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How to Treat Plugged Milk Ducts and Mastitis

How to unclog a milk duct while breastfeeding, to avoid mastitis or even a breast abscess. Learn the symptoms and my top tips as a mum who breastfed for five years.

How to Unclog a Milk Duct While Breastfeeding

how to unclog a milk duct while breastfeeding | Image shows a woman holding her baby and breastfeeding.
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I’ve been meaning to write this post for such a long time now. If you’re here then it’s likely because you’re breastfeeding and have discovered a stubborn blocked milk duct.

Between my two girls, I’ve breastfeed for a total of five years, and I’ve experienced this issue countless times. Today I’m going to give you my top tips for how to clear a clogged milk duct – and how to prevent it from recurring.

Note: the following information does not replace advice from a medical professional. For additional support see your healthcare provider or a lactation consultant.

Dealing With a Blocked Milk Duct

Blocked milk ducts are almost a rite of passage for breastfeeding women. They’re not fun, but thankfully they can usually be managed effectively at home.

Fast detection and management is vital to prevent mastitis occurring.

What is a Clogged Milk Duct?

A clogged duct, also known as a blocked milk duct or a plugged duct, is a blockage of one or more milk ducts carrying breastmilk from the tissue to the nipple.

It’s often the case that women can experience recurrent blockages in the same area of the breast.

What Causes a Plugged Milk Duct?

Ducts may become blocked when milk flow is interrupted and milk is not adequately removed from the breast, for example if baby misses a feed the breasts may become engorged which can contribute to the problem.

It’s also possible that you may experience a clogged duct as a result of a milk blister (also known as a milk bleb), since a small amount of milk will frequently build up behind the nipple pore when a blister forms into a white spot.

Clogged Milk Duct Risk Factors

Risk factors for developing plugged ducts include:

  • Missing a feed
  • Abundant milk supply / not fully draining the breasts when nursing
  • Infrequent feedings
  • A change to nursing schedule resulting in periods of not feeding
  • Wearing tight fitting bras
  • Using nipple shields
  • Poor latch (try the nipple flipple exaggerated latch technique to help with this)
  • Having previously had a clogged duct

Clogged milk ducts can be treated effectively at home; however the issue can quickly escalate to a more serious illness if left unresolved. The primary risk factor for this is that blockages can go undetected until they amass to a large size, by which point mastitis may be imminent.

Fast detection and management is vital to prevent mastitis occurring.

Baby Nursing

Blocked Milk Duct Symptoms

The main symptoms of a plugged milk duct include the following:

  • A firm lump in the breast which may quickly increase in size;
  • Tenderness of the tissue surrounding the hard lump resulting in a generally sore breast;
  • As the blockage becomes larger it may develop into a red swelling;
  • If redness develops, your skin is also likely to be warm to the touch.

What Does a Blocked Milk Duct Feel Like?

Initially you may be entirely unaware of a mild blockage. As it develops without treatment, you’ll begin to notice some discomfort in the area.

It may be warm, with a tender lump developing, which feels sore to massage. You may also experience some pain whilst nursing. 

Breastfeeding Through a Blocked Milk Duct

If you recognise these symptoms, keep reading to learn how to unclog a milk duct while breastfeeding before it develops into mastitis.

How to Treat a Blocked Milk Duct

I remember the first time it happened to me; I was really anxious because on top of what’s already a difficult time, I knew that it’s critical to deal with a clogged milk duct fast. Failing to act quickly can unfortunately lead to bigger more problems, which I’ll explain later.

But, with careful management, it’s entirely possible to deal with a blocked breast duct at home, and it can be resolved within a few hours.

How to Clear a Clogged Milk Duct

Here are my top tips for how to unclog a milk duct while breastfeeding:

1. Check Your Breasts Every Day

This is important since it’s easy to miss a blockage which is deep in the tissue of your breast until it becomes more severe. Gently but firmly explore your breast tissue each time you have a shower to identify any telltale areas of firmness.

2. Continue to Breastfeed Frequently!

The worst thing you can when dealing with a blocked milk duct is to stop nursing on the affected side. Start feeds on the blocked side and aim to completely drain the breast. Nurse from the affected breast frequently – but be careful not to neglect feeding on the other side.

Breastfeeding

3. Nurse With Baby’s Chin Pointing Towards the Blockage

A good latch and aiming baby’s chin towards the blockage during feeding may help to unblock a clogged milk duct.

Known as ‘dangle feeding’, this may involve laying your infant on his back and hovering over him, making sure baby’s latch is sufficiently strong.

4. Use a Hot Nappy 

Heat can be useful to help relieve a blockage. While many may recommend warm compresses or a heating pad, I discovered something better…

One of my best tips is to pour hot water from the kettle into a nappy as it retains the heat for a long time. Apply the nappy as hot as you can stand.

This is a good time to make a mental note for if ever you see an accident involving a baby or toddler: get their nappy off immediately.

Alternatively you could try using a microwaveable heat pack such as this one:

5. Therapeutic Breast Massage of the Affected Area

Firmly massage the area of engorgement in a circular motion whilst applying heat. Alternatively you could try hand expressing whilst in a hot shower or bath.

