Therapeutic ultrasound
Cordelia Uys, April 2021
- Nina van Dyk at her practice in Hampstead
In recent years, a new form of treatment has become available to breastfeeding mothers who are experiencing blocked ducts and mastitis. In addition to the usual self-help steps, such as applying cold compresses and doing gentle lymphatic drainage massage (see https://www.cordeliauys.co.uk/revised-information-on-dealing-with-blocked-ducts-and-mastitis ) there is now the option of having therapeutic ultrasound treatment to shift blockages. Very often, when home remedies are not working, ultrasound treatment means women can avoid the need for antibiotics.
Here is a description by chiropractor Nina van Dyk of how therapeutic ultrasound works. Nina, whose practice is in Hampstead https://www.hampsteadchiropractic.co.uk/nina-van-dyk/, has a master’s degree in chiropractic and a post graduate master’s in advanced chiropractic paediatrics. She is also as a very experienced breastfeeding mother of two.
Therapeutic ultrasound for treating blocked ducts and mastitis
Therapeutic ultrasound is a great tool for easing inflammation; it can be used for breast engorgement, to clear blocked ducts and for mastitis.
How does it work?
Ultrasound therapy works by emitting an ultrasound wave: tiny piezoelectric crystals (which change shape through an electrical charge) are emitted from the sound head. This micro massage, and the small oscillation of the particles, increase the movement of fluid in the tissue and cell membrane, pushing and pulling on the cell, rapidly changing pressure and moving the ultrasound waves through the tissues.
Ultrasound waves control inflammation by speeding up healing, reducing pain and improving tissue extensibility. They increase local vasodilation and blood flow, helping cells to heal. Capillary pressure and cell permeability are also increased, while painful nerve signals are dampened down.
Is treatment painful?
The treatment is very comfortable; patients only feel gentle heat. Often the blockages in the ducts clear during the procedure and there is a noticeable difference when palpating breasts afterwards. It is not uncommon for patients to leak milk during a treatment due to the heat.
How long does each appointment last?
Taking a history usually takes about 20 to 30 minutes. How long each treatment lasts depends on the size of the affected area: an area of around 1 to 2 inches takes 10 minutes. The first appointment usually lasts about an hour and subsequent ones, around 40 minutes. Our patients generally recover after 1 to 4 sessions. If there is no improvement, we refer patients to a breast surgeon, who can arrange for a diagnostic ultrasound, to check for a galactocele or breast abscess.
Can I bring my baby?
Babies can come and stay in their pushchair, but it is not possible for their mother to hold them during the treatment, so most mums don’t bring them. It is important for the patient to breastfeed no later than 20 minutes after a treatment, so her baby will need to be close by.
Additional treatments and strategies
Therapeutic ultrasound works best when combined with lymphatic drainage massage, lymphatic taping, using an electric massager at home, as well as manual massage, applying heat compresses and breastfeeding frequently. The rugby hold and the laid back/baby-led breastfeeding position can be very helpful for clearing blockages.
The importance of getting additional support from an IBCLC Lactation Consultant or Breastfeeding Counsellor
When a mother is suffering from mastitis and/or blocked ducts, it is vital she gets support from an IBCLC lactation consultant or breastfeeding counsellor who can help her work on attachment and positioning and check her baby for a tongue tie.
Physiotherapists and chiropractors who use ultrasound are trained to identify red flags and often work closely with other health care professionals, such as IBCLCs or GPs, to ensure the best and most appropriate care is given, in order to prevent recurrences of blockages and inflammation.
Links:
For women reported in this case series, chiropractic management including ultrasound therapy was beneficial treatment for women presenting with blocked ducts and difficulties breastfeeding: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437340/
Sprint Physiotherapy have carried out a restrospective study of the patients they have treated for blocked ducts and mastitis using therapeutic ultrasound.
Sprint Physio study into the use of ultrasound for treating blocked ducts and mastitis.
Therapeutic ultrasound treatment in and around London:
Fiona Lafferty (osteopath with experience of supporting breastfeeding) at Hampstead Health Osteopathy:
http://hampsteadheathosteopath.co.uk/
Sara Randall (IBCLC lactation consultant and osteopath) at Perfect Balance Clinic St Albans:
https://www.perfectbalanceclinic.com/our-team/sara-randall-osteopath/
Dr Sharon Silberstein at Dr Silberstein Clinic in Hampstead Garden Suburb:
https://www.breastfeedingdoctor.co.uk/
Sprint Physio:
https://www.sprintphysio.co.uk/services/womens-health-and-pregnancy/index.html
Nina Van Dyk (chiropractor with experience of supporting breastfeeding) at Hampstead Chiropractic: