Version May 2024
| Recommendation | Rationale |
| Feed on demand, and include the affected breast | This maintains milk production from the affected breast. As the edema improves over 48 hours, the milk will resume flowing from that region. |
| Avoid overfeeding (complete emptying) from the affected breast | Because ductal narrowing is caused by edema, increasing demand for milk production from the affected breast will only create more lymphedema. |
| Optimize feeding technique | Ensure that the infant has an effective latch; try to use multiple comfortable breastfeeding positions to ensure that milk flows from each area of the breast. |
| Minimize breast pump use | Pumping is often inferior to direct infant feeding, assuming that the infant is feeding well. Pumping can stimulate milk production while not removing the milk well, leading to areas of edema. Pumps often don't remove milk well due to improper flange fit, pump cycle, or vacuum settings. |
| Avoid use of a nipple shield | A nipple shield can cause uneven and inadequate breast milk removal. |
| Wear a bra that is supportive but not tight | Localized edema and stasis can be caused by either lack of breast support (dependent lymphedema) or excessively tight bra or clothing. |
| Avoid deep massage or use of vibrating devices on the breast | Because ductal narrowing is caused by localized edema, deep massage and vibration will likely create more inflammation, increasing the risk of phlegmon, abscesses, and galactoceles. Gentle lymphatic drainage may help mobilize lymphatic edema. |
| Use analgesics (NSAIDs or acetaminophen) and cold compresses | These interventions help to relieve pain and may also reduce inflammation. Cold compresses are generally preferred, although some people find that warm showers decrease discomfort. |
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