Coping With A Clogged Milk Duct - Breastfeeding - BabyCenter

If you're breastfeeding and notice a sore, lumpy spot on your breast, you might have a clogged milk duct. While it can be uncomfortable (and a little alarming), don't panic! Clogged ducts are a common breastfeeding problem and they usually clear up on their own within a few days. The key is to manage inflammation and keep milk flowing – without overdoing it.

Experts now recommend a gentler approach to treating clogged ducts, ditching the old advice of aggressive massage and heat. Instead, simple strategies like rest, ice, and ibuprofen can help ease the discomfort and get you back to pain-free nursing.

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Read on to learn what causes clogged ducts, how to treat them, and when to check in with your healthcare provider.

Key Takeaways

• A clogged milk duct happens when excess milk causes breast tissue to get swollen and painful and push on the milk ducts.
• Clogged milk ducts usually go away on their own in a few days, but they can also develop into mastitis.
• To treat a clogged milk duct at home, get as much rest as possible, continue to nurse your baby, apply ice packs, and take anti-inflammatory medication such as Ibuprofen.

What's a clogged milk duct?

Milk ducts are small, straw-like tubes that carry milk from your mammary glands to your nipples. When your body makes breast milk faster than it's expressed, milk can get backed up in the duct. The tissue around the duct may become swollen and inflamed and press on the duct, causing a blockage. This is called a clogged, blocked, or plugged duct. According to one studyOpens a new window, 4.5% of women have clogged ducts in their first year of breastfeeding.

Clogged ducts can appear anywhere that you have milk ducts, including on the nipple (causing a milk bleb), breast, or near the armpit.

The good news: Clogged ducts can usually be successfully treated at home. The bad news: If a clog doesn't go away, it can lead to mastitis, a painful inflammation of breast tissue that can progress to an infection. If you have a clogged duct that doesn't go away in a couple of days, or if you develop mastitis symptoms – like a fever, flu-like symptoms, and an area on your breast that's hot and tender – call your provider right away. If mastitis develops into a bacterial infection, you may need antibiotics to treat it.

"It can be scary for moms to feel a clogged milk duct, mostly because of horror stories of them developing into mastitis," says Kate Shand, an international board-certified lactation consultant. "But we now know that clogged ducts and most cases of mastitis are due to inflammation that can be handled at home with ice, ibuprofen, and watchful waiting."

What does a clogged duct feel like?

A clogged duct feels like a small, hard lump about the size of a pea or larger. It may be sore to the touch. You may feel a knot in the tissue, tenderness in your breast, or an aching like you've been punched. It may be uncomfortable to nurse, too.

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Other signs of a clogged duct include:

• Redness in the area
• A hot sensation or swelling around the lump that may feel better after nursing
• Pain during letdown
• A milk blister (bleb) in an opening on the nipple
• Decrease in milk supply (Sometimes milk flow on the affected breast will be slower than usual, and your baby may be fussy when nursing on that side.)
• Milk that's grainy, stringy, or thicker than usual
• Nipple discharge

It's possible to have a clogged duct and not have any symptoms. In the best-case scenario, the duct could open on its own without causing any problems. Once the duct is unclogged, the area may still be red or feel tender for a week or so, but any hard lumps will be gone, and it won't hurt as much to nurse.

What causes a clogged duct?

Unfortunately, some moms seem to be more prone to clogged ducts than others, and experts aren't sure why.

Here are some common reasons milk ducts become clogged:

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• Engorgement, which means you have more milk than your baby is eating, leading to breasts that are overly full.
• Your baby is having trouble feeding – because of a poor latch or tongue tie, for example.
• You're having trouble nursing because of cracked nipples or another breastfeeding problem.
• You're nursing more often on one side than the other. This can cause milk to build up on the less frequently emptied breast.
• The flange on your breast pump is the wrong size. (The flange is the funnel-shaped part of the pump that fits over your breast.) If it's too small, it can rub against your nipple, causing inflammation and hindering the flow of milk. If it's too large, it can cause trauma around your areola (the dark, circular area around the nipple).
• You've abruptly weaned your baby. (If possible, try to wean your baby gradually.)
• You haven't been able to nurse your baby or pump as often as usual – because you've returned to work or your baby is sleeping for longer stretches, for example.
• A duct becomes compressed or damaged. This can happen due to pressure from a nursing bra that doesn't fit well, for example.
• You're under stress. Stress lowers your body's production of oxytocin, the hormone that causes your breasts to release milk.
• You've had surgery, such as a breast biopsy. The area that was operated on may interfere with milk drainage and cause a blocked duct.

