A common breastfeeding problem breastfeeding mothers might encounter is a blocked milk duct.
Also known as clogged ducts, blocked milk ducts can feel like a painful or tender lump in your breast; this is the result of inflammation around a blockage in one or more of your milk ducts.
With prompt treatment, most mothers can remedy the blocked milk duct quickly, relieve breast pain and resume comfortable breastfeeding.
Here’s everything you need to know about blocked milk ducts or, as they are sometimes called, plugged ducts.
Symptoms of a blocked milk duct
A mother can have a blocked milk duct at any time while breastfeeding. Blocked ducts rarely occur in the first five days after giving birth, however, and most commonly occur within the first few months.
A blocked duct typically occurs in one section of one breast and the onset is usually gradual.
If you have a blocked duct, you will typically have these symptoms:
- A tender hard lump in one section of one breast
- A patch of redness on the overlying skin
- Mild pain in the area of the blocked duct, especially when your let-down reflex occurs
- A mild fever; you might have a low-grade fever (lower than 38.5°C) but otherwise feel generally well.
What causes plugged ducts?
Blocked ducts are most likely to occur when milk is not removed from your breast frequently or effectively. The blockage in the milk ducts is caused by inflammation in the surrounding breast tissue.
These are the risk factors for blocked milk ducts:
- Your baby is not attaching optimally to your breast
- Your baby doesn’t remove milk well from your breast – for example, due to tongue-tie or other anatomical problem
- Feeds are restricted – for example, due to feeding according to a schedule rather than according to your baby’s individual needs
- An oversupply of breast milk.
You can read more about oversupply in BellyBelly’s article Too Much Milk? Managing Oversupply of Breastmilk - A white spot or ‘milk bleb’ on your nipple, which can create a blockage at one of the openings on your nipple. This can cause milk to be ‘banked up’ along the same duct that leads away from your nipple opening into your breast
Speak with an Australian Breastfeeding Association counsellor or see a lactation consultant, who can help you work out what might have caused your plugged milk duct and what you can do about it.
Treatment for blocked milk ducts
If you have a blocked milk duct, it is important to keep breastfeeding as frequently as you normally would.
If you exclusively pump, make sure you stick to your regular schedule. Longer periods between pumping sessions can increase the risk of a developing mastitis from an unresolved blocked milk duct.
Pumping more often, in the hope of increasing milk flow and draining the plugged milk, is ineffective and could result in an oversupply of milk, therefore making the problem worse.
Frequent feeding and milk removal will help clear the blockage. If milk isn’t removed frequently, there is a risk the blocked milk duct could become mastitis.
For more information on mastitis, you can read BellyBelly’s article Mastitis | 9 Painful Signs, Symptoms And Treatment.
The following tips can help you clear a blocked duct:
- Apply a warm compress – for example, a wheat bag – to the affected area for a few minutes before breastfeeding
- Loosen your bra or take it off during breastfeeds to prevent any restrictions and keep milk moving evenly through the breast
- Feed first from the affected breast; this is the side that a baby tends to suck at most vigorously, and will remove milk most effectively
- Use gentle breast massage while feeding, to encourage more thorough emptying of the breast
- Hand express after feeding, if the breasts still feel full or lumpy
- Use cold packs after breastfeeds, for pain relief and to help reduce inflammation
- Changing breastfeeding positions. Some mothers find this helpful in removing a blockage
- Rest as much as possible.
Speak with an Australian Breastfeeding Asscoiation counsellor or see a lactation consultant, who can provide you with more tips and information.
When to see a doctor about blocked milk ducts
Although a plugged duct is generally an easily resolved breastfeeding ailment, it’s important to recognize when you should consult your healthcare provider for further advice.
If left untreated, a plugged duct can potentially evolve into inflammatory mastitis or a breast infection.
You should see a doctor if you have any of these symptoms, in addition to having a blocked milk duct:
- Flu-like symptoms (e.g. body aches, fever, chills or general feeling of fatigue)
- Nipple damage with signs of infection (e.g. your nipple might be red, hot to touch and thick, yellow pus might be present)
- Presence of pus or blood in your breast milk
- A blocked milk duct has not cleared within 24 hours.
If an infection is present, your doctor might prescribe a course of antibiotics.
How to prevent blocked milk ducts
In any case, prevention is better than treatment. The most effective way to prevent plugged milk ducts is through frequent and effective milk removal.
Because your milk supply is maintained on the principle of supply and demand, it’s also important you are removing just enough milk to meet your baby’s needs and not overstimulating your milk supply.
For more information, you can read BellyBelly’s article How Does Breastfeeding Work? An Explanation.