Q&A with Gynecologic Oncologist Allison Gockley, MD
Read this question-and-answer article featuring Allison Gockley, MD, a gynecologic oncologist in the Department of Obstetrics and Gynecology and Mass General Cancer Center.
Patient EducationAug | 3 | 2023
Lactation and breastfeeding are a unique experience for every parent and infant. Your feeding journey may have different phases: beautiful, challenging, satisfying, remarkable, and complicated—sometimes, all at once. It can leave parents searching for fast fixes or relying on decades-old information.
Amelia Henning, CNM, MSN, IBCLC, director of the Mass General Breastfeeding & Lactation Clinic, and Annie Brewer, RN, IBCLC, bust myths and share new evidenced-based information to help parents succeed with breastfeeding and pumping.
Mastitis is a spectrum of inflammation that can happen in breast tissue when a person is breastfeeding. It starts with simple inflammation but may progress to an infection that needs antibiotics or other medical interventions.
It was previously thought that breast massages and heat are the best remedies for mastitis and clogged ducts. People were told to avoid ice because it was thought to decrease milk flow and production. Heat and massage can worsen the problem by increasing blood flow and inflammation in the breast and putting more pressure on the ducts which makes it harder for the milk to drain. Deep massage can also damage the tissue, and small blood and lymphatic vessels in the breast.
New evidence shows that treating the inflammation will resolve most clogged ducts and mastitis. If you develop a red, swollen or tender spot on your breast, treat the inflammation similarly to how you’d treat a sprained ankle. You can remember the steps using the acronym, GRACE:
If you do not feel better in 24-48 hours, please call your health care provider for an evaluation.
Creating a ‘freezer stash’ of milk may seem like an attractive option, but practices like power pumping—where you pump on and off for 60 minutes—can lead to an overproduction of milk and mastitis. It generally isn’t recommended. While it can mimic a baby cluster feeding (when a baby wants to nurse more frequently), power pumping should only be used occasionally under the direction of an experienced lactation care provider.
These practices and items recently rose in popularity, but they certainly are not necessary.
While previously there was some evidence that cabbage leaves can help with early postpartum engorgement (increased breast swelling as your milk first comes in), recent evidence shows no difference between the use of cabbage leaves and ice packs.
If you’re breasts are feeling engorged or if you are experiencing inflammation due to mastitis, you can try soft ice packs (layer a towel or other thin cloth between the ice pack and your breast) and gentle touch to encourage lymphatic drainage (use a gentle sweeping motion as you rotate around the breast, sweeping up towards your collar bone). This is a method of gently moving extra fluid into the lymph system to be properly drained.
Collecting prenatal colostrum can be a great tool and is especially beneficial for those who may have a more difficult time producing milk after their baby is born, but it is certainly not a ‘must do.’
If you are prenatally producing and expressing colostrum—which is the first milk produced by the breasts during pregnancy and in the early days after childbirth—and choose to collect it, expect very small amounts. In fact, drops are normal. Most pregnant people can begin this practice after 36-37 weeks of pregnancy, but as always, check with your prenatal care provider first.
The greatest benefit of prenatal colostrum collection is learning the skill of hand expression.
Learn more about hand expression »This was a very common approach for many years. However, new research shows there’s no significant evidence that yeast grows on nipples. The vast majority of “nipple yeast” is due to skin irritation (dermatitis) or trauma from improper pump use or latching.
Please reach out to your pediatric provider and your midwife, OB, or lactation care provider if you are experiencing symptoms that you think might be yeast or if your baby is experiencing thrush (a common fungal infection that can affect the mouth and throat).
While breastfeeding can have ups and downs, especially as both you and your baby are learning this new skill, it should not hurt long-term. If it does or if you’re feeling overwhelmed, there is support.
Amelia Henning, CNM, MSN, IBCLC
Over 1/4 of the babies born each year at Mass General are delivered by midwives, who manage prenatal care, labor and delivery and postpartum care.
We believe that as a patient you are an important member of your own care team. Find classes and information resources to support your care.
We provide state-of-the-art, individualized care for women and their families before, during and after childbirth.
Mass General for Children patients have access to compassionate preventive and primary care in a number of community locations.
Read this question-and-answer article featuring Allison Gockley, MD, a gynecologic oncologist in the Department of Obstetrics and Gynecology and Mass General Cancer Center.
During the summer of 2021, Caroline and her husband, Ryan, found out they were expecting a daughter, due on St. Patrick’s Day.
Read about what the new FDA approval of an over-the-counter birth control pill means for you, with insights from physicians in the Department of Obstetrics and Gynecology at Massachusetts General Hospital.
Read answers to the top 10 questions from patients about fertility, IVF, egg-freezing, and more from reproductive specialists and nurses at the Mass General Fertility Center.
The Massachusetts General Hospital Department of Obstetrics and Gynecology is pleased to expand urogynecological care for patients on the North Shore. We provide comprehensive urogynecologic evaluation and treatment for female pelvic floor problems to help patients return to their lifestyle.
Read this question-and-answer article featuring Allison Gockley, MD, a gynecologic oncologist in the Department of Obstetrics and Gynecology and Mass General Cancer Center.
During the summer of 2021, Caroline and her husband, Ryan, found out they were expecting a daughter, due on St. Patrick’s Day.
Read about what the new FDA approval of an over-the-counter birth control pill means for you, with insights from physicians in the Department of Obstetrics and Gynecology at Massachusetts General Hospital.
Read answers to the top 10 questions from patients about fertility, IVF, egg-freezing, and more from reproductive specialists and nurses at the Mass General Fertility Center.