoke lactostasis.
- No less dangerous is a complete refusal to breastfeed.
Of course, these are far from all the reasons why lactostasis can develop.
Other factors that provoke its occurrence include:
- Features of the anatomical structure of the milk ducts (too narrow passages, flat nipples);
- Improperly fitted underwear: tight bra or refusal to wear it;
- Rest at night in an inappropriate position, namely on the stomach;
- Frequent stress.
How to understand that you have lactostasis and not mastitis?
Knowing the symptoms of lactostasis will distinguish it from mastitis.
Among the signs indicating milk stagnation are:
- Breast augmentation in size, its asymmetrical shape.
- The appearance of tubercles in the mammary gland, uneven density.
- Feeling of expansion of the mammary gland from the inside, soreness when touched.
- Violation of the exit of milk from the breast: it can be sprayed, stand out in drops, or be absent altogether.
After a few days, lactostasis can turn into mastitis (provided that there is no quality treatment). This condition is extremely dangerous and requires immediate medical attention.
The difference in symptoms of lactostasis and mastitis:
Skin on the mammary gland
Color not changed
Within normal limits
High (breasts are hot to the touch)
Normal or slightly increased. Always stabilizes after breast emptying.
Violated: weakness, lethargy, increased fatigue, headaches and muscle pains are observed
Lymph node condition
Without any changes
Increased in size
Find out more: mastitis in a nursing mother - what to do? First signs
Risk factors for the development of lactostasis
There are risk factors that can provoke lactostasis:
- The baby was given formula in the maternity hospital. It is much easier to drink milk from a bottle than from a mother's breast, especially since in the first days after birth, the sucking apparatus of the crumbs is not sufficiently strong. For these reasons, one should not hope that the baby will be able to effectively empty the female breast immediately after birth.
- Already starting from 3-4 days, a woman's colostrum is replaced by milk. It arrives in significant volumes and the baby is not able to suck it completely.
- By about 10 days from the beginning of lactation, milk becomes more fatty, which increases the risk of stagnation in the ducts of the breast.
- The tortuosity of the milk passages and their narrowness is a risk factor for the development of lactostasis.
Pressing on the mammary gland with a finger during feeding or too tight a bra can trigger the development of lactostasis.
10 tips to avoid lactostasis
The following tips will help to avoid stagnation in the mammary glands:
- The newborn should be applied to the breast frequently, choosing the correct position for feeding.
- A few minutes after feeding, it is necessary to express the half-drunk milk with a crumb.
- If too much milk arrives, then you can give the baby 2 feeds in a row the same breast. This will allow you to adjust its production.
- The breast must be supported during the feeding process, but it is strictly forbidden to pinch it with your fingers or press on it.
- Underwear should be not only of high quality, but also comfortable.
- During sleep, you should lie on your side.
- It is important to avoid bruising your breasts.
- Before each feeding process, the mammary gland should be washed with warm water.
- The chest should always be dry and clean. If milk leaks, use the inserts.
- Cracked nipples are the gateway for infection. Therefore, they need to be treated with high quality and in a timely manner.
It is important to remember that adequate rest and sleep is a prerequisite for maintaining the health of not only the mother, but also the child. Stressful situations contribute to the increase in vascular tone and milk comes out with certain difficulties.
The baby draws milk best from those milk lobes that are located in front of his nostrils. Therefore, you should alternate the positions during feeding so that the baby's nose is constantly in a different position relative to the breast.
The most optimal feeding positions:
- The baby rests on a pillow that lies on the woman's lap. The head of the crumbs should be held in such a way as if there is a ball in the hand.
- Lying on the bed with a jack.
For a woman, a competent psychological attitude is very important, which will make life easier for herself and the little man. To do this, you need to spend as much time as possible in the fresh air, eat healthy food, take walks with the baby. If a woman notices the first signs of lactostasis, then they need to be stopped in a timely manner, without ignoring the presence of a problem.
It is necessary to express milk when the baby does not completely empty the breast.
The following recommendations can help prevent the development of milk stagnation:
- The mammary gland should not be in the cold, but it should not be overheated either.
