Here are helpful steps for doing therapeutic breast massage in lactation for relief of engorgement, plugged ducts and mastitis:
- Assume a comfortable position, preferably reclining.
- Apply some extra virgin olive oil to your fingertips.
- Gently massage within the areola with your fingertips.
- Then gently massage with small circular movements all around the breast. Alternate this circular massage with gentle fingertip tapping on the breast and kneading the breasts gently with the backs of your fists.
- In between massage, use hand expression to remove milk from the breast. When the milk starts flowing, decrease the frequency of massage to 1-2 times for every 3-4 times of hand expression.
- Continue this massage for up to 30-45 minutes/breast. Baby can breastfeed on the breast not being massaged while the massage is going on.
For engorgement and mastitis, a further helpful massage technique is to massage the outer sides of the breasts in long strokes up towards the lymph nodes in the axilla (arm pit) and massage the inner sides of the breasts toward the lymph nodes in the center of the chest. This technique helps to remove fluid from the breast that cannot be hand expressed. This further reduces engorgement.
For plugged ducts, it helps to the non-massaging hand to apply gentle pressure behind the plug to help move it down through the milk duct.
References: Bolman, Maya; Saju, L.; Oganesyan, K., Kondrashhova, T., & Witt, A. (2013). Recapturing the art of therapeutic breast massage during breastfeeding. Journal of Human Lactation, 29(3), 328-331.