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Complications with expressing and breastfeeding

Mastitis is a breast infection that can be caused by blocked milk ducts, but this is not always the case. It can also be caused by cracked nipples, since infection has a route through which to enter the breast.

If you have mastitis, you may have some of the symptoms of blocked ducts (see below). However, mastitis also causes flu-like symptoms and a general feeling of being unwell. It may need treatment with antibiotics and therefore it is important you consult your doctor.

It is also very important not to stop expressing, as this can make the symptoms worse. Don’t worry – your milk is still safe to use.

Blocked ducts
Milk travels to the nipple through tubes called ducts. Sometimes the milk ducts can become blocked. Symptoms are pain or redness in the area around the blocked duct or a hard lump in the breast.

Blocked ducts can occur when the breast is not well drained, and therefore can be more of a risk for mothers who are expressing their milk.

There are many things you can do:

  • massage the affected area before and during expressing.
  • use a hot towel on the affected area or take a hot shower.
  • express milk with a pump. 
  • avoid underwired bras and tight clothing.

Thrush is a yeast infection that can cause pain when expressing. It can be passed from mother to baby when breastfeeding.

The symptoms are painful breasts or a burning feeling. The nipple can also become red and shiny.

If you think you have thrush, it can easily be treated. It is best to seek advice from the nurses on the neonatal unit. Both you and your baby should be treated.

Sore nipples
One of the most common pumping problems with expressing is sore nipples. To help prevent sore nipples, make sure the funnel is the correct size. If friction is created while expressing, you may need a larger size of breast shield. Ask your nurse, midwife or lactation consultant for advice.

Always apply the lowest vacuum setting that will produce milk. High vacuum won’t make the milk flow any faster and may make your nipples sore.

Small amounts of milk
It is common for mothers to express only small amounts of milk. Reasons for this can include being in a hurry, a collection set that is too small or not allowing enough time for milk ejection to occur before using a pump.

If your supply decreases
Occasionally, when mothers have been expressing for several weeks, the milk supply will suddenly reduce for no apparent reason. Usually, this is just temporary. It does not necessarily mean that you are losing your milk supply.

Try not to focus on the amount of milk gathered when you express, but do ensure you are expressing eight to 10 times per day. Concentrate on relaxing and take practical steps to trigger milk production:

  • Expressing with your baby near by, breast massage and Kangaroo Care are all helpful ways to increase your milk supply.
  • Sometimes changing the method you use to express can also help. For example, if you are double-pumping, try single-pumping with extra massage, or vice versa.
  • Hand expression will give you more control over the way your milk is expressed and may also be helpful in other ways too.
  • Some mothers say that having a photo of their baby near by when they express also helps.

It may be helpful to express in short bursts. Try expressing either once an hour, over a period of eight hours in a row, for 15 minutes each session, or every two hours for about 30 minutes each session, if you can manage.

You may need to set some time aside and plan your expressing routine, especially if you have other children or other commitments. This can really help your milk flow and re-establish your pattern.



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