Clogged milk duct treatment

Until recently, breastfeeding moms with a clogged duct were told to nurse as often as possible and apply heat and massage. Now we know that these measures, though well-intentioned, can make matters worse!

Instead, use these strategies to reduce inflammation and unclog the duct:

• Continue breastfeeding, but don't overdo it. It's perfectly safe to nurse your baby while you have a clogged duct. It may even help with the clog. And the antibacterial properties of breast milk will keep your baby safe from bacteria, even if you develop an infection. But don't worry about emptying each breast at every feeding, and don't breastfeed or pump more frequently than your baby needs. The more you nurse, the more milk your body will produce. And if you produce more than your baby needs, the problem will likely get worse instead of better.

• Get rest. This is difficult when you have a baby to care for, especially if you have other children, but it's an important step towards healing. If possible, ask someone to help you for a few hours a day so you can take naps. If you haven't yet, consider introducing a bottle so someone else can help with feedings.
• Very gently "sweep" your breasts with your hands. Start at the clog and gently move your hands over your breast in circular motions. Don't use deep massage, which can increase the inflammation. Be very gentle.
• Vary your nursing position. For example, if you use the cradle hold, try the football hold or nurse lying down. This will help ensure that all your ducts are drained. And while there's no scientific evidence proving that it works, many women swear by this trick: Position your baby at your breast with their chin pointed toward the sore spot, and then have them latch on and begin nursing. This may help concentrate suction on the clogged area.
• Avoid wearing tight bras or tight clothing. This might put pressure on your breast and lead to (or worsen) a clog.
• Eat well and drink water. Focus on nutritious foods to boost your immune system, and drink plenty of fluids to stay hydrated.
• Consider medication. Taking ibuprofen can help relieve pain and inflammation. Ask your healthcare provider or lactation consultant before taking medicines or herbs while you're breastfeeding, though, even if it's an over-the-counter medication.

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• Apply cold. Cold packs (an ice pack wrapped in a towel or even a cold washcloth) may help reduce inflammation and ease pain. Use every hour or more, leaving the ice on for about 10 minutes at a time. (In addition to ice, experts used to recommend heat to help drain the duct and alleviate pain, but this can make inflammation worse.)

• Try lecithin. There's no scientific support for this, but it's often suggested that lecithin (a fatty substance found in plants and animals) can help prevent and eliminate clogged milk ducts by making the milk less sticky and so less prone to blockage. Lecithin is available as a supplement. If you'd like to try it, ask your provider for a brand recommendation and guidelines on how often to take it.
• Try probiotics. Again, we don't know for sure if they help, but some experts believe that probiotics can help decrease inflammation by restoring the growth of healthy bacteria.
• Try therapeutic ultrasound. For a stubborn blockage, you may want to try ultrasound to loosen the clog. One studyOpens a new window showed reduction in pain by half after one treatment, and further reduction after additional treatments. Talk with your provider to get a referral to a physiotherapy or sports-medicine clinic where they can do the treatment.

"I had a clog recently and used ice and ibuprofen," says BabyCenter Community member IvyMK. "It was more effective than using heat and massaging, which actually increased the swelling for me."

It can be scary for moms to feel a clogged milk duct, but most cases can be handled at home with ice, ibuprofen, and watchful waiting. - Kate Shand, an international board-certified lactation consultant

Clogged milk duct picture

You may be able to see (as well as feel) the hard lump where the duct is plugged. It may look reddened and inflamed.

Note: The following picture shows a naked breast with a clogged duct and is NSFW.

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Will a clogged milk duct eventually dry up?

Most clogged ducts will clear on their own in a day or two, with or without treatment. A clogged duct can temporarily affect your milk supply a bit, but it won't cause you to stop producing milk.

But if a clogged duct doesn't go away, it may develop into mastitis or cause a milk-filled cyst to form. (These are called galactoceles, and while they're usually painless, they can also become infected and require drainage.) So it's a good idea to help clear the clog with some of the measures mentioned above.

If your breast still hurts after self-treatments for 24 hours, or if you have a fever or other signs of an infection (skin that's red and hot to the touch, flu-like symptoms, or a large area that's tender and painful), call your provider.

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Also, know that a lump may not be breastfeeding-related. "Keep in mind that during your breastfeeding journey it can be perfectly normal for breasts to be sore and lumpy on and off," says Shand. Always contact your provider about any lump on your breast that isn't getting better.