Physiotherapy and Blocked Ducts.
Breast engorgement and mastitis are painful barriers to breastfeeding mothers. These issues can often lead to the early cessation of breastfeeding (1).
Early intervention, education and support are critical for continuation of successful breastfeeding. Women’s health physiotherapists can provide both support and beneficial treatment of engorgement, blocked ducts and mastitis (2).
The normal biological process of engorgement can cause breasts to become hard, swollen and painful, leading to blocked ducts and mastitis. Treatment techniques such as gentle massage, frequent feeding, correct feeding positions and therapeutic ultrasound have been shown to improve these symptoms (3).
Research has reported that when used in combination with correct positioning/latching, frequent feeding and massage, the use of therapeutic ultrasound can further promote the drainage of the breast (4).
Therapeutic ultrasound uses sound waves to dilate milk ducts that have become blocked. Dilated ducts create more space for milk to pass through, preventing and relieving any blockages (3).
Ultrasound produces sound waves at a frequency that increase cell wall permeability (5). This effect aids in the reduction of inflammatory cells and can therefore, in the presence of infection, also improve the effectiveness of antibiotics.
Therapeutic ultrasound can also assist with the drainage of lymphatic fluid out of the breast tissue, further reducing swelling and pain.
Following ultrasound treatment, gentle drainage massage following the duct pathway can continue to enhance the flow of milk through the milk ducts towards the nipple. We ask our mums to feed their baby soon following treatment for optimal treatment benefits.
In most cases, ultrasound therapy is effective in improving pain and reducing blockage size in 1-3 sessions. Research has shown that consecutive treatment can prevent recurrence of blockage in the same duct.
We always advise our mums to see their GP for assessment prior to our treatment for blocked ducts or mastitis. Your referral to us for continued education and relief of blocked ducts is much appreciated.
1) Amir, L.H., Forster, D.A., Lumley, J. et al. A descriptive study of mastitis in Australian breastfeeding women: incidence and determinants. BMC Public Health 7, 62 (2007). https://doi.org/10.1186/1471-2458-7-62
2) Diepeveen, L. C., Fraser, E., Croft, A., Jacques, A., McArdle, A. M., Briffa, K., & McKenna, L. (2019). Regional and Facility Differences in Interventions for Mastitis by Australian Physiotherapists. Journal of human lactation : official journal of International Lactation Consultant Association, 35(4), 695–705. https://doi.org/10.1177/0890334418812041
3) McLachlan Z, Milne EJ, Lumley J, Walker BL. Ultrasound treatment for breast engorgement: A randomised double blind trial. Aust J Physiother. 1991;37(1):23-28. doi:10.1016/S0004-9514(14)60531-6
4) Lavigne, V, Gleberzon, BJ. Ultrasound as a treatment of mammary blocked duct among 25 postpartum lactating women: a retrospective case series. J Chiropr Med. 2012;11(3):170-178.
5) APA de Oliveira Perrucini, Priscila Daniele PT, PhD; Poli-Frederico, Regina Célia PhD; de Almeida Pires-Oliveira, Deise Aparecida PT, PhD; Dragonetti Bertin, Larissa PT, MSc; Beltrão Pires, Flavia PT, MSc; Shimoya-Bittencourt, Walkiria PT, PhD; Martins Santos, Viviane PT, PhD; Medeiros Coelho, Julice PT, PhD; Franco de Oliveira, Rodrigo PhD Anti-Inflammatory and Healing Effects of Pulsed Ultrasound Therapy on Fibroblasts, American Journal of Physical Medicine & Rehabilitation: January 2020 - Volume 99 - Issue 1 - p 19-25 doi: 10.1097/PHM.0000000000001265
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