What’s the difference between Engorgement, a Blocked Duct and Mastitis? 

Berwick Family Osteopathy

 Photo credit: by Mart Production – Pexels

Sometimes it can be confusing knowing what is going on with your body when the symptoms can be very similar between different conditions relating to the breast. Here is a breakdown on what’s the differences are between three common conditions; Mastitis, Blocked ducts and Engorgement.  



Mastitis is now seen as a spectrum of conditions involving inflammation in the breast lobes resulting from duct inflammation and swelling in the milk glands. If the ducts continue to narrow and congestion worsens, then inflammatory mastitis can develop, and an infection may follow if left untreated in the 24-48 hours (about 2 days) after the onset of symptoms. It is always important to seek medical advice if this occurs, as women can get very sick with severe Mastitis if left untreated. Mastitis commonly occurs due to an overproduction of milk due to a change in breast feeding routine, missed feeds or difficulties emptying the breast during feeds. However, it can be from a multitude of reasons such as antibiotic use, tight bra or clothes, high stress, and more.  

Symptoms usually include:  

  • Muscle aches in the upper body or the whole body   
  • Red or pink skin over the affected area 
  • Swelling in the breast  
  • Tenderness over the breast tissue or whole chest area  
  • Skin can be taut or shiny from swelling  
  • General feeling of illness  
  • Fever (keep in mind you can develop the fever before it becomes an infection!)


Berwick Family Osteopathy

 Photo credit: by Mart Production – Pexels



Engorgement can be a broad term for when the breast is enlarged, swollen and painful. This swelling comes from milk, lymph and blood vessel congestion. Your milk may not flow easily, and your baby can find it difficult to suckle due to the change in the shape of your nipple. This is normal part of your milk starting to pick up production in the 2-6 days postpartum, and this is called physiological engorgement. But it can occur later in your breast-feeding journey, and this is called pathological engorgement. It can be a result of decreased drainage of the breast from a case of mastitis or a blocked duct, or a missed/delayed feed, tight clothes, or musculoskeletal tightness affecting the breast tissue.  


Blocked Ducts  

A blocked duct is when there is a blockage anywhere along the duct system. This could be right near where the milk is produced all the way to the central ducts that feed directly into the nipple. However, don’t think of it as a clog or plug stopping the milk, but a narrowing of the duct due to surrounding inflammation. Imagine a flexible tube is the duct and tying a rubber band or pinching it with your finger; that is the blockage! This can happen for similar reasons stated with mastitis and can be a precursor to developing inflammatory Mastitis. Usually, the symptoms are milder than mastitis for example you may have some localized swelling or lump in the breast, a pink tinge to the skin and some tenderness over the area. It can be easy to use at home self-management strategies to get on top of blocked ducts before they develop into Mastitis, if you know the signs and have the correct strategies at home to self-manage.  


Does it sound like you have one of these conditions?

If you are suffering from any type of lactation struggles and are wondering if an Osteopath can help you, give us a call at Berwick Family Osteopathy and Spinal Clinic on (03) 9702 0094, or make an appointment with Dr Amelia Sloan online. 

We can’t wait to see you in the clinic and help you with your health.

Blog written by Dr Amelia Sloan – Registered Osteopath
Berwick Family Osteopathy & Spinal Clinic

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