Plugged Ducts

It’s common in the early days of nursing for your breasts to feel slightly uncomfortable as your milk comes in and your nipples adjust to breastfeeding. Some types of pain, however, are not normal and require your attention. If you notice a small, hard bump or lump on one of your breasts, you could have a plugged milk duct.

What are Plugged Milk Ducts?

A plugged, or clogged, milk duct is a red, small, sore, hard lump that occurs due to a milk obstruction. It may be located near the nipple area or farther back in the ductal system. It normally only affects one breast and appears slowly.

Causes of Plugged Ducts

Inside of your breasts, you have 15 to 20 milk ducts that empty into eight to 10 ductules in your nipples. When your breast makes milk, it is released down these ducts to nourish your little one. If your breasts aren’t being completely emptied of milk during nursing or pumping, the milk can become clogged, causing a painful plugged milk duct. This typically occurs if:

• Your little one isn’t nursing often enough.
• Your little one has an improper latch.
• You abruptly stop nursing.
• You are using a pump that isn’t strong enough to completely empty your breasts.
• You have an illness, such as a cold or flu, and aren’t nursing as often as you did prior to your illness.
• Your milk duct has become compressed due to an ill-fitting nursing bra or sleeping on your breasts, which can cause the milk to become obstructed.
• You recently had breast surgery, such as a breast biopsy, that affected the milk ducts and is preventing the milk from being released.
• You are under extreme stress, which caused your body to lower its amount of oxytocin. Oxytocin signals your milk ducts to release the milk; if your oxytocin levels are too low, your milk ducts may not get the proper signals necessary to release the milk.

Signs and Symptoms

Signs and symptoms of a plugged milk duct include:

• A small, hard lump or bump that is painful or tender to the touch.
• Redness on the side of your breast or near your nipple.
• A warm sensation or swelling in your breast that goes away or is reduced after nursing.
• Milk that seems to come out slower during nursing or pumping.
• Painful feelings that occur during letdown.

Dangers of Plugged Ducts

While you don’t need to panic if you have a plugged milk duct, it is important to take care of it right away. A plugged milk duct can become infected, which will cause a more serious condition called mastitis to occur. If you have a plugged milk duct and experience any of the following, it’s important to contact your doctor right away:

• Chills
• Fever
• Flu-like aches and pains
• Extreme tiredness

Treatment Options

The good news is that most plugged milk ducts will resolve with the proper treatment. If you have a plugged milk duct, try to remove the obstruction with one of these tips:

Empty Your Breast as Often as Possible

During nursing, offer your little one the side with the plugged duct first. Don’t pull him or her off of your breast and let them nurse completely. If your little one falls asleep or stops nursing, use a breast pump in order to remove as much milk as possible. If you are experiencing a strong letdown and it’s too painful to pump or nurse, try nursing on the opposite breast for a few minutes and then switching sides.

Use Breast Compression During Nursing or Pumping

Compressing your breast during nursing and pumping can help remove more milk. To try compression, first make a “C” shape with your hand; your thumb should be on top of your breast and your fingers supporting it underneath.

Position your hand so it isn’t on your areola. Every time your baby sucks, press down with your thumb. Don’t change the position of your thumb and don’t push down hard enough that it causes pain. While your baby swallows, release the pressure and then repeat.

Try Applying Heat

Run warm water on a washcloth and apply it to the lump during nursing. The warmth can help the milk flow better and can relieve your pain. Alternately, try taking a warm shower and letting the water hit the tender spot.

Change Nursing Positions

If you normally prefer the cradle position for nursing, try switching nursing positions. The football hold or crossover hold may help your little one stimulate more of your milk ducts and release the clog.

Take Care of Yourself

We know that it’s hard to make time for yourself while caring for a new little one (especially if you have other children to care for), but it’s important to care for yourself. Take your little one to bed and try to get some rest, drink plenty of water and eat as healthy as possible.

Mastitis versus Plugged Ducts

Plugged ducts are the result of a milk obstruction, which is due to your little one not emptying your breasts completely or constrictive clothing. Mastitis can occur due to bacteria entering your breasts through a crack in your nipple or when a plugged duct becomes infected.

Plugged ducts will typically resolve within 24 to 48 hours with treatment at home. Mastitis needs to be treated with antibiotics because it can affect the entire body and may become serious.

Nursing with Plugged Ducts

The best thing you can do to resolve your plugged ducts is to nurse. Though your milk flow may be slightly slower in your affected breast, which may frustrate your little one and cause them to be fussy, it’s important to nurse or pump as much as possible. The clogged duct won’t harm your baby even if you should develop an infection.

Plugged milk ducts can be a frustrating (and uncomfortable) part of nursing. With the right treatment, your clogged duct will soon be resolved and you will be back to nursing as usual.