"I'm worried I will need to stop breastfeeding if this doesn't improve!"
Mastitis, blocked ducts, and blebs (milk blisters) are common breastfeeding & pumping issues, but their impact on mothers often goes beyond the physical pain. Mastitis, an infection that causes breast inflammation, can make breastfeeding and pumping excruciating and leave a mother feeling fatigued, feverish, and depleted. Blocked ducts and blebs can feel like painful obstacles, preventing milk from flowing freely, often leading to frustration, tears, and a sense of helplessness. The idea of giving up on breast milk—something that many mothers value so deeply—because of these challenges can be heart-wrenching.
Breastfeeding and pumping is often seen not just as a method of feeding but as an emotional lifeline, reinforcing a mother’s connection with her baby. When issues like mastitis or blocked ducts arise, the possibility of being forced to stop can feel like a personal failure. Many mothers blame themselves or feel like they are losing control over a significant part of their early motherhood experience. The fear of losing that closeness, of not being able to provide nourishment in the way they’d hoped, can take an emotional toll.
The Urge to Power Through the Pain
For mothers who are deeply committed to providing breastmilk for their baby, the instinct to power through the pain is strong. Many will endure significant discomfort in the hope that things will improve, clinging to the belief that if they can just get past this difficult phase, breastfeeding and pumping will become easier. Unfortunately, pushing through without proper care can worsen the situation, leading to further complications and, in severe cases, the necessity to stop lactation altogether. This scenario often compounds the emotional strain, leaving mothers to grapple with feelings of guilt, frustration, and disappointment.
Shifting the Focus: Looking Beyond the Surface Problems
While mastitis, blocked ducts, and blebs are typically treated symptomatically—through antibiotics, anti-inflammatories, or changes in feeding positions—the root causes of these issues are often overlooked. Many mothers go through cycles of recurrent episodes or blockages, treating the surface symptoms without resolving the underlying problem. To truly address these challenges and alleviate the fear of having to give up breastfeeding or pumping, a deeper investigation into the background foundation of breast tissue is crucial.
The breast is a complex network of milk ducts, glands, ligaments, connective tissue and fatty tissues, all of which play a vital role in milk production and flow. However, issues such as inflammation, scar tissue, or even misalignment in the structure of the breast can hinder the normal function of these components, leading to recurring problems like mastitis and blocked ducts. Investigating these structural or tissue-based issues can provide more long-term relief than just treating the symptoms.
For example, some research suggests that structural issues in the breast—such as the formation of fibrous tissue or adhesions after previous problems—can restrict milk flow and make it easier for ducts to become blocked or inflamed. By focusing on techniques that address the health of the breast tissue itself, mothers can take proactive steps toward not only healing the immediate problem but also preventing future complications.
Therapies such as ultrasound, physical therapy, or specialized massage aimed at releasing scar tissue or improving circulation in the breast can help improve milk flow and reduce the likelihood of recurring blockages. Additionally, maintaining proper hydration and a balanced diet can support healthy tissue function and resilience, making the breast less susceptible to inflammation and infection.
Did you know? Dysphoric Milk Ejection Reflex (D-MER) is a condition that affects people who breastfeed or pump milk. It causes sudden and intense negative emotions just before you “let down” (release milk). It lasts just a minute or two, BUT causes intense unhappiness (dysphoria) & other unpleasant emotions. NOTE: As it's related to let-down it can also happen if your breasts accidentally have a let down at any other time, which can be common during lactation.
Why has the structural tissue in the breast been ignored as a cause?
The structural tissue of the breast has often been overlooked as a potential cause of breastfeeding problems like mastitis, blocked ducts, and blebs for several reasons, primarily due to traditional approaches to breastfeeding support that focus more on surface-level issues rather than the underlying anatomy. Here are some reasons why the structural tissue has been ignored:
1. Focus on Immediate Symptoms
Breastfeeding problems, such as mastitis or blocked ducts, are often addressed by targeting the symptoms directly—like treating infections with antibiotics or massaging blocked ducts. These interventions provide temporary relief, but they don't address the underlying issues. For example, while antinflammatories can treat inflammation, they do not resolve the root cause, such as underlying structural imbalances in the breast tissue that may predispose a mother to repeated blockages.
Since the immediate priority is often to relieve pain or restore milk flow quickly, healthcare professionals and mothers alike tend to focus on the surface-level treatment, ignoring what’s happening within the breast's foundation.
2. Lack of Understanding of Breast Anatomy
The anatomy of the breast is incredibly complex, consisting of lobules, ducts, glandular tissue, and connective tissues, including ligaments and fat. Historically, there’s been limited research into the structural elements of the breast, particularly how these tissues can influence breastfeeding success or contribute to problems.
Most breastfeeding support has traditionally focused on latch techniques, milk supply, and nipple health—factors that are more visible and easier to address. The role that structural tissue plays in supporting milk production and flow has received far less attention. This gap in research has made it less likely for structural issues to be recognized as a root cause of breastfeeding problems.
