If your breast feels sore, lumpy and hot, you're not alone — blocked ducts and mastitis are common, especially in the early weeks. The good news is that most cases settle with simple home care. Here's how to look after yourself, why you should keep your milk moving, and the signs that mean it's time to ring for help.
What's happening
A blocked duct is a tender, firm lump in one part of the breast, often with a small area of redness. The skin and tissue around it can become swollen and inflamed — this is mastitis. It may or may not involve an infection. Mastitis usually affects one breast and can come on quickly.
Common triggers include oversupply, long gaps between feeds, pressure on the breast (tight bras, sleeping positions, baby carriers), a shallow latch, or simply being run-down and exhausted.
Symptoms to recognise
- A hard, tender lump or wedge-shaped firm area
- Red, warm, swollen skin (redness can be harder to see on darker skin — go by warmth, swelling and tenderness)
- Aching or burning, sometimes worse during a feed
- Feeling generally unwell, achy, shivery or flu-like
- A raised temperature or fever
Self-care that helps
Think gentle. Current breastfeeding-medicine guidance has moved away from the old advice to massage hard and "pump out" the lump — that can worsen the inflammation and swelling.
Easing a blocked duct or mastitis at home
- Rest as much as you can — get into bed with your baby and feed lying down if that's comfortable.
- Keep feeding or expressing normally from the sore side; don't suddenly stop.
- Apply a cool pack between feeds to ease swelling and pain; brief warmth (like a warm shower) just before a feed can help milk let down.
- Stroke the breast very gently towards the nipple and armpit to encourage drainage — soft, light touch only, no deep digging.
- Loosen tight bras or clothing and avoid pressure on the area.
- Stay well hydrated and ask your pharmacist or GP about suitable pain relief.
Keep feeding and removing milk
This is the single most important thing: milk needs to keep moving. Stopping suddenly makes a blocked duct or mastitis worse and can lead to an abscess.
- Offer the sore side as normal — your milk is safe for your baby.
- Feed responsively rather than to a rigid schedule; aim for comfortable, regular drainage.
- Vary your feeding position so different ducts drain.
- If your baby isn't fully softening the breast, hand express or pump gently to comfort, not to empty completely — over-emptying signals your body to make even more milk and can worsen oversupply.
- Check baby's latch and positioning, as a shallow latch is a frequent culprit.
If you're worried about supply or how much your baby is taking, your child-health nurse or a lactation consultant can help.
When it's urgent
Mastitis can move fast. Mild symptoms may settle in a day with rest and milk removal — but don't wait it out if you're unwell.
| Situation | What to do |
|---|---|
| Mild lump, no fever, feeling okay | Self-care; review in 12–24 hours |
| Symptoms not improving after 12–24 hours of self-care | Contact your GP |
| Fever, chills, or flu-like aches | See your GP promptly — you may need antibiotics |
| Rapidly spreading redness, severe pain, or a firm tender swelling | Seek urgent medical care |
| You feel very unwell, or symptoms keep returning | Get reviewed — this needs proper assessment |
A note on your baby
Your breast milk is still safe to give while you have mastitis. If your baby is under 3 months and develops a fever of their own, that always needs urgent medical assessment — ring your doctor or health line straight away.
Regional guidance
Australia's Australian Breastfeeding Association and Raising Children Network, the AAP (HealthyChildren) in the US, and the Academy of Breastfeeding Medicine all agree on the core message: keep milk moving, rest, use cool packs and pain relief, and seek medical care for fever or symptoms that don't improve. Up-to-date guidance leans away from forceful deep massage and "fully emptying" the breast, favouring cool packs between feeds, gentle stroking and comfortable, responsive feeding instead.
Every situation is a little different. For anything that worries you, or if you're unsure, please reach out to your GP, child-health nurse, midwife or a lactation consultant — that's exactly what they're there for.