Lump in the breast during breastfeeding

Lactostasis, or stagnation of milk in the breast, is the most common problem among nursing mothers. We will give you some recommendations on how to deal with such a situation. The initial signal of milk stagnation is unpleasant symptoms in the mammary gland area, when any area is painful to touch.

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Upon palpation, you may feel a lump or compaction that has formed. Another sign of lactostasis is complete hardening of the breasts. Lobules in the mammary gland can be felt.

The main causes of lumps in the mammary gland during breastfeeding

Stagnation is a phenomenon when the outflow of milk from the breast area stops or is disrupted. It can be due to various reasons, the most common of which are:

1. Long interval when breastfeeding.
2. A monotonous method of “releasing” the mammary gland (as a rule, this occurs during pumping, when due attention is not paid to any area of ​​the breast).
3. Stagnation after a night's rest, when the mother was in an unfavorable position for a long time or lay on her side.
4. A significant reduction in the amount of milk consumed by the child (usually occurs during the period when complementary foods are introduced, at 5-6 months).
5. Blockage of the mammary gland ducts, which is caused by the formation of cracks in sensitive areas - the nipples.

Breast tumor

Facts of the degeneration of a benign tumor into cancer are described only for atypical ductal hyperplasia and for benign processes with proliferation and dysplasia. All of these conditions cannot be determined by examination, ultrasound, mammography or other non-invasive tests. They can only be detected by a biopsy and examination under a microscope of the formation that was found using the above non-invasive diagnostic methods.

Even the detection of atypical hyperplasia, dysplasia or proliferation does not guarantee the development of breast cancer: these conditions only increase the risks by a maximum of 4 times. In most women, these conditions never develop into cancer.

Not every tumor found in the breast is necessarily malignant or will become so!

What measures to take if milk stagnation occurs?

Regardless of the reasons for stagnation during breastfeeding, the actions taken should be the following: get rid of stagnant milk, or rather, strain and free the mammary gland from milk. To do this you need:

• Place the baby on the breast where congestion occurs. This should be done so that the area of ​​compaction is located under the lower lip of the newborn. If the lump is in the upper part of the gland, it should be positioned with its feet towards the mother's face.
• Take a hot shower, then, after thoroughly warming up and relaxing, massage the breast area. Then you can express milk directly in the bathroom.

If such measures do not help remove the lump in the breast area, you should contact a local consultation or call an obstetrician-gynecologist at home. To hesitate in this case means to aggravate the situation: the compaction will increase, and after a short time you will not be able to raise your arm due to unbearable pain.

“Stone” breasts - what to do?

author: Victoria Nesterova IBCLC

This article is for mothers who are faced with breast fullness in the days when colostrum is replaced by milk (usually 3-4 days after birth, but maybe a little earlier or later). Also, the described techniques can be useful for breast swelling in the first or second day (even at the stage of colostrum).

So. The milk has arrived. The breasts filled up and became not just heavy, but very full and painful. Even the temperature sometimes rises for a day. Sometimes it's really scary. And if it’s also difficult for a child to grab it, what to do and what not to do? What do you need to know first?

Go. Point by point details:

1. Read carefully: this is temporary . After 1-2 days, the breasts will enter the “working” mode, deal with the new working conditions, and the feeling of heaviness and fullness will go away. You not have such breasts throughout the feeding period. It is important for you and your baby to work well during these one and a half to two days, helping your breasts - and everything will work out. 2. What to do now ? The most important rule: do not let your breasts “rest.” She must work, give milk. Then the sensations will return to normal sooner.

An example of the wrong tactics is when your breasts begin to fill up, take a break from feeding until the morning - and what if it resolves somehow on its own. Right now.

An example of a correct one is to start feeding the baby more often, waking him up if he sleeps for too long. Pay attention to correct application (articles about how to assess whether it is correct and how to apply) 3. About awakening . Milk begins to come in, new sensations appear - we switch to the “ feeding on mother’s demand ” mode. You have every right to wake up your baby and ask him to help you if your breasts are already “calling.” This is also temporary. 4. Keep the path for milk clear . a. There are different options for the arrival of milk: if everything is in order, the breast may become hot, heavy, even with some kind of compaction, but at the same time the areola remains elastic, the baby can latch on well (captures both the nipple and the areola), the milk flows freely. After feeding, such breasts become noticeably softer and lighter. In this case, you don’t need to do anything special, just apply-apply-apply (see point 2). Everything will return to normal very soon (see point 1)

b. But in some cases, and all sorts of stories are told about them, it turns out that swelling of the breast and areola is added to the fullness of the breast.

• The breasts feel “stony”, very painful, the areola is inelastic and overcrowded.
• Pressing on the areola is also painful (sometimes very painful! and this pain even interferes with feeding the baby).
• The nipple becomes flattened.
• The milk does not flow out - swelling interferes, blocking its path.
• It may be difficult for a child to latch onto such a breast; he slips from the dense areola (like a ball) onto the nipple or cannot latch on at all.
• Feeding often does not provide relief due to the fact that milk does not come out.
• Expressing milk isn't very good either.

This situation is called engorgement. Here the breasts and baby need additional help, which we will talk about. The main thing is to remember that this is not the end of the world and everything will work out.

Inside, breasts with and without engorgement differ in the level of swelling (diagram, just for clarity):

Algorithm of actions to prevent engorgement: Frequent latching of the baby (or pumping if for some reason he cannot breastfeed on his own) from the first days - even at the colostrum stage. In the right position! In different (if possible) and comfortable for mom (this is a must) positions. Drinking regime is normal, according to thirst. Research has shown that limiting drinking does not help prevent engorgement. We won't get anything but dehydration for mom. What to do with the breasts if engorgement has already occurred? Open the way for milk. An indispensable and very effective technique is the technique of softening the areola with pressure according to Jean Cotterman. Minimum 1 minute, if engorgement is more severe - 2 or 3 minutes.

What happens in this case: the fingers gently and painlessly squeeze the excess swelling deeper. For a while, the areola again becomes soft and elastic, the nipple becomes more pronounced, but most importantly, the path for milk - the ducts - is cleared. The baby can latch on - and can receive milk.

Once again, a detailed article is here. Let's study it carefully! This is the key to painlessly “resolving” the situation with stone/very painful breasts from fullness. The way they knead sometimes in maternity hospitals is barbaric, because forceful kneading of a swollen, congested gland is not only very painful, but also pointless - in this case, the path for milk is blocked! The areola is swollen, the ducts are pinched... "Stone" breasts can be brought into working condition much more effectively in such a soft, painless way.

For greater effect, we soften it with pressure like this: Lay down on your back. Place a pillow under your shoulder blades so that your chest is even higher. We throw the arm on the side of the chest that we plan to work with to the side. Several times with the edge of the palm we gently stroke the breast from the nipple towards the subclavian lymph nodes - i.e. to the collarbone, and to the axillary - to the armpit. Movement is as if we are dispersing water. The goal is to preliminarily “disperse” the swelling. It is he who gives the pain and stoneness, and not the actual milk. (thanks to Jean Cotterman, Maya Bohlman, Tatyana Kondrashova for ideas). After this - actually softening with pressure - we place our fingers around the areola and hold the “daisy”. Minimum one minute, longer if necessary. You will feel the areola becoming softer, your fingers seem to sink deeper.

Wait... Wait... Remember - at least a minute (by the clock!), longer if necessary... Your goal is an elastic areola like a lip or earlobe. Milk may begin to flow out - but we hold it and wait further. For an additional effect, after softening the pressure, you can additionally pick up the area around the areola with your hands.

Manual pumping technique - read the link.

The difference is that the fingers are closer to the nipple, and not on the border of dark and light skin. Your goal is to soften the areola a little more. A little milk will flow out and the areola will become even softer. Is the areola completely soft and painless when squeezed? That’s it, you can latch on to your baby (or express if he’s not breastfeeding yet). Now the milk will flow out and the sucking will be effective, the breast will soften further.

Applying in a position where the baby is lying on top of the mother (the mother is half-sitting), by the way, is a good option to further remove swelling. And the baby’s own reflexes work more effectively this way.

Gently stroke (or simply place your fingers on) the sore areas of the breast as you feed. The movements should not pull the nipple out of the baby's mouth. This will help empty the lobules faster.

