How to prevent breast engorgement and mastitis when breastfeeding

Updated: Jun 22, 2019

Engorgement is more likely to occur when breast milk remains stagnant in the ductal network for too long, restricting the regular flow of milk.


The volume in the breast needs to be flowing at regular intervals to reduce the risk of blocked ducts, engorgement and mastitis.


High volume milk that is not flowing regularly may result in a thickening of the milk and that may progress to inflammation, painful hard lumps and possible infection.


In my experience it is really important for the baby to be in symmetrical contact with the breast to improve and ensure effective intra-oral function and milk transfer.

A common cause of engorgement is related to the history of a delayed or interrupted first breastfeed following the birth of the baby.


Any interruption to breastfeeding, or feeding with other milk products over the first 72 hours can compound the engorgement and increase the risk of mastitis.


Many women have also experienced engorgement when they miss a feed (say overnight) or when the baby starts extending sleep periods.

If in doubt, relieving the pressure in the breasts keeps the milk flowing. Many women are unaware that gently expressing the breasts, just for comfort during these extended spacing of feeds relieves the pressure in the breasts and therefore reduces the risk of milk pooling, breasts becoming engorged, blocking of ducts and mastitis.

Mastitis can be inflammatory (to start with) and can develop into infectious mastitis and sometimes the formation of an abscess.


Antibiotics is the first line of treatment for infectious mastitis and encapsulated abscess. Furthermore, draining of an abscess may be necessary.


Mastitis can be associated with localised inflammation, a rise in body temperature, hot and cold chills and aching joints.


Women describe this as feeling similar to flu symptoms and the onset can be quite rapid. It is preferable to relieve engorgement as soon as possible either by breastfeeding or by expressing, to reduce the risk of mastitis.



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Dr Robyn Thompson

The Thompson Method
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