Seven steps for when your milk-making breast develops a painful red lump

Breasts that make milk are lumpy. These lumps disappear after breastfeeds. If you have an inflamed breast lump, here are the seven things to do.

1. Never try to massage or rub away a breast lump. Deeper massage bruises the sensitive, highly vascular tissues of a milk-making breast and worsens the lump. Light massaging up towards the armpit doesn't help drain away fluid, and might make inflammation worse for some women.

2. Offer the affected side for a breastfeed as often as possible, without ever pressuring the baby. Let-down or milk ejection results in dilation of the milk ducts. Dilation of the milk ducts relieves inflammation.

3. Frequent short breastfeeds are more effective than long less frequent breastfeeds for resolving a breast inflammation. This is because milk ejections occur more often with frequent short feeds than longer, less frequent feeds.

4. Consider gentle hand expression milk from the inflamed breast if baby is not interested in feeding and more than a couple of hours have passed. You can see a video about how to hand express here.

5. Fever is a sign that your body is revving up your immune system to help heal the inflammation. Anti-inflammatories or paracetamol don’t heal inflammation, so you don’t have to take them. Too much anti-inflammatory medication might weaken your body’s inflammation-fighting powers, though, so it’s best to use anti-inflammatories and paracetamol sparingly, just when you need them.

   • Anti-inflammatories effectively relieve muscle aches and breast pain, so you might take them at bedtime to help with sleep.

   • You might take them during the day sometimes for comfort.

6. It might be a few days before the fevers settle, the lump shrinks, and you begin to feel better. If after a few days you are feeling worse, or the lump continues to enlarge or worsen, see your doctor. If you are worried about how sick you are feeling at any time, see your doctor.

7. See your doctor if

   • A few days have passed and you are feeling worse

   • A few days have passed and the lump is continuing to enlarge or worsen

   • You are worried about how sick you are feeling at any time

   • A breast lump, whether painful or non-painful, persists for a week. Your doctor will usually talk with you about having an ultrasound to make sure there's no abscess. Also, breast cancer in a milk-making breast can spread fast. It’s vital to make sure any persistent lump is harmless (which it mostly is, just not always).

You can use an ice pack if you want to, but it doesn't help heal breast inflammation and is often more bother than it's worth. Cold causes milk ducts to narrow, at a time when you want your milk to flow as much as possible. If you decide to use an ice pack, make sure you don't apply any pressure over the area of inflammation, and that the ice isn't directly applied to the skin and breast so that it causes damage from freezing. Many women decide it's easier and more effective just to see if the baby wants to suckle for a minute.