No need to forcefully knead your entire breast! Stories about “pumping” are very impressive, but when the path for milk is closed (due to swelling of the areola), it is not only very painful, but also very pointless. Remember, if you soften the areola, freeing the ducts from being compressed by edema, the milk will flow, and engorgement can actually be removed almost painlessly. cold to the breast - a cool cabbage leaf washed with soap - until it wilts, or a bag of ice or frozen vegetables - always wrapped in a towel! - for 15-20 minutes. This will not “chill” the chest, but it will very well help relieve swelling. Repeat the preparation of the areola as long as necessary. Give yourself a little extra time before feeding. Don't forget that your breasts shouldn't rest ! If the child has eaten and eaten, fallen asleep and clearly no longer fits in it, and the breast is still full and uncomfortable, you can additionally help yourself by going to the shower (warm, comfortable) and pumping the breast a little while standing under streams of water. Let the water flow down your back, along the collar area. This way the milk flows out easily. Sometimes in the shower you just need to gently massage your breasts, lean over, and the milk will flow by itself. We do not strain until “dry”, but until relief is achieved, just to relieve the discomfort - for this, it is enough for about a teaspoon of milk to flow out. It became easier - we dried ourselves, got dressed, rested, and again bothered the baby. Picking up does not replace applying.

If the baby is very lethargic, sleepy, and losing weight, it may make sense to collect expressed milk and give it to him from a spoon or from a syringe without a needle. Look at the circumstances.

Useful video: breast massage for engorgement and pumping from the wonderful consultant Maya Bolman IBCLC

The Basics of Breast Massage and Hand Expression from Maya Bolman on Vimeo.
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Dangerous consequences of lumps in the mammary gland during breastfeeding

Mastitis is the most hated consequence of stagnation. And if mastitis is not treated in time, purulent formations may appear in the mammary gland, which will require surgical intervention.

This means the end of natural feeding. That is why everything must be done to prevent the formation of mastitis. A spontaneous feeling of heat (temperature up to 40 °C) should alert you. The main thing is not to panic and consult a doctor in a timely manner. With the help of physiotherapeutic and ultrasound procedures it will be possible to clear the ducts.

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Causes

Lactation mastitis is common in nursing mothers. A prerequisite for the development of this problem is lactostasis - stagnation of milk in one or more lobules of the mammary gland and the subsequent addition of bacterial flora to the ongoing process. A wide range of factors contribute to this. The main ones are:

• Small cracks on nipples. It is through the nipples that infection most often enters, so the slightest damage can cause the penetration of pathogenic flora and the appearance of the first symptoms.
• Weakened immunity and unstable hormonal levels associated with recent childbirth.
• Neglect of hygiene rules, which creates favorable conditions for infection.
• The presence of chronic bacterial diseases such as tonsillitis or sinusitis.
• Milk stagnation associated with insufficient pumping or irregular feeding.

Even one of the listed reasons can lead to unpleasant consequences. Therefore, it is necessary to monitor your health and react at the first symptoms of mastitis.

Reasons for appearance

The formation of compaction in nursing women is facilitated by the anatomical structure of the milk canals and external factors. Among the various reasons for the appearance of a ball in the mammary gland are:

1. Narrowing of the milk ducts. This structural feature complicates the process of fluid separation during lactation. The problem is relevant for women with increased milk production.
2. Unorganized breastfeeding regimen. An indiscriminate approach causes a delay in the flow of milk and contributes to the accumulation of fluid in the mammary glands. Feeding the baby should be done regularly and correctly.
3. Rare breastfeeding. If the mother does not have time to feed the baby on demand, the risk of stagnation increases.
4. Breast injuries and strong compression can trigger an inflammatory process. As a result, pain is felt, lactation is disrupted, and swelling occurs. It can also lead to the formation of globules in the mammary glands in women.
5. Abrupt cessation of feeding the child. There can be many reasons for such an action. However, it should be remembered that weaning should be done in stages.
6. Tight underwear can also cause lumps to form. Breastfeeding women should not wear a bra with hard underwire.
7. Milk with increased fat content and density usually flows worse and leads to stagnation.
8. It is not recommended for a nursing mother to sleep on her stomach. Incorrect posture causes pressure on the breasts, which leads to a delay in milk flow.
9. The structure of the nipples. It can be difficult for a baby to attach to the breast correctly, so he is not able to fully empty the mammary gland.
10. Refusal of a newborn to breastfeed.