• Palpable thickening, ?lump
  • Localised warmth
  • Pain – sore to touch
  • Occasional fever


As for engorgement; clear area between lumpiness and nipple. May take hours or days. Breast massage whilst baby is suckling will help (duct anatomy slide 63).  If baby has a long night sleep (or day) for no reason OR if baby’s cries are neglected in the mistaken belief that sleep training is the done thing, then engorgement, blocked duct, painful lump and/or reduced milk production may result. Baby’s cortisol levels stay elevated in spite of trained longer sleep. All mammals have evolved to sleep with their babies for evolutionary survival which includes the optimising of milk production and safety.