How to prevent breast inflammation when you're breastfeeding or lactating	Why is this protective?
1. Working breasts are often quite lumpy. These lumps go away with breast feeds. You don’t need to do anything about them, except offer your baby frequent flexible breastfeeds – and see your doctor if any lump persists for more than a week.	For a long time, women were told to massage out any lumps. This caused deep bruises in the fragile, highly vascular tissue of the lactating breast, and increased women's risk of worsened breast inflammation and abscess.
2. Offer the breast to your baby frequently and flexibly, without pressuring your baby.	Spacing out breastfeeds can result in a build-up of milk which triggers breast inflammation. We can trust your baby to self-regulate his milk needs and your supply (once underlying problems have been sorted out). Babies are very sensitive to being pressured at the breast though, which can accidentally backfire and create a conditioned dialling up at the breast, which we definitely want to avoid!
2. Try to get rid of any breast tissue drag during breastfeeding (and also during pumping if you're doing that), especially if you have nipple pain.	Breast tissue drag during suckling compresses or squashes the milk ducts, resulting in backpressure in the glands, triggering inflammation. Nipple pain is a definite sign of breast tissue drag.
4. Never apply any pressure or vibration to a developing breast lump. Even light massage can be irritating to highly vascular, sensitive breast tissue, doesn't help (despite what you might hear) and should be avoided	External pressure on the breast may bruise or irritate the very sensitive, vascular, hardworking tissues of your breast, which worsens the inflammation. You can think of this as being similar to a pimple or zit on your face. If you keep touching it with your fingertip, no matter how lightly, it is likely to keep worsening. If you leave it completely alone, your body's immune response settles it down most quickly.
5. Avoid tight-fitting garments or bras or breast shells and silverettes, and perhaps even silicone rolls under the breast, which place mechanical pressure on the breast. If you do decide to use them, just do so cautiously, being aware of the risks. Be aware that wearable pumps also risk placing prolonged mechanical pressure on your breasts.	Any mechanical pressure will squash or compress the milk ducts, which are very easily compressible. 60% of your milk ducts are in a three centimetre diameter around the base of your nipple. Because your milk glands continue to secrete milk, milk pressure might continue to rise inside the glands if the ducts are compressed, until inflammation is triggered.

Although there aren't evaluation studies yet to support the Possums (or Neuroprotective Developmental Care) approach to preventing breast inflammation which I've detailed in this table below, it arises out of the NDC mechanobiological model of breast inflammation, has been peer-reviewed and published.

Selected references

Douglas P. Re-thinking benign inflammation of the lactating breast: a mechanobiological model. Women's Health. 2022;18:17455065221075907.

Douglas PS. Re-thinking benign inflammation of the lactating breast: classification, prevention, and management. Women's Health. 2022;18:17455057221091349.

Douglas PS. Does the Academy of Breastfeeding Medicine Clinical Protocol #36 'The Mastitis Spectrum' promote overtreatment and risk worsened outcomes for breastfeeding families? Commentary. International Breastfeeding Journal. 2023;18:Article no. 51 https://doi.org/10.1186/s13006-13023-00588-13008.