Many women experience clogged milk ducts at some point in their breastfeeding journey. If addressed quickly, a clogged duct can be resolved relatively easily without medical intervention. However, some clogged ducts can turn into mastitis. In this piece, I’ll explain everything from what a milk duct is to what you can do to prevent or relieve a clogged duct and keep mastitis at bay.
What is a milk duct?
A milk duct is a pathway for breast milk to travel through the breast and out the nipple.
What is a clogged duct?
A clogged duct (also referred to as a blocked duct or plugged duct) happens when milk becomes stagnant in the duct.
What is mastitis?
Mastitis is inflammation of the breast tissue. This inflammation may or may not involve an infection.
What are some symptoms of blocked ducts?
Symptoms of blocked milk ducts can include breast tenderness, breast pain, nipple pain, redness, heat, decreased milk supply, and palpable lumps. Occasionally, babies will be fussy at the breast due to the decreased flow of milk caused by the blockage.
When a clog has dislodged, you may express stringy clumps of milk, although you might not notice them unless you’re pumping or hand expressing. This milk is safe for your baby to consume.
What are some symptoms of mastitis?
Women who experience mastitis may have the symptoms above along with flu-like symptoms such as fever (101.3 °F or above), chills, fatigue, and an overall unwell feeling.
What causes plugged ducts?
Engorgement: Breast engorgement generally occurs a few days after birth when breast milk supply is increasing rapidly. It also may occur when supply is overabundant or the breasts are not properly emptied (e.g., your baby sleeps longer than usual, and you wake up with full, firm breasts).
Ill-fitting bras: Nursing bras with underwire that goes toward the axillary (armpit) area or maternity bras that are too tight or constrictive may block milk ducts (and even lymph drainage), preventing milk from draining adequately.
Ineffective emptying of the breast: This can be from missed feeds or pumping sessions, less frequent breastfeeding sessions due to a busy schedule or weaning, hurried feeds, oral anatomy issues, nipple shield use, and even poor latch.
- Unnecessary pressure on the breasts: Tight clothing (including a tight nursing bra), diaper bag straps, baby carriers, and sleeping on your stomach can all put pressure on your breasts, which could lead to clogged ducts.
What causes mastitis?
Clogged ducts: Clogged ducts can have many different causes, as outlined above. If clogged ducts aren’t resolved, they can turn into mastitis.
Nipple breakdown or infection in the nipple: A poor latch or ill-fitting pump parts can cause nipple injury, allowing bacteria in, which can lead to a breast infection or mastitis.
Anemia: A 2014 study indicated that anemic women may be more susceptible to mastitis since they are more vulnerable to infections.
- Previous history of mastitis: Moms who have previously battled mastitis are at an increased risk of recurrence. This is often because the initial cause of mastitis wasn’t uncovered and dealt with properly.
How can I prevent and manage clogged ducts and mastitis?
Dangle feeding/pumping: While on hands and knees or leaning over a bed or table, allow your breasts to dangle freely and nurse, pump, or hand express. This allows gravity to help pull the clog free.
Electric toothbrush: Turn on your electric toothbrush, and use the back (flat) part of the head to help loosen the clogged area.
Epsom salt bath: Following the ratio on the package, fill a large bowl or bathtub with warm water, and allow the breast to soak, massaging the breast if desired.
Frequent feeds/milk expression: Empty the breast often to help promote drainage and prevent mastitis and clogs.
Heat: Using heat before breastfeeding can help milk move freely and relieve clogs. Warm washcloths, showers, and hot packs can provide heat. Exercise caution and place a cloth layer between you and the heat source to prevent injury.
Lecithin supplements: These supplements are thought to help decrease the viscosity of the milk, allowing it to flow more freely through the milk ducts. Lecithin supplements may also be used to prevent recurring clogged ducts.
Medications: Use only as prescribed by your physician for pain and inflammation relief. Antibiotics may be needed if an infection is present.
Positioning: Switch up your nursing position to provide a new angle for proper milk duct drainage. Nurse your baby with their chin pointed toward the clog.
Rest: Get plenty of rest; remember to care for yourself in order to care for your baby. Take your baby in bed with you and continue breastfeeding there to get more rest. Practice safe-sleep measures to help ensure your baby’s safety if you fall asleep.
Therapeutic breast massage: Massage may help to dislodge clogs, promote lymph drainage, and encourage milk removal.
- Ultrasound therapy: Research from the Journal of Chiropractic Medicine suggests the use of ultrasound once a day for two consecutive days may help free clogs. Physical therapists and chiropractors who use ultrasound therapy for clogged ducts report better results.
If you feel like you may have a clogged duct or mastitis and your symptoms aren’t subsiding with proper management, it’s important to act quickly and reach out to an IBCLC, your OBGYN, or your primary health care provider for further assessment and treatment. If a blocked duct isn’t managed in a timely manner, it could result in mastitis and, potentially, breast abscess, a pus-filled lump in the breast caused by an infection.
While clogged ducts and mastitis can be inconvenient and uncomfortable, it doesn’t mean your breastfeeding journey has to come to an end. Your milk supply may dip, but it should rebound quickly after the clog has resolved, allowing you and your baby to breastfeed for as long as you both desire.
- Wambach, Karen, and Jan Riordan. Breastfeeding and Human Lactation.
Jones & Bartlett, 2016.
This information is for educational purposes only and does not constitute medical advice. Please reach out to an International Board Certified Lactation Consultant (IBCLC) or your health care team with any questions.