Treating and Preventing Plugged Milk Ducts

Plugged milk ducts, also called clogged milk ducts or blocked milk ducts, are hard, tender lumps that form in the narrow milk ducts of the breast. They prevent the flow of breast milk. Plugged milk ducts are a common breastfeeding problem, and they can cause swelling, redness, and pain in the area of the breast where they develop. 

Causes of Clogged Milk Ducts

These common breastfeeding issues can lead to a blocked duct. In most cases, you can resolve these to prevent future problems.

• Incorrect breastfeeding latch: If your baby is not latching onto your breast well, they may not be able to draw that much milk out of your breast. When breast milk is left behind, it can block the ducts. 
• Breast engorgement: Breast milk can build up in your breasts and clog your milk ducts if you don't breastfeed often enough, miss feedings, wait too long between feedings, or supplement with formula. Breast engorgement can also develop when your baby begins sleeping through the night.
• Blebs: Blebs can plug up the openings of your milk ducts and cause your breast milk to back up and get stuck in the narrow passageways that allow the milk to flow from where it's made in your breast out to your nipple.
• Overabundant milk supply: If your body produces too much breast milk, it can lead to breast engorgement and plugged milk ducts.
• Excessive pressure on your breasts: A bra that has an underwire, or one that is too tight, can put pressure on the breast tissue and lead to clogged milk ducts. The straps of an infant carrier or a heavy diaper bag can also cause pressure on your breasts.
• Dehydration and fatigue: Lack of rest and not drinking enough fluids can put you at a greater risk of developing plugged milk ducts.
• Exercise: Plugged ducts can result from vigorous or strenuous exercise, especially of the upper body.
• Weaning: If you wean your baby quickly, it can lead to breast engorgement, plugged milk ducts, and mastitis.

Prevention

To keep milk ducts from clogging in the first place, breastfeed your baby often. To keep your breast milk flowing through your breasts and prevent it from backing up in the ducts, you need to remove it regularly and frequently. Do not skip feedings or wait too long between feedings.

Change breastfeeding positions with each feeding to allow your baby to drain different areas of your breast. Avoid restrictive clothing and nursing bras that are too tight or have an underwire, and do not sleep on your stomach. All of these can put pressure on your breasts. It's also important to stay hydrated.

When it is time to wean your baby, try to do so gradually. You may need to express small amounts of milk in between feedings to relieve engorgement. But don't express too much, or you'll signal to your body that it should continue making milk.

Treatment for Clogged Milk Ducts

Continuing to breastfeed can help clear the block. Certain positions and techniques may help. It's almost important to get enough rest and stay hydrated.

Breastfeed Often

First, make sure your baby is latching on correctly. Seek the advice of a lactation consultant, your doctor, or a breastfeeding support group if you need help with your baby's latch.

Breastfeed often—every one to three hours, or on-demand—to keep your breast milk flowing through the ducts. If it's not too painful, start feeding your baby on the side with the plugged milk duct first. Your child's suck will be stronger at the beginning of a feeding, which may help to remove the clogged milk.

If that breast is too tender, begin the feeding on the opposite breast and wait until after the let-down reflex is stimulated. Then switch to the breast with the plug.

When you're latching your child onto your breast, try to position them so that their nose or chin is toward the plugged duct. They may be better able to dislodge the blockage in these positions.

Apply Heat

Apply heat to the clogged area before each feeding to help with your let-down reflex and the flow of your breast milk through your ducts. Gently massage the affected area while applying heat, and while you're breastfeeding your baby. See your doctor or a lactation specialist to learn how to use therapeutic breast massage and use it at home to help prevent and manage plugged milk ducts.

Express Milk

Use hand expression or a breast pump after you breastfeed your child to remove more breast milk and try to free the blockage. It's important to empty the breast of breast milk as completely as you can.

Supplements

Ask your doctor about taking a lecithin supplement. Lecithin is a nutritional supplement that is safe to take while you're breastfeeding. It is believed to help resolve and prevent plugged milk ducts. A typical dose is one tablespoon of granulated or liquid lecithin each day, or one capsule (1200 mg) three or four times a day.

When to Call Your Doctor

When treated right away, a plugged milk duct usually begins to get smaller or go away within a few days. Left untreated, it can get worse and lead to more serious complications, such as mastitis or a breast abscess. Call your doctor if:

• The lump does not go away within three days.
• The lump grows. 
• The area is red, and it increases in size.
• You develop a fever.