Updates to Treatment of Breast Inflammation: Engorgement, Plugged Ducts and Mastitis

EMILY WINTERS, RN, MSN, IBCLC June 10, 2025

Summary

As a breastfeeding parent, it is important to know how to handle somecommon breast health issues that can come up during lactation. Three of the main conditions are Engorgement, Plugged Ducts and Mastitis. In 2022, the Academy of Breastfeeding Medicine updated the recommendations for the treatment of these conditions, and many of the treatments that used to be suggested are no longer recommended. Medicine is constantly changing and we are always learning new and better ways!

Engorgement

Usually refers to the 3-5 days postpartum when colostrum starts to transition to mature milk and the breasts are heavy, transitioning to holding milk and postpartum swelling is causing some inflammation. It can also be used to describe anytime the breasts are full and uncomfortable.

Plugged Duct

A blocked duct is inflammation of a single milk duct that is not allowing milk to pass through. This can be identified by one area of the breast still feeling full and uncomfortable even after feeding or pumping.

Mastitis

Mastitis is inflammation of the breast tissue (more widespread than a plugged duct). If not cleared it can lead to an infection. The recommendation used to be treatment with antibiotics at the onset of symptoms, but the new recommendation is anti-inflammatory treatment (see below) for 24 hours first. Signs and symptoms include: Redness/warmth/pain to breast tissue, chills, fever, and increased heart rate.

New Treatment Recommendations

• Ice to affected area

• Gentle movement of the breasts and lymphatic massage

• Ibuprofen to help with inflammation

• Pump and feed as normal

• Sunflower lecithinand/or Probiotics (For persistent or frequent inflammation)

• Antibiotics- if symptoms worsen or do not improve within 24 hours

  
  

OLD Recommendations (No Longer Evidence Based Practice)

• Heat/warm shower

• Aggressive massage and vibration

• Dangle feeding

• Saline soaks/castor oil

• More frequent feeding or pumping

For additional support please reach out!