- The bra should support the breasts without pinching them.
- If cracks appear on the nipples, then you need to get rid of them.
- During lactation, the purity of the mammary gland must be monitored with special care.
If you do not have a complete understanding of how to properly feed a child, then you need to collect as much information as possible on this issue. Tips from informative articles posted on the Internet, recommendations of breastfeeding specialists will help.
How to express milk correctly with lactostasis?
With lactostasis, milk must be expressed according to certain rules:
- First you need to stimulate the production of the hormone oxytocin. A warm shower, a back massage along the spine in the thoracic region can help in this regard. It is important to calm down, take a comfortable position, drink warm tea.
- It is best to express milk with your hands, as this is the most gentle method. Of course, you can use a breast pump, but if cracks are present, the vacuum created will make them take longer to heal.
- The chest should be placed on four fingers, placing the thumb and forefinger on the edge of the areola, and rhythmically pressing on the mammary gland. In this case, the fingers should go towards the chest, that is, into the breast.
- The position of the fingers should be changed by passing them around the areola. This will allow the breast to empty completely.
- Sometimes the following situation is observed: the breast is not completely emptied, but milk does not come out. A light breast massage can help in this case. It is necessary to gently tap on the surface of the breast with the pads of the fingers, it is easy to move the knuckles, starting from its base and leading to the nipple. You need to massage the entire surface of the chest.
- If a woman is in a medical facility, then she can undergo ultrasound treatment. It also helps to improve milk flow.
- It is strictly forbidden to squeeze the breast tissue, squeeze it with your fingers. With such manipulations, there is a risk that the woman will crush the lobules filled with milk, which will aggravate the situation.
- Expressing can take from 30 minutes to an hour.
- After expressing milk, you can offer the breast to your baby. In general, infant sucking is the most effective method of emptying the breasts.
Is there a specific treatment for lactostasis?
Specific measures for the treatment of lactostasis exist. To get rid of the problem, it is necessary to normalize the outflow of milk from the breast. Changing feeding patterns and frequent, correct pumping can help.
The optimal feeding regimen is when the baby is applied to the breast every 2 hours, at least. First, you need to offer the baby the breast where stagnation has formed. Before starting feeding, you need to warm it up by standing under a warm shower or applying a warming compress. To prepare a compress, you need to moisten a cloth in warm water and wrap it around the mammary gland, leaving it for 10 minutes. The heat will allow the milk ducts to expand and the milk will pass through them more easily.
Breast massage is another method of treating lactostasis. It is good to do it before you start feeding or before expressing.
In no case should you refuse to pump out, because this method is the first priority in helping women with milk stagnation. After pumping, the baby should be offered the breast and then a cool compress should be applied to it. This will reduce swelling and relieve soreness.
It is important to remember that a healthy breast needs quality care just as much as a breast that is stagnant. It also needs to be emptied in a timely manner and washed well.
Expressing milk too often is not recommended. Three times a day is enough to get rid of excess milk. After stagnation has been arrested, pumping must be abandoned, as it provokes excess milk production.
Some women start taking various medications on their own to get rid of lactostasis. This can be quite dangerous. For example, applying compresses with alcohol or camphor oil to your breasts can cause the breasts to become inflamed and no longer produce milk. In addition, camphor oil can get into milk, and with it into the baby's body, which will adversely affect his health.
If a woman has cracks on her nipples, then you should try to speed up their healing with the help of an ointment. The doctor can help pick it up. The imposition of drugs with an antibacterial component in the absence of an inflammatory reaction is not advisable.
When you cannot get rid of milk stagnation on your own in 2-3 days, you should consult a doctor.
Answers to popular questions about lactostasis
What is the main reason for stagnant milk? We can safely call the main reason for lactostasis is the incorrect organization of breastfeeding. The development of stagnation is promoted by incorrect postures taken by a woman during feeding, poor-quality nipple capture by a baby. Not less dangerous is insufficient water intake by a nursing mother, which contributes to an increase in the viscosity of milk. Clogged milk ducts and long feeding breaks are risk factors.
