How to Prevent and Relieve Clogged Milk Ducts

Clogged milk ducts are painful and can make breastfeeding so much more challenging. Once you have a clogged duct, your chances of getting another increases if you aren’t careful. Worst of all, a clogged duct can lead to mastitis if not properly treated.

Unfortunately, clogged ducts are very common. The whole idea for Rachel’s Remedy actually began with a clogged duct! (Buy Rachel's Remedy Breastfeeding Relief Packs here) We’ve been through it before, and we’ve done the research on how to identify and treat them so that you don’t have to. Read on for a better understanding of what clogged ducts are, why they happen, and most importantly of all, how to prevent them from ever happening again. 

What is a blocked, plugged, or clogged milk duct?

Your ducts are small tubes that carry milk from the tissues deep in your breast to your nipple, forming a network of branching passages that come together at the nipple itself. Muscle cells squeeze milk along these ducts to create a flow when your baby feeds. Clogged, plugged, or blocked ducts mean that milk is not moving well in a part of your breast, and then builds or backs up, preventing the milk from getting through.

You can recognize a clogged duct as a painful lump in your breast that might be red, irritated, and sore, and that can vary from the size of a pea to a peach. Occasionally, a clogged duct can show up as a red, swollen, tender patch on the surface of your breast rather than a lump. The area might still feel full after feeding due to the back up of milk behind the clog. 

Where the plug actually is can shift. It will typically feel more painful before a feeding and less afterward, as well as less lumpy or smaller afterward. Nursing on the side that has the clog may be painful—although it’s important to keep nursing on that side!

Side effects of clogged ducts might include a slowing down of milk on that side, as well as occasionally “strings” or grains of thickened milk or fatty-looking milk, which happens due to the build-up of milk at the clog. 

Why did I get one?

There are a couple of possible reasons. Clogs develop when milk flow is restricted, or when there is poor drainage from your breast in some way. They often happen in the early weeks of breastfeeding, when your body is getting used to how much milk your baby needs and your baby is still getting used to feeding. They can also happen when there is a change in your feeding schedule. 

Here are some of the reasons you might have a clogged milk duct:

• An abrupt change in your baby’s feeding schedule. Did your baby finally sleep all the way through the night last night and miss your regular 2 am feeding? Did you have to skip feedings for some reason? Missed or irregular feedings, or an interval between feedings that’s longer than usual, can cause a back up of milk to form. Even though sleep is so precious and necessary for yours and the baby’s health, you should get up in the night to pump if your baby skips a feeding to prevent engorgement and clogged ducts.
• Always nursing in the exact same position. This can cause a clog—as can pressing your breast so that your baby can have nostril space while feeding.
• Inadequate draining of the breast. If you still have milk while your baby is finished feeding, a clog can form so it’s very important to empty your breast completely. So get that pump out if you need it!
• Constricting your breasts. Wearing a tight or poorly fitting bra, very tight clothing or a baby carrier that squishes your breasts (ow!) can impede milk flow and help to cause a clog whether you’ve been feeding or not, due to the continuous pressure on your breasts.
• A plugged nipple pore or “bleb.” A nipple bleb looks like a tiny white spot at the end of the nipple that hurts when your baby feeds. This may be due to an overgrowth of skin cells or a collection of fragments or fatty material residue from your milk. It also might be a small, whitish-yellow milk plug at the opening of a duct on the nipple, blocking the milk from getting through.
• Rapid weaning. When weaning, you ideally want to give your body plenty of time to acclimate to reduced feedings. Circumstances don’t always allow enough time for proper weaning, and rapid weaning can cause a clog.
• Exhaustion. The small muscle fibers that push the milk through your breast require energy just like your other muscles. If you’re exhausted, the milk will be harder to push through, and so can clog.

Don’t ignore a clogged duct hoping it will get better—you need to deal with it ASAP! A clogged duct can lead to mastitis, and you have enough to deal with without having to get sick and be in pain.

What can I do to deal with it? 

Here is what you can do if you have a clogged duct: 

1. Continue nursing!

One of the best ways to relieve a clogged duct and get your milk flowing properly is to keep breastfeeding. Try to nurse more frequently than usual—making sure not to miss any regular feedings—and be careful to make sure that your baby is latched well. Start each feeding with the affected breast, and try to switch positions to allow for better drainage. If your baby does not fully drain the breast, express or pump milk from it after feeding in order to prevent more clogging.

2. Moist heat!

The American Academy of Pediatrics recommends moist heat as the most effective and highly recommended treatment for relieving your pain and loosening the plug. The AAP recommends warm, wet compresses or several hot showers a day. What new mom has time for that? Use our Breastfeeding Relief Packs to provide portable moist heat without getting your clothes wet, so that you can soothe, relieve, and, best of all, prevent clogged ducts with ease.

3. Massage!

After each feeding and between moist heat applications, gently massage the breast in order to help release the clog. Massage with your thumb from behind the plug toward the nipple, giving particular attention to the firm area. Then also try “clearing a path” by massaging from the front edge of the plug towards the nipple.

Continue these steps until you feel relief!

How do I know if I have mastitis?

