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Therapeutic Breast Massage in Lactation | Image Courtesy of Mehmet Turgut Kirkgoz via Unsplash
Therapeutic Breast Massage in Lactation | Image Courtesy of Mehmet Turgut Kirkgoz via Unsplash

Therapeutic Breast Massage in Lactation Can Help Make Breastfeeding Less Painful

Breastfeeding is widely accepted as the normal standard for providing nutrition to newborns, however, many women who do not reach their breastfeeding goals. US national data stated that breast pain was a commonly reported reason for women weaning less than 1 month postpartum. Within that segment, 29% of women who participated in the study stated that “breastfeeding was too painful” to continue.

In the same study, 24% of women reported “breasts feel(ing) too full or engorged” as another reason to discontinue breastfeeding prior to 1 month postpartum.1 Currently, The American Academy of Pediatrics recommends exclusive breastfeeding of infants for the first six months of life. As physical therapists who treat patients with postpartum conditions, we are well positioned to make a big impact on patients with breastfeeding related pain and reduce barriers to continued breastfeeding!

Therapeutic Breast Massage in Lactation (TBML) is a specific type of manual therapy that specially trained providers can perform to relieve pain and excessive engorgement related to breastfeeding. What’s even better is that your physical therapist at Femina Physical Therapy can teach you how to perform this massage yourself to prevent more pain in the future!

First, let’s get familiar with different types of breastfeeding related conditions.

The common attribute among these conditions is that they are typically caused by milk stasis or inadequate removal of milk from the breast:

  • Engorgement: Uncomfortable swelling of the breast associated with increased milk secretion
  • Blocked Milk Ducts: Engorgement can lead to inflammation surrounding the milk duct, causing the duct to collapse and stop the flow of milk. This can sometimes form a tender lump in the breast. A milk bleb may form in the appearance of a small, white bump on the nipple.
  • Mastitis: Inflammation of the breast. It may be non-bacterial or with a bacterial infection of the breast. It is associated with a hard, red and swollen part of the breast. Systemic symptoms can be present including fever, chills and body aches. When infection is present, it must be treated by antibiotics prescribed by your provider prior to being treated in physical therapy.

Traditionally, therapeutic breast massage for the alleviation of blocked milk ducts has involved deep, painful massage strokes towards the nipple. What we now know about engorgement and blocked milk ducts is that inflammation surrounding the duct is the culprit. Our lymphatic system is responsible for moving inflammation throughout the body, and this system lives directly under the skin and gets suppressed by the use of deep pressure. By performing light massage strokes opposite to the flow of milk, we can encourage lymphatic flow to reduce inflammation, giving milk ducts room to allow for adequate flow.

Therapeutic Breast Massage in Lactation Step by Step:

Step 1: Stimulate your lymphatic system
  • Close your eyes. Take 10 long diaphragmatic breaths into your low belly. Perform 10 gentle, circular strokes at the base of the neck. Finally, perform 10 circular strokes in the armpit.
Step 2: Perform massage on the affected breast
  • With a flat palm, use broad, light sweeps starting from under the breast towards the armpit with the hand opposite to the breast you are working on. Perform this for 1-2 minutes. Use light pressure, similar to if you were petting a cat. Use enough pressure where you are moving your skin just a bit.
  • Using the same broad stroke, sweep upwards from the nipple, over the chest and neck, ending at the chin. Perform this for 1-2 minutes.
  • Follow your therapeutic breast massage by nursing your baby or by hand expressing.

Additional tips for therapeutic breast massage:

  • Perform your therapeutic breast massage prior to every time you are expressing milk if you are dealing with a blocked duct until the blockage is cleared.
  • Avoid deep and painful pressure of the breast tissue
  • Consider following up your Therapeutic Breast Massage in Lactation with some cold compress as opposed to heat to reduce inflammatory process
  • Consistent milk removal is key to improving symptoms!

References:

  1. Li R, Fein SB, Chen J, Grummer-Strawn LM. Why mothers stop breastfeeding: mothers’ self-reported reasons for stopping during the first year. Pediatrics. 2008;122(suppl):S69-S76.
  2. Cooper BB, Kowalsky D. Physical Therapy Intervention for Treatment of Blocked Milk Ducts in Lactating Women. Journal of women’s health physical therapy. 2015;39(3):115-126. doi:10.1097/JWH.0000000000000037
  3. Witt AM, Bolman M, Kredit S, Vanic A. Therapeutic Breast Massage in Lactation for the Management of Engorgement, Plugged Ducts, and Mastitis. Journal of Human Lactation. 2016;32(1):123-131. doi:10.1177/0890334415619439

What Our Patients Have to Say

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Testimonial by Mary L.

I started seeing Heather to treat my Interstitial Cystitis in November 2016. At this time, I was extremely miserable, in constant pain, and felt as though no one was listening or understood what was going on with my body. I have just finished my last appointment and I can honestly say that my life has completely changed for the better because of Heather and her team of PTs! I live almost completely pain free, and when I do have flare ups, I am able to treat them at home on my own. I am so grateful that this office was recommended to me a honestly cannot recommend them enough!

Read more: Testimonial by Mary L.

Testimonial by T.H.

I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

Read more: Testimonial by T.H.

Testimonial by S.P., Age 26

I would like to start off by thanking Heather Jeffcoat for educating me and curing me of Vaginismus. I had been married for almost three years before I was referred to Heather. I never knew about Vaginismus until almost three years into my marriage. I knew something was wrong when I went on my honeymoon and came back a Virgin. I had always imagined how magical my first night would be but boy was I wrong.

Read more: Testimonial by S.P., Age 26

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

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