Milk Stasis

Milk stasis, or restricted milk flow, is caused by blocked milk ducts. Milk stasis is caused by incompletely emptied breast, where uneaten milk remains inside, blocking inflow of new batches of milk.

As the excess milk cannot flow out freely from the breast, milk stasis occurs. This may lead to painful swelling of both breasts caused by their fullness (breasts are hard, reddened, warmer, and milk does not flow out of them) or to local blocking of a milk duct, forming a small, palpable lump (or several lumps) under the skin. The area of the lump is reddened and painful to the slightest touch. Milk stasis is not accompanied by fever, although sometimes mum's temperature may be slightly raised. In such a situation latching the baby on is unpleasant and painful.   

Causes of milk stasis

Milk stasis can occur:

  • Often in the first weeks after the birth, during so-called breast fullness, when the baby sucks too rarely, too short, or is incorrectly latched on.

  • When you massaged and squeezed your breasts to rub the lump away and squeeze milk out, e.g., during breast fullness, this only aggravates the problem, as pressure on the breasts may damage the swollen milk ducts and cause great and unnecessary pain.  

  • When you extracted great quantities of milk, to completely empty the breast. This action is doomed to failure, as the breast is never empty. When milk is extracted from the breast by the baby and the breast pump, the breast will respond by producing enough milk for the baby and the pump... The baby will eat his fill, and what about the rest? This situation, when there is more milk then the baby needs, always poses a risk of milk stasis.

  • When you do not give the breast to the baby because of painful nipples. Milk is still produced in the breast that is not regularly emptied, and this leads to milk stasis.

  • When the baby slept during his meal time, and the breasts were not emptied on time. Similar situation occurs, when the baby is ill or teething painfully, and refuses to suck the breasts which continue to produce the same amount of milk as the baby needed when he was healthy.

  • When you started supplementation with infant formulas, and the baby extracted less milk from the breast.

  • When you give the baby additional sweetened drinks, and the satiated child demands the breast less often, or sucks only for a short time.  

  • When the baby grasps the breast too shallowly and sucks incorrectly. This way, he extracts milk only from those ducts that are located close to the areola, causing milk stasis in deeply located ducts.

  • When you feed the baby in an incorrect position, preventing him from correct grasping and emptying of the breast.

  • When you squeeze your breast during breastfeeding, blocking milk outflow.

  • When you wear too tight a bra, pressing on the breast.

  • When the breast was injured, e.g., the baby kicked it and damaged a duct.

  • Due to weariness, stress, nervous situation, depression. These conditions inhibit secretion of oxytocin responsible for milk flow.  

What you can do

When you suffer from milk stasis, you must act immediately, as when ignored it can easily turn into mastitis. To avoid that, follow the tips below:                

  • When the stasis is caused by raw nipples, treat them (read about this in the chapters: What to do with painful, sore, cracked or bleeding nipples or Fungal infectionBacterial infection).

  • Feed the baby from the affected breast as often as possible (start two or three feedings with the affected breast, then one with the healthy one, and then again two or three feedings with the affected one).

  • When the pain during feeding is very strong, use painkillers. Take paracetamol or ibuprofen about 20–30 minutes before feeding.

  • Rest a lot. Ask somebody to help you with house chores, and do only what is really necessary.  

  • Before feeding, put a warm compress on the breast to facilitate milk flow. Use a heated tetra nappy or a towel soaked in warm water to make the compress. You can also warm the breast with a warm shower.

  • Adjust your feeding position, so the baby sucks milk from different breast areas. When you have fed your baby holding him in front of you, now place him under your arm to suck from the part of the breast with milk stasis (read more in the chapter Breastfeeding positions - seating or underarm positions).

  • During feeding, caress the breast slightly from the base towards the nipple (especially in the lump area), to facilitate milk flow. Remember that strong rubbing, squeezing and kneading may damage swollen milk ducts and result in mastitis.

  • After feeding, put a cold (but not very cold!) compress on the breast, e.g., of cold nappy. Cold compresses will slightly inhibit lactation, as well as reduce bacterial growth. Also compresses of cooled and slightly crushed white cabbage leaves on breasts will bring some relief (cabbage juice has an astringent and anti-inflammatory properties).

  • Wear a comfortable bra that supports the breast well without pressing on them. During the first weeks after the birth, when the lactation is not stable yet, wear bras without underwire.

  • When the baby does not want to suck the affected breast (because milk flows slower out of it) or completely refuses to suck, extract some milk from the painful breast, but just enough to feel some relief. By extracting large amounts of milk you will stimulate lactation unnecessarily and aggravate the situation.

  • Do not let anybody to talk you into breast bandaging, as this will not remove milk stasis, and can damage swollen milk ducts.

  • Drink a lot. If you do not drink enough, you may become dehydrated.

  • When the milk stasis was caused by problems with milk flow (that is, spontaneous letdown reflex is inhibited), it means you need more peace and rest. Try to relax, feed in a quiet, cozy place. And if this does not help, ask a doctor (preferably a gynecologist) to prescribe you oxytocin, supporting the letdown reflex. Nowadays, liquid oxytocin formulation (as for injections) is used, with which you wet gauze swabs and put them into your nostrils about 5 minutes before feeding/extracting; this facilitates spontaneous letdown reflex. It should not be used more than just a few times, and always after consulting a doctor or a lactation consultant/advisor.  

Is breastfeeding still possible?

Absolutely! Breastfeeding is the most effective treatment for milk stasis. The little snacker will empty the breast most effectively. No breast pump is a match for him, particularly, when the breast is not used to mechanical milk extraction.