If it’s been more than a few days since you developed the clogged duct, if the lump increases in size or redness, or if you are experiencing flu-like symptoms, see your doctor or IBCLC right away. While the symptoms of mastitis can be very similar to a clog, the pain, heat, and swelling are usually more intense. There may be red streaks extending outward from the affected area, and symptoms can also include fever, chills, flu-like aching, and malaise.

Mastitis is an inflammation of the breast that can be caused by obstruction (clogged duct), infection, or allergy. Some studies show approximately 20% of women get mastitis, though it is less common in countries where breastfeeding is the norm and frequent breastfeeding is typical. Mastitis is most common in the first few weeks, and may come on abruptly, usually affecting only one breast. The usual causes are clogged ducts and engorgement, but mastitis can also be caused by infection, stress, fatigue, anemia, and weakened immunity.

You should see your doctor or IBCLC if you suspect you have mastitis, and be sure to follow their advice. Mastitis is treated variably depending on how serious it is, but is generally treated in the same ways you would a clogged duct (frequent nursing, massage, moist heat compresses, rest), as well as more rest, an increase in fluids, a focus on adequate nutrition, possibly a course of antibiotics, and (did we mention) rest, rest, rest.

Side effects can include lumpy, clumpy, “gelatin-like,” or stringy expressed milk. Most doctors do not recommend that you stop breastfeeding while you have mastitis—in fact, it is part of the healing process, as we discussed earlier with clogged ducts. Milk may also take on a saltier taste due to increased sodium and chloride content. This is fine for the baby, but your baby might be unsettled by the change in taste.

If your mastitis is the result of an infection, or if you are experiencing flu-like symptoms, your doctor or IBCLC might prescribe you antibiotics. Other reasons they might prescribe antibiotics early on include:

• Mastitis is in both breasts,
• Baby is less than 2 weeks or old,
• You have recently been in the hospital,
• You have broken skin on the nipple that looks infected,
• There is blood or pus in your milk,
• Red streaking is present near a clog or blocked duct,
• Your temperature increases suddenly,
• Or symptoms are sudden and severe.

All of these might mean that your mastitis is an infection, which makes it important to treat it quickly with antibiotics. If antibiotics are prescribed, make sure you continue to take the full amount that your doctor gave you. We understand about being worried that the antibiotics might be transmitted in the breast milk and affect the baby, but the type of antibiotics prescribed do not usually cause any issues for the baby—and not completing the antibiotics increase your chances to get mastitis again if it was due to an infection.

How can I prevent clogged ducts in the future?

Clogged ducts are painful, and no one wants to have to deal with one, let alone multiple, clogged ducts. Here are some recommendations by experts to prevent clogged ducts and mastitis in the future:

1. Breastfeed regularly and do not allow yourself to become engorged. Use a pump to empty your breast completely if your baby finishes feeding and your breast is not empty.
2. Keep pressure off of your breasts. Experts suggest avoiding restrictive clothing, wearing a bra without underwire, temporarily wearing a bigger size bra, or not wearing a bra at all. The important takeaway is that anything that presses on your breasts for a long amount of time can cause a clog to form!
3. Change your nursing positions to allow the baby to drain milk from all areas of the breast equally.
4. Don’t sleep on your stomach.
5. Increase your fluid and Vitamin C intake to keep your immune system active and your muscles energized!
6. If you notice dried milk plugging openings in your nipples, wash them gently with warm water after each breastfeeding session.
7. Continue to use moist heat and massage after each feeding to prevent clogs and relieve breastfeeding-related pain! Remember, the AAP recommends moist heat to treat and PREVENT clogged ducts and mastitis from ever happening in the first place. Our Breastfeeding Relief Packs can help. Buy them here.

Continued difficulties with clogged ducts may signal a problem with your baby’s latching or with a nursing position. If you have repeated clogged ducts, discuss it with your doctor or IBCLC.

Continue to use moist heat and massage your breasts to keep pain at a minimum. Being a mother is hard, and dealing with nipple and breast pain only makes it harder. Make it easier on yourself by taking simple measures to prevent clogged ducts!

We hope you find our clogged duct research for breastfeeding moms useful. Rachel’s Remedy is committed to helping nursing moms breastfeed comfortably.

Prevent clogged ducts and mastitis, increase milk flow, and relieve discomfort using Rachel's Remedy. 

This is by no means meant to stand in place of advice from your doctor or IBCLC. If you are having a problem or have a concern, it is always best to speak to your doctor.

Sources: 
https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Clogged-Milk-Ducts.aspx

http://www.babycentre.co.uk/a8494/blocked-ducts-during-breastfeeding

https://www2.aap.org/breastfeeding/healthProfessionalsFAQ.html

aap.org:   New Mother's Guide to Breastfeeding, 2nd Edition (Copyright 2011 American Academy of Pediatrics 2015)

http://www.bfmed.org/Resources/Protocols.aspx

http://www.who.int/maternal_child_adolescent/documents/fch_cah_00_13/en/

http://www.nevdgp.org.au/info/nrdgphandouts/BreastCareForBlockedDucts.pdf