BE KIND TO YOU!
Many parents need help during different parts of their child-raising journey. Lactation health is so common a cause of stress & anxiety that the best thing to do is get help early. This may be a lactation consultant, a good GP, even a counsellor or psychologist if that's where your needs lie. Take care of YOU!
3. Lack of Specialised Knowledge
Lactation consultants and healthcare providers are usually trained to deal with the more obvious causes of breastfeeding issues, such as poor latching or feeding positions. However, the deeper causes related to the breast’s structure often fall outside their usual scope of practice. Physical therapists, massage therapists, or specialists who work with body mechanics may have more knowledge in this area, but they’re rarely part of the breastfeeding support team.
Without specialised training to identify and treat issues in the breast's connective tissue, healthcare providers may not recognize structural imbalances, adhesions, or scar tissue as the root cause of blocked ducts or recurrent mastitis. As a result, this critical aspect of breast health has been largely ignored.
4. Emphasis on Lactation Rather Than Breast Health
The primary focus of breastfeeding support has always been to ensure proper milk production and transfer. While this focus is crucial, it can overshadow the importance of breast health and the physical state of the breast tissue itself. The connective tissue and other structural components play an essential role in how milk is stored, produced, and expressed, but they don’t directly relate to how much milk is produced or how well a baby latches.
This has led to a divide between lactation management and breast health, with the former often getting more attention. Treating breastfeeding as a purely functional process—where milk is produced, stored, and delivered—leaves little room for addressing the impact of the underlying tissue structure on milk flow.
5. Scar Tissue and Adhesions Are Invisible
Scar tissue, adhesions, and other structural issues inside the breast tissue are not easily visible or detectable without specific diagnostic tools or techniques, such as ultrasound or manual therapy. This makes it difficult for healthcare providers and lactation consultants to detect these problems unless they have specialized knowledge.
For example, scar tissue from previous surgeries, injuries, or even past infections can restrict milk flow by compressing milk ducts or creating areas of inflammation. Without the tools to identify these hidden issues, the structural problems in the breast remain unseen and untreated, contributing to recurring complications like blocked ducts or mastitis.
6. Fragmented Healthcare Approach
Breastfeeding is often seen as a stand-alone issue rather than part of a broader maternal health picture. As a result, lactation consultants focus on feeding-related concerns, while other healthcare professionals, such as OB-GYNs or general practitioners, may address breast health in isolation, if at all. This fragmentation of care means that no single healthcare provider is looking at the whole picture—combining lactation and the breast's structural integrity.
Bringing structural tissue into the conversation requires a more integrated approach that looks at the breast as both a functional organ for feeding and a body part with complex tissue that can impact lactation.
Moving Forward: Why It’s Important to Consider Breast Tissue Structure
Recognizing the importance of breast tissue structure can offer a new perspective on why some breastfeeding problems persist despite addressing surface-level issues. Therapies such as manual lymphatic drainage, ultrasound, or specialized breast massage can help break up scar tissue, reduce inflammation, and restore milk flow by addressing the foundational tissue in the breast.
By taking the structural integrity of the breast tissue seriously, we can provide more comprehensive care for lactating mothers, helping them prevent recurring problems and continue breastfeeding with greater ease and less pain.
Hope for the Future building Confidence
For mothers struggling with mastitis, blocked ducts, or blebs, it’s important to remember that these challenges don’t always mean the end of the breastfeeding journey. By shifting the focus to the foundational health of the breast tissue, there’s hope for long-term solutions that can help sustain breastfeeding.
Rather than just managing pain or enduring through hardship, exploring the structural and tissue-related aspects of the breast can empower mothers to reclaim control of their breastfeeding experience. With the right support—whether that’s from lactation consultants, physical therapists, or healthcare providers who specialize in breast health—mothers can find a path forward that allows them to continue nourishing their babies without the persistent fear of having to give up breastfeeding.
Ultimately, caring for the breast as a whole, rather than simply reacting to the surface symptoms, offers a new perspective on overcoming these challenges. It opens the door to healing in a holistic way, providing both physical relief and emotional reassurance that breastfeeding can still be a cherished part of the motherhood experience.
Author: Dr Katie Willy
Osteopath & Your Two Jugs Co-Founder
Elise Fuller & Katie Willy
Osteopaths & Your Two Jugs Co-Founders
Elise & Katie are Melbourne based osteopaths who have been actively treating breastfeeding women in clinic since 2015. During 2020 lockdown they launched Your Two Jugs to educate more mamas about how to treat their own mastitis, blocked ducts and engorgement. Their online video based courses Boobology and Mastitis Rescue is available now with all the techniques we show our mamas in clinic.
Your Two Jugs is passionate about support for mamas from the top. Boob Hero is a comprehensive health care practitioner course to educate manual therapists on their contribution to supporting breastfeeding women with hands on care. Empowerment all starts with education, and the more support available for women, the better.