A clogged duct is a common ailment experienced by breastfeeding mothers. For that reason, you might find a lot of conflicting advice about what to do to relieve a clogged milk duct.

Before following any advice on how to clear a clogged milk duct, it helps to understand exactly what it is.

Understanding plugged ducts

Inside a lactating breast are clumps of alveoli lined with milk making cells. These alveoli are joined together to form lobules. These smaller structures, the lobules, join together to form lobes, from which small, thin ducts run towards the nipple, where breast milk is made available for your baby to drink.

A plugged milk duct occurs when there is insufficient milk removal from a lactating breast. This causes a swelling of one of these tiny milk ducts, which restricts milk flow. The pressure surrounding the plugged duct causes inflammation in the surrounding breast tissue and results in a hard lump in the affected area.

What causes clogged milk ducts?

There are several reasons why milk ducts might be blocked. These include:

Engorgement – when the breasts are not being frequently or adequately emptied

Oversupply – when your breasts produce more milk than your baby needs
Scheduled feedings – when you feed your baby according to a time schedule rather than on demand
Missed feedings – for example, if your baby sleeps longer than expected and your breasts become overly full
Clothing that puts pressure on the breast or restricts milk flow – for example, wearing a bra with underwires
An anatomical problem that prevents your baby from draining the breast effectively – for example, tongue tie.

Symptoms of blocked milk ducts

If you have a clogged duct, you might notice one or more of the following symptoms:

Pain when breastfeeding
A white spot on your nipple
A tender or hard lump in the breast
A wedge-shaped, hardened area of the breast.

You can read more about this BellyBelly’s article Blocked Milk Duct – Symptoms and Treatments.

If you discover a lump in your breast that does not resolve after 24 hours, it’s important to follow up with your healthcare provider.

How to tell the difference between a clogged milk duct and mastitis?

Mastitis is inflammation of breast tissue that might or might not include an infection.

One of the most common causes of mastitis is from an unresolved plugged duct. Plugged ducts usually cause only localised pain, in the affected area; mastitis can affect the entire breast, as well as causing a fever and body aches.

You can read more about mastitis symptoms in BellyBelly’s article Mastitis | 9 Painful Signs, Symptoms And Treatment.

Should you still breastfeed if you have a clogged duct?

If you have a blocked or clogged duct, it’s important to continue breastfeeding or stick to your regular pumping sessions.

If you are considering weaning from breastfeeding, due to recurrent blocked ducts or mastitis, talk to a lactation consultant and ask for advice. Conservative breastfeeding management can often help address the issues that might be causing this.

If you decide to wean from breastfeeding and move to pumping, it’s best to make sure the blocked duct is resolved before you do so.

For more information about weaning, you can read BellyBelly’s article Weaning From Breastfeeding | A Gentle Approach.

Should I pump to clear a clogged milk duct?

If you are exclusively breastfeeding, you shouldn’t need to use a breast pump to help clear a clogged duct. The best advice is to keep breastfeeding or pumping to your usual schedule.

Old advice for the treatment of blocked ducts and mastitis recommended feeding or pumping more often than usual, to help clear the blockage. We now understand this can increase breast milk supply and contribute to the problem, rather than solve it.

If you are experiencing blocked ducts due to your baby’s inability to effectively drain the breast, it’s best to seek advice from a lactation consultant.

How do I know when a milk duct is unclogged?

You will know when any plugged ducts are resolved as you will no longer experience symptoms of pain in the breast or nipples, and you should no longer be able to feel a lump in the affected area.

Most clogged ducts are resolved with conservative management techniques, such as frequent and effective removal of milk from the breast.