Mastitis is an inflammation of the breast that is most often related to breastfeeding. With mastitis, redness is usually seen in only one section of the breast.

Physiotherapy can safely and effectively treat blocked milk ducts. Most blocked ducts generally resolve on their own within 24 to 48 hours after they start, but if your blocked duct persists, therapeutic ultrasound may be an effective solution for you.

What is a blocked duct?

Lactating mothers produce breast milk. Breast milk is transported through specialized ducts in the breast to the nipple, where the baby receives the flow while sucking. Occasionally, one or more of the breast ducts may become blocked by milk, leading to a red, tender lump or firm area in the breast. Some nursing mothers may also get a white spot on their nipple known as a ‘bleb’. Blocked ducts generally occur when there is slow emptying of the breast duct- This can happen for many reasons, pressure from a tight bra or strap, a poor latch from baby, or because your baby is not feeding long enough or missing feedings.

A blocked duct can be very painful, and milk flow from the affected breast will also be slower than usual, which can also cause your baby to be upset.  This may create a stressful and uncomfortable breastfeeding experience.

How does therapeutic ultrasound work?

Ultrasound for blocked ducts is a conservative treatment which helps to drain the breast of the milk blockage. An ultrasound machine sends sound waves with gentle heat through the breast tissue, providing a ‘micro massage’ to the blocked area. This unclogs the duct and encourages milk flow through the breast.

Steps include:

• Assessment to determine affected tissue and area rdequiring treatment.
• Obtaining a detailed history on breastfeeding and factors that may have contributed to the blocked duct or mastitis.
• Ultrasound applied to the affected breast tissues. The ultrasound probe is moved around the affected breast tissue, it is not painful, and gentle warmth will be felt. 
• Breastfeeding advice and treatment plan regarding positioning, what to do before and after breast feeding and how to maximize milk flow and reduce duct compression. 
• Demonstrations on how to properly self massage to promote lymphatic drainage rather than compressing the ducts.

Following treatment is an optimal time to feed your baby or pump the affected breast to fully release and drain the milk from the breast. You will feel a softening of the breast after the treatment, as well as a significant reduction of the uncomfortable symptoms of the blocked duct. Sometimes, but not always, two treatment sessions are required to get this effect. However, consecutive treatments have been shown to prevent the blockage from recurring in the same duct.

Additional strategies to help with a blocked duct:

• Empty the breast frequently through nursing or pumping often.
• Hand express breast milk before or after a feeding.
• Change feeding positions to each breast to ensure the emptying of each duct.
• Maintain a healthy diet while staying well hydrated.
• Place a warm compress over the blocked duct while gently massaging the affected area.
• Consult a lactation consultant to ensure baby is latching properly and to assess your technique.

Should I see my doctor?

If this is your first experience with this condition, it is important to ensure that an infection is not present in your breast. If you are experiencing fever or chills along with the breast tenderness, schedule a visit with your doctor.  Treatment with antibiotics may be necessary if an infection is present.  A physiotherapy session for ultrasound can be scheduled following and your doctor will advise you to do so.