This condition can occur at any time during a successful
lactation. A tender or painful lump, sometimes in the form
of a triangle, can be felt in a part of the breast with some
redness of the overlying skin. But there are no systemic
symptoms. This can be due to an obstruction of a milk
duct because of an impeded milk flow. When the breast
is not properly emptied or when there is local pressure,
e.g., by restrictive clothing, a tight bra, or heavy bags, the
milk is ineffectively removed from this part of the breast,
and then, engorgement develops, which can compress the
ducts [114].
In case of a duct obstructed by a hard particulate
matter, this material can be expressed with the milk [114].
Local pressure of the breast has to be smoothed out, with
the infant attached properly, positioned with the chin
toward the lump to remove the milk stasis by repeated
forceful milking [114]. A warm/hot compress on the lump
prior to milk removal may facilitate the process. Breast
massage beginning in front of the lump toward the nipple,
and then starting the kneading successively closer toward
the lump but always pushing toward the nipple can empty
the plugged ducts with less pain [18]. When a small white
spot is visible at the tip of the nipple, it can be opened
with a sterile needle or by rubbing with a towel [114].
Recurrently blocked ducts are a problem in many lactating
women [18]. Predisposing risks are those that impair a
complete and thorough emptying of all parts of the breasts
over longer periods of time.