6. Pay Attention to Technique

When massaging, try visualising the blockage; this will help you to use the correct technique:

Rather than attempting to massage from behind the blockage or clogged area, first try emptying the tissue in front, which will make it easier to move the blockage along. Then you can move on to firmly massaging around the blockage to break it up, and from behind to drain the breast. 

Alternatively try offering the breast to baby after you’ve broken up the blockage. 

Breastfeeding
How to clear a clogged milk duct? Nursing through it is considered part of the treatment for a blocked milk duct.

7. Apply a Cold Gel Pack 

After massages and feeds you may like to alternate from the hot nappy with a cold gel pack or flannel on the affected area. This will help with any swelling and inflammation and may ease your discomfort. 

Don’t forget it’s fine to use paracetamol and ibuprofen whilst breastfeeding too. Note aspirin is best avoided.

8. Try an Electric Toothbrush

The vibrations from the flat end of an electric toothbrush or similarly vibrating device (ahem) can also help to break up and loosen a blockage. 

Alternatively try a lactation massager for a similar effect:

9. Soak the Affected Breast in a Warm Epsom Salt Bath

Plugged ducts can cause pain and swelling, and using epsom salts can help to draw out the plug and relieve discomfort.

How to Prevent Recurring or Frequent Clogged Milk Ducts

  1. Choose appropriate bras

I highly recommend avoiding underwire bras whilst breastfeeding, and definitely ensure they are not too restrictive as an ill-fitting bra with tight straps can certainly aggravate the issue by applying too much pressure to the breast tissue.

  1. Try varying feeding positions

Different feeding positions may help to prevent painful lumps from developing, as baby may be more efficient at draining the breast in a specific hold.

How to clear a blocked milk duct, plus how to treat mastitis or a breast abscess. Symptoms, tips, and prevention. #blockedmilkduct #mastitis #pluggedmilkduct #breastabscess #breastfeedingproblems #breastfeedingsupport #breastfeedingtips #breastfeedingadvice #cloggedmilkduct
  1. Sunflower Lecithin supplements

I’m not generally a fan of complementary treatments, preferring to err on the side of caution and rely on proven, licensed, and regulated medicines. However, we all do things out of desperation and after dealing with a particularly stubborn clogged duct and hearing of several positive experiences from friends, I decided to try taking soya lecithin supplements.

Despite my reservations and not having any evidence as to why this should work, I can nonetheless recommend the product.

I won’t promise it will work for you, but really, what do you have to lose except hopefully a stubborn clogged milk duct?

Can I Continue to Breastfeed With a Blocked Milk Duct?

Yes! Insufficient draining of the breast is what causes the issue in the first place. So, not only can you, but frequent nursing is highly recommended as part of the treatment for the problem.

Can I Continue to Breastfeed With a Blocked Milk Duct?

Mastitis

As mentioned previously, it’s vital that you take action fast if you notice a blocked duct. Unfortunately failing to treat the problem quickly enough is likely to lead to mastitis, since it’s unlikely that the issue will resolve by itself.

In my five years of breastfeeding, despite countless bouts of plugged milk ducts, I’ve only ever developed mastitis which required antibiotics once.

What is Mastitis?

Mastitis is a bacterial infection of the breast tissue, which is often brought on by inefficient draining of the breast. It is usually necessary to treat with antibiotics.

In my five years of breastfeeding, despite countless bouts of plugged milk ducts, I’ve only ever developed mastitis which required antibiotics once.

Symptoms of Mastitis

Mastitis presents in much the same way as a blocked duct, with a couple of additional symptoms:

  • A firm, wedge-shaped mass in the breast which feels like hard, sore lump;
  • Tenderness of the sore area and surrounding breast tissue;
  • Pain when nursing;
  • Heat and inflammation of the breast around the site of the mass;
  • Generally feeling unwell;
  • Body aches;
  • Fever and flu-like symptoms;
  • You may also experience nipple discharge.

Treatment of Mastitis

Treatment is the same as with a blocked duct, and a visit to your GP to obtain antibiotics may well be necessary.

Can I Continue to Breastfeed With Mastitis?

Yes! It’s fine to continue nursing if you have mastitis; your GP should be able to prescribe antibiotics which are safe for your baby.

Vulnerability as a woman

Breast Abscess

If mastitis is not treated promptly, it can quickly develop into a breast abscess.

What is a Breast Abscess?

An abscess in the breast is a build up of pus caused by an untreated infection (mastitis). They usually affect breastfeeding women, though mastitis and breast abscesses may sometimes occur in women who are not nursing and also in men.

Breast Abscess Symptoms

The symptoms of a breast abscess are much the same as mastitis, outlined above.

Treatment of a Breast Abscess

You will need to visit your GP. If an abscess is suspected or confirmed, you will be referred to hospital to have the pus drained from the area. You may also be prescribed antibiotics to clear the breast infection.

Can I Continue to Breastfeed With an Abscess?

Yes, you should be able to continue nursing. As above, you should be prescribed antibiotics which are suitable for your baby.

If your GP advises you to discontinue breastfeeding during the healing period, you will need to express instead; you may continue to nurse on the unaffected side. 

While these issues may seem daunting, if identified quickly, a blocked duct can be treated promptly and effectively, helping to prevent more serious issues from occurring.