by Jordan Berns

The subject of breast pain is an important one to talk about, especially because mastitis, plugged ducts, and engorgement are the main reasons why women stop breastfeeding one month postpartum. These may all seem like different issues, but they are linked through the condition of milk statis (when milk stops moving through the breast).

How do I stop breast pain?

In a 2015 Northeast Ohio study, breastfeeding women were asked to perform a therapeutic breast massage for engorgement (TMBL) on themselves to reduce both nipple and breast pain. According to the Humenick 6-point pain scale, the women with engorgement had a mean pain level of 5.31. After therapeutic breast massages and hand expressing, the mean pain decreased to 3.48. In the same experiment, 57% of mothers’ plugged ducts disappeared and 17% of the women had a bleb removed with the help of therapeutic breast massages.

Here’s how to perform a therapeutic breast massage:

  1. Start by taking a relaxing, warm shower. This will help increase blood flow to the breasts.
  2. Sit back and get in a comfortable position with your baby. You can perform the therapeutic breast massage on one breast while your baby is nursing on the other breast, switching halfway through.
  3. Dab a little extra virgin olive oil onto your fingers.
  4. Massage your areolas with your fingertips.
  5. Continue by massaging small circles all over your breast. Every now and again, try to include some soft fingertip tapping.
  6. Use the backside of your fists to softly knead your breast.
  7. Between massages, hand express some milk. As your symptoms improve, lessen the amount of times you need to hand express. (See below for instructions on how to express milk!)
  8. For treating plugged ducts: relieve pain by taking your free hand to gently push behind the plug to guide it down the afflicted duct so it can be released.
  9. For engorgement and mastitis: massage in long, horizontal movements starting from the breast to the armpit and then massage going in the opposite direction inwards.
  10. Be careful to remain gentle; if you push too hard, small amounts of tissue can be damaged. Bruising is a common sign that a therapeutic breast massage is being done too roughly.

How to express breast milk:

  1. The best way to express milk is by starting with a therapeutic breast massage! This will help to get the milk moving.
  2. Position your thumb as the top of a letter “C” shape, and let the rest of your fingers make up the bottom arch.
  3. Place your thumb and fingers in a semicircle, roughly an inch away from your nipple.
  4. Press the hand letter “C” back into your breast.
  5. Roll your thumb and forefingers in the same direction towards each other.
  6. Milk will begin to be expressed. Keep repeating steps four and five in a rhythmic motion.
  7. Every so often, switch up the positioning of your hands to make sure you drain all areas of your breast.
  8. Every woman’s most effective position will be different, so don’t be discouraged if it doesn’t work perfectly the first time!

In the 2015 study, all breastfeeding women reported a decrease in pain with the help of therapeutic breast massages. These massages also helped them to continue to exclusively breastfeed, especially as breast massages can help increase overall milk supply.

Remember to talk to your doctor if you find lumps or lymph nodes under your collarbone or arm that are swollen. Also, report any of these to your healthcare provider: liquid coming out of your breasts that isn’t milk, swelling, or changes in your skin’s color and texture. Be mindful of past surgeries and scars when executing a breast massage and continue with home breast exams throughout your life. 71% of breast cancer in women under 50 is first found in a home breast exam.

Breastfeeding may be painful at first, but it doesn’t have to be. Therapeutic breast massages are just one of the many ways to make breastfeeding a more simple and comfortable process. If you are struggling with a therapeutic breast massage, especially if you are bruising, dial up your doctor or lactation consultant for help!



Witt, Ann M, Bolman, Maya, Kredit, Sheila, Vanic, Anne. "Therapeutic Breast Massage in Lactation for the Management of Engorgement, Plugged Ducts, and Mastitis." J Hum Lact. 2016 Feb;32(1):123-31. doi: 10.1177/0890334415619439. Epub 2015 Dec 7.


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