How to distinguish lactostasis from mastitis? Engorgement of the mammary glands and lactostasis respond to discomfort in the chest, but it will be very painful only with mastitis. A woman can cope with stagnation on her own, without medical assistance, but only on condition that she acts correctly.
So, the main differences that are inherent in the concepts themselves:
- Breast engorgement is considered to be overflowing with milk. It is accompanied by a feeling of expansion of the breast from the inside. After feeding or pumping, the condition returns to normal.
- With lactostasis, milk does not come out of the gland, or it comes out partially, as there is a blockage of one or several lobules. The chest becomes painful, and a swelling forms in the place where the congestion has formed. Slight redness of the breast skin is possible.
- Mastitis is an infection of the breast with pathogenic bacteria. This condition is accompanied by an increase in body temperature, the appearance of severe pain. It is forbidden to treat mastitis without the help of a specialist. Moreover, therapy should be under the supervision of a surgeon. Lactostasis will surely turn into mastitis in 3-4 days, if milk stagnation is not eliminated in time.
How to properly organize breastfeeding in order to prevent the development of lactostasis? Breastfeeding experts recommend putting your baby to the breast on demand. This will allow you to empty it efficiently and do without pumping. You can even feed your baby every 10 minutes. It will be necessary to express milk only when the woman is away from home.
What is the best position for feeding? The correct posture for lactostasis is the one in which the child lies with his chin against the formed tubercle of stagnation. In this case, a woman should not be tense. The poses should be constantly alternated: hold the baby on the arm, fit with the jack, sit or lie down. Regular changes in posture can help prevent stagnation.
How should a baby latch on to the breast correctly? When the breast is correctly gripped, the mother will see the baby's tongue, while his lips are turned outward, and the areola of the breast is in the mouth. During the performance of a tiny sucking movement, the pharynx will be heard, the child's mouth is wide open, and the chin is pressed against the mammary gland.
What manipulations can lead to the development of lactostasis? Sometimes the medical staff in maternity hospitals give the woman the wrong advice, for example, they advise to hold the breast near the baby's nose, pressing on it with their fingers. In fact, such manipulations can lead to milk stagnation.
What cannot be done so as not to provoke stagnation? To minimize the risks of developing lactostasis, you need to fully rest. You should refuse to feed the baby with a mixture, you should not often give the baby water to drink, you should not express milk unnecessarily and take a long night break during feeding.
How to relieve the symptoms of lactostasis? If a woman has milk stagnation, then it is necessary to try to attach the baby to the breast as often as possible. Sometimes it is enough to simply remove the white speck on the nipple, thereby removing the external blockage of the duct. Only regular breastfeeding or expressing milk with a quality breast pump can cope with internal blockage. Before you start feeding your baby, you can take a warm shower, drink tea, and do a light breast massage. Cracks on the nipples will heal faster if you apply ointments with a regenerating effect on them. However, a doctor must recommend them.
Is straining and warming your breasts beneficial? Sometimes you can come across stories about how midwives kneaded a woman's breasts with rough hand movements, and supposedly this got rid of lactostasis. In fact, any hard massage can seriously harm the mammary gland. In such a situation, rupture of a lobule or duct is not excluded, which will only worsen the condition. If you warm up your breasts, this will provoke the flow of milk, which means that it will increase its stagnation.
Can I ask my husband to suckle the breast? No. Sucking on the breast by a man does not lead to the production of oxytocin, which means it will not allow the ducts to open. In addition, millions of bacteria live in the mouth of an adult, and among them may be Staphylococcus aureus, which provokes the development of mastitis.
What are the prohibitions for lactostasis? During lactostasis, a woman should not be allowed to feel thirsty; it is also forbidden to apply alcohol and camphor compresses. The chest should not be squeezed, for example, by bandages or bandages. This will disrupt normal blood flow in the chest and cause complications.
Sometimes doctors themselves give bad advice, so who should you listen to? As a rule, surgeons with lactostasis advise to stop breastfeeding, pediatricians also insist on transferring the child to artificial mixtures. It is important to find a specialist who will fight to the last to ensure that the baby receives breast milk, but not to the detriment of the mother's health.
The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist
Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.