Plugged Duct Management When Breastfeeding

What Is A Clogged/Plugged Duct?

An area of the breast where milk flow is obstructed.

Why Is It A Big Deal?

Your body responds to the unresolved blockage by sending inflammatory cells to the area, which further compress the duct and reduce milk flow. Inflammation can cause reduced milk supply and potentially lead to mastitis. Clogs also tend to be recurring, which is why it’s important to see a lactation consultant to find and address the root cause, and not just google how to get rid of it and think you’re done. Mastitis can come on like a freight train, with little warning, and can become serious very quickly.

What Are The Signs And Symptoms Of A Clogged Milk Duct?

Signs vary, but usually present with tenderness or a lump, and often restricted milk flow. Clogs can be felt:

Deep in the ductal system- feels like lump or area of engorgement and tenderness

Closer to the surface- may feel like a pebble under the skin, tender
At the nipple pore- we call this a milk blister/bleb. These are handled a little differently, so we’ll address blebs in another article.

Why Does This Happen?

Plugs can occur for a variety of reasons. Here are some common causes:

Improper latch
Ineffective suck
Tongue tie or other oral restriction
Sleepy or distracted eater
Oversupply of milk
Rigid scheduling or timed feedings
Skipped feedings or pumping sessions
Returning to work
Use of a nipple shield
Weaning abruptly
Compression tight or ill-fitting bras, especially underwires
Sleeping on one side
High consumption of saturated fats
Secondary infections that cause inflammation, like thrush
Dehydration or electrolyte imbalance
Stress and fatigue
Lowered immunity or anemia, which is one reason diet is so important for lactation

**It’s important not to try to self diagnose. These issues are highly individual, and it’s very easy to get it wrong and compound your issues. We take insurance, as do many other IBCLCs, so it usually costs you nothing at all to let a specialist help you.**

Can You Still Breastfeed With A Clogged Duct?

Yes! You absolutely can and should breastfeed with a clogged duct. Plugged ducts do not negatively impact your milk composition or your baby! As you’ll learn in the next section, it is important to keep the milk flowing by either nursing or pumping.

How Do You Unclog Breast Milk Ducts?

First, make an appointment with a lactation consultant. While you’re waiting for your visit, be sure to:

Empty your breasts frequently- every 2 hours (unless you have oversupply)
Before nursing/pumping, apply moist heat and gently massage the area to encourage milk flow
Hand express after feedings to ensure breasts are empty
Use cold compresses after milk removal to reduce pain and inflammation
Rest as much as possible
Eat well and stay hydrated

Other strategies and dietary changes may be implemented by your lactation consultant to help reduce and prevent recurrence. These recommendations are individual and are not right for every situation. approved and monitored by your lactation consultant and in some cases, your physician.

How Can I Prevent This From Happening Again?

Follow your care plan from your lactation consultant and attend any recommended follow-up visit(s)
Ensure that your baby has good latch and can transfer effectively
Stay away from underwires and excessively tight bras
Empty your breasts regularly
Eat a diet low in saturated fats
Sleep on your back (side and stomach sleeping puts pressure on your milk ducts)

Risk Factors For Recurrence:

Any of the issues that may cause a clog initially, if not resolved, will likely result in recurrence. This is why it’s so important to see a lactation consultant.

Treatment:

While working with an IBCLC:

Dietary changes- increase fluids and decrease saturated fats, increase choline intake
Adding probiotics
Regular breast massage
Empty breasts fully and frequentlyD

Plugged Duct Management When Breastfeeding