‘Drainage’ of breastmilk by the infant

Proposed mechanism

It's argued that the suction of 'draining' the breast clears the blocked ducts that have caused mastitis.

Evidence

Long periods at the one breast, also often associated with feed spacing, may reduce frequency of ductal dilations and limit milk removal, causing decreased milk supply.

Hand express or pump after breastfeeds

Proposed mechanism

Hand expressing or pumping after breastfeeds when a woman has breast inflammation has been said to ‘drain’ breast and release any blockage.

Evidence

However, this practice risks increasing a woman's supply above her infant's need, which increases the risk of high intraluminal pressures and inflammation.

Breast inflammation does not result from duct blockages.

Dangle feed or position the infant so chin or nose points to the area of inflammation or blockage

The advice that a woman positions her body so that her breast falls down from above into the infant's mouth, or that she tries to position the infant's chin over the area of inflammation, are

• Not evidence-based

• Lack a physiological rationale, and

• May cause breast tissue drag, worsening breast inflammation.