Breast milk production operates on a supply-and-demand system. When milk is removed, the body receives a signal to produce more, ensuring an adequate supply for the infant. “Pumping” refers to the mechanical removal of breast milk, often using a breast pump, which mimics the suckling action of a baby. This process helps maintain milk supply when direct nursing is not possible or sufficient.
Immediate Physical Sensations
When breast milk is not removed regularly, the breasts can become engorged. This condition causes the breasts to feel full, hard, swollen, and painful. Engorgement occurs as the breast tissue overfills with milk, blood, and other fluids, leading to discomfort.
The pressure from engorgement can result in a throbbing sensation and tenderness throughout the breasts. Sometimes, the fullness can cause nipples to become stretched or flattened, making it difficult for an infant to latch. In some instances, milk may spontaneously leak from the breasts due to the high internal pressure.
Developing Complications
If milk stasis continues, it can lead to health issues such as plugged ducts and mastitis. A plugged milk duct occurs when a milk duct becomes blocked, preventing milk from flowing freely. This often presents as a tender, sore lump or knot in the breast, sometimes with localized redness and warmth, and can develop if the breast is not fully emptied or if feedings are skipped.
Mastitis is an inflammation of the breast tissue, which can sometimes involve a bacterial infection. It often arises from untreated plugged ducts or when bacteria enter the breast. Symptoms include flu-like symptoms such as fever, chills, body aches, and fatigue. The affected breast may become red, swollen, and warm, with pain that is often more intense than that of a plugged duct, sometimes showing red streaks on the skin. If left untreated, mastitis can potentially lead to a breast abscess requiring surgical drainage.
Effects on Milk Production
When milk is not consistently removed, whether through nursing or pumping, the body receives a signal that less milk is needed. This reduced demand signal leads to a gradual decrease in milk production over time.
Consistently not pumping or nursing contributes to the body naturally ceasing milk production, a process akin to natural weaning. The buildup of milk in the breast also triggers the release of a protein called Feedback Inhibitor of Lactation (FIL), which actively slows down milk synthesis. Once milk supply has significantly decreased due to prolonged lack of removal, re-establishing a full supply can be challenging.
When to Seek Support
Seek professional medical attention if certain symptoms arise after not pumping breast milk. If a fever of 101°F (38.3°C) or higher develops, or if severe, worsening pain, red streaks on the breast, or pus draining from the nipple is observed, contact a healthcare provider. These signs could indicate a developing infection like mastitis that requires prompt treatment.
For persistent discomfort, recurring plugged ducts, or concerns about a decrease in milk supply, a lactation consultant can offer specialized guidance. They can provide strategies for milk removal, address latch issues if nursing, and help manage engorgement. In cases of severe symptoms or if home care measures do not provide relief within 12 to 24 hours, consulting a doctor is important to prevent further complications.