Pain-Free Breasts: Troubleshooting for Mastitis and More

Published on: September 15, 2019

As first-time mothers, most women aren’t prepared to deal with particular situations that may arise when breastfeeding. Our lactation counselor offers some quick troubleshooting that could help you if you encounter a sudden lump on your breastfeeding journey.

By Lia Segall Pasternak

When my first son was born, I didn’t know anything about breastfeeding, except that it seemed natural. In the movies, they always show a happy, tired mum who just had a baby. She puts the baby on the breast, and then the baby eats—that’s it right??? … WRONG!

It was a hard lesson to learn. My baby was about two weeks old, I thought I had everything under control, and I was finally starting to feel like a human again when suddenly I got a fever. From one minute to the next, I was in a lot of pain and was feeling terrible! 

My husband and my mum panicked. They wanted to take me to the ER. I had a tiny baby to feed and all I could think about was how cold I was and the pain I had in my breast.

After digging around on Google, I learned I had mastitis and found all kinds of home remedies to deal with it. Luckily for me, I was able to manage it and recovered well. 

BUT. Please don’t do what I did! 

After a few months, when I decided to become a lactation counselor, I found out that if I had done the wrong thing, I could have risked my whole breastfeeding journey and even my health.

Do consider it critical to consult a lactation professional if anything doesn’t feel right when nursing your baby. Mastitis and similar issues are mostly caused by a bad latch or problems with breastfeeding management, so you need to see someone to keep it from recurring.

Three most common breastfeeding problems

Clogged duct

These are little (or big) lumps that you can find on your breast that are sometimes painful and sometimes not. 

These lumps appear because some hardened milk blocks the ducts that are supposed to let the liquid flow to the nipple. The milk gets hard because the breast wasn’t drained properly. Commonly, clogged ducts can be caused by a bad latch or a bra or carrier that’s pressing on a specific point. 

When you feel a lump, the best way to treat it is to apply heat. Start massaging the lump, pushing towards the nipple, and hand express milk so you can extract the milk from that specific point. You can use a breast pump if you combine it with massage, or go into the shower and massage and hand express to help release the clog with warm water.

Pro tips:

– Invest in a good quality well-fitted nursing bra, and consult with a professional on choosing and using your baby carrier. 

– Fix your baby’s latch. Consult a lactation professional, even very subtle adjustments to baby’s position can prevent clogged ducts. 

– You can use a silicone breast pump like a Haakaa (see fig 1) inside the shower, the warmth of the water can be soothing and can promote letdown, to clear the clog. 

– Taking soy lecithin, a supplement available in capsule form from pharmacies is safe for breastfeeding. It does not change the constitution of your breastmilk, but it homogenizes it, dispersing the fat globules throughout the milk to prevent clogging.  


Also known as a milk blister, a bleb is a white dot that appears on the nipple and it might be painful. It hurts because one of the exits for milk will be closed. It can cause an inner clog as well. A bad latch is usually the cause. 

The best way to treat a bleb is by rubbing it with a warm wet towel or gauze after a shower, trying to hand express and some massage to push the milk out from that point. Most importantly, you need to fix the latch and try different breastfeeding positions. A great position to deal with this is placing your baby on its back and nursing on all fours (Dangle feeding)—gravity will help clear the clog and the bleb. 

Whatever you do, do not pierce the bleb with a needle yourself. If you feel it needs to get drained, ask a lactation professional to do it for you.


When you don’t treat a clogged duct or bleb, it can quickly become mastitis. Mastitis is defined as inflammation of the breast tissue or ducts. It is sometimes but not always accompanied by infection. Symptoms include a red, hot, sore area on the breast, fever, and flu-like symptoms. If not treated promptly and adequately, mastitis can develop over time into an abscess or even sepsis, which can be life-threatening. It is vital therefore to seek medical attention for suspected mastitis, the key is to act quickly. Initially the inflammation may be managed with heat, rest and pain relief, however, you may be prescribed antibiotics (suitable for breastfeeding)if there is evidence of bacterial infection.  Ongoing management can include taking regular analgesia (Ibuprofen is anti-inflammatory) applying warm compresses, resting, and keeping your breasts empty. You can massage your breasts to help clear the infected area, especially when hand expressing or pumping. If you do this symptoms should improve within 24 hours though you should continue any prescribed medication to the end of the course, and consult your doctor again if symptoms do not improve. You should also consult a lactation professional to fix the latch to stop the problem recurring. 

Tips to prevent these problems

An ounce of prevention is worth a ton of cure, so here are some tips for avoiding those pesky lumps:

  • Make sure your baby is emptying your breasts properly after meals. You should feel the are breasts emptier after nursing, and there shouldn’t be any hard, painful areas.
  • If you feel pain or discomfort, make sure to pump or hand express enough milk to feel relief but no more, so you don’t create an oversupply.
  • If you’re dropping a feed, do it gradually. You can shorten the feed or pump/hand express a little bit for a few days until your body gets used to it.
  • If you’re leaving your baby, make sure you take your breast pump with you and don’t let your breasts get too full, painful, or uncomfortable.
  • Come to BAMBI Bumps, BAMBI New Moon, and Bangkok Breastfeeding Cafe to be surrounded by other mums and breastfeeding professionals, who will be able to guide and help you if you need to know anything related to breastfeeding and becoming a mother.

Hopefully, these tips will help and you will not have to experience any of the mistakes I made as a new mum. Find out more at BAMBI Bumps & Babies.

Image courtesy of Kevin Liang on Unsplash. 

This article is not to be taken as medical advice. Please see a healthcare professional if you experience any of these issues.

About the Author

Lia was born and raised in Mexico, she moved to Israel in 2010, got married and had a son in 2014 who made her fall in love with breastfeeding.

Lia quit her job and went to study to become a lactation counselor.  After moving to Thailand in February 2017, Lia started volunteering with BAMBI Bumps and Babies and Bangkok Breastfeeding Cafe. She had Maya, her daughter, and continues to give all mothers a human approach and support on their breastfeeding journey. 

The views expressed in the articles in this magazine are not necessarily those of BAMBI committee members and we assume no responsibility for them or their effects.

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