Many women experience clogged milk ducts at some point in their breastfeeding journeys. If addressed quickly, a clogged duct can be resolved relatively easily without medical intervention. However, some clogged ducts can turn into mastitis.

In this piece, I’ll explain everything from what a milk duct is to what you can do to prevent or relieve a clogged duct and keep mastitis at bay. Before I dive into how to get rid of a clogged duct, some background information:

What is a milk duct?

A milk duct is a pathway for breast milk to travel through the breast and out the nipple.

What is a clogged duct?

A clogged duct (also referred to as a blocked duct or plugged duct) happens when milk becomes stagnant in the duct.

What is mastitis?

Mastitis (aka lactational mastitis, lactation mastitis) is inflammation of the breast tissue. This inflammation may or may not involve an infection.

What are some symptoms of blocked ducts?

Symptoms of blocked milk ducts can include breast tenderness, breast pain, nipple pain, redness, heat, decreased milk supply, tender lumps, and palpable lumps. Occasionally, babies will be fussy at the breast due to the decreased flow of milk caused by the blockage.

When a clog has dislodged, you may express stringy clumps of milk, although you might not notice them unless you’re pumping or hand expressing. This milk is safe for your baby to consume.

What are some symptoms of mastitis?

Women who experience mastitis may have the symptoms above along with flu-like symptoms such as fever (101.3 °F or above), chills, fatigue, and an overall unwell feeling.

What causes plugged milk ducts?

• Engorgement: Breast engorgement generally occurs a few days after birth when breast milk supply is increasing rapidly. It also may occur when supply is overabundant or the breasts are not properly emptied (e.g., your baby sleeps longer than usual, and you wake up with full, firm breasts).
  
  
• Ill-fitting bras: Nursing bras with underwire that goes toward the axillary (armpit) area or maternity bras that are too tight or constrictive may block milk ducts (and even lymph drainage), preventing milk from draining adequately.
  
  
• Ineffective emptying of the breast: This can be from missed feeds or pumping sessions, less frequent breastfeeding sessions due to a busy schedule or weaning, hurried feeds where you've stopped breastfeeding before your breast is completely empty, oral anatomy issues, nipple shield use, and even poor latch (potentially resulting in less milk flowing and stagnant milk).
  
  
• Unnecessary pressure on the breasts: Tight clothing (including a tight nursing bra), diaper bag straps, baby carriers, and sleeping on your stomach can all put pressure on your breasts, which could lead to clogged ducts.

What causes mastitis?

• Clogged ducts: Clogged ducts can have many different causes, as outlined above. If clogged ducts aren’t resolved, they can put you at risk for developing mastitis.
  
  
• Nipple breakdown or infection in the nipple: A poor latch, undeveloped breastfeeding technique, or ill-fitting pump parts can cause nipple injury, allowing bacteria in, which can lead to a breast infection or mastitis.
  
  
• Anemia: A 2014 study indicated that anemic women may be more susceptible to mastitis since they are more vulnerable to infections.
  
  
• Previous history of mastitis: Moms who have previously battled mastitis are at an increased risk of recurrence. This is often because the initial cause of mastitis wasn’t uncovered and dealt with properly.

How can I manage and prevent clogged milk ducts and mastitis?

• Dangle feeding/pumping: While on hands and knees or leaning over a bed or table, allow your breasts to dangle freely and nurse, pump, or hand express. This allows gravity to help drain the breast and pull the clog free.
  
  
• Electric toothbrush: Turn on your electric toothbrush, and use the back (flat) part of the head to very gently massage and help loosen the clogged area of the breast. It’s important to listen to your body and use only gentle pressure so as not to further damage inflamed tissue.
  
  
• Epsom salt bath: Following the ratio on the package, fill a large bowl or bathtub with lukewarm water, and allow the breast to soak, gently massaging the breast if desired. Use heat sparingly on the affected breast.
  
  
• Regular feeds/milk expression: Stay consistent in your feeding or pumping routine by continuing to nurse, hand express, or use a breast pump to help promote normal drainage and prevent mastitis and clogs. Vary breastfeeding positions and remember to alternate and adequately empty both breasts.
  
  
• Ice or heat: Using ice to help reduce inflammation between breastfeeding sessions can help milk move freely and relieve clogs. Ice packs, cold compresses, or washcloths can provide comfort and help reduce swelling of a plugged duct. Be aware that heat treatment can potentially exacerbate clogs or mastitis, although some may find relief in utilizing warm compresses, warm showers, etc., to treat symptoms. Exercise caution with both ice and heat treatments, and place a cloth layer between the affected breast and the cold or heat source to prevent injury.
  
  
• Lecithin supplements: These supplements are thought to help decrease the viscosity of the milk, allowing it to flow more freely through the milk ducts. Sunflower lecithin may also prevent recurrent plugged ducts. Talk with your provider before beginning any new medication or supplements while breastfeeding.
  
  
• Medications: Use only as prescribed by your physician for pain and inflammation relief. Mild pain relievers may help. Antibiotics are typically needed to treat mastitis. Drink plenty of water while taking medication.
  
  
• Positioning: Switch up your nursing position to provide a new angle for proper milk duct drainage. Nurse your baby with their chin pointed toward the clog/affected area.
  
  
• Rest: Get plenty of rest; remember to care for yourself in order to care for your baby. Take a shower and bring your baby in bed with you to continue breastfeeding as you get some rest. Practice safe-sleep measures to help ensure your baby’s safety if you fall asleep.
  
  
• Gentle therapeutic breast massage: Gentle massage may help to dislodge clogs, promote lymph drainage, and encourage milk removal. Only utilize gentle massage for comfort, and do not apply increased pressure to sensitive or painful areas, which may cause additional damage to the breast.
  
  
• Ultrasound therapy: Research from the Journal of Chiropractic Medicine suggests the use of ultrasound once a day for two consecutive days may help free clogs. Physical therapists and chiropractors who use ultrasound therapy for clogged ducts report better results.

If you feel like you may have a clogged duct, recurring clogged ducts, or mastitis and your symptoms aren’t subsiding with proper management, it’s important to act quickly and reach out to an IBCLC, your OBGYN, your primary care provider, or other healthcare professionals for a physical exam, further assessment, and treatment for mastitis or a plugged duct.

If a blocked duct isn’t managed in a timely manner, it could result in mastitis and, potentially, breast abscess, a collection of pus in the breast caused by an infection, or other breast diseases.

Certain illnesses like inflammatory breast cancer can share symptoms of mastitis, so make sure you inform your medical team if your mastitis is not recovering after treatment.

While clogged ducts and mastitis can be inconvenient and uncomfortable, it doesn’t mean your breastfeeding journey has to come to an end. Until you heal or treat clogged ducts, your milk supply may dip, but it should rebound quickly after the clog has resolved, allowing you and your baby to breastfeed for as long as you both desire.

Additional Resources:

• American Academy of Pediatrics
• Academy of Breastfeeding Medicine
• La Leche League International
• https://ibconline.ca/information-sheets/blocked-ducts-mastitis/
• https://kellymom.com/bf/concerns/mother/mastitis/
• https://kellymom.com/nutrition/vitamins/lecithin/
• https://www.llli.org/the-safe-sleep-seven/
• Wambach, Karen, and Jan Riordan. Breastfeeding and Human Lactation.
  Jones & Bartlett, 2016.

This information is for educational purposes only and does not constitute medical advice reviewed by medical reviewers. Please reach out to an International Board Certified Lactation Consultant (IBCLC) or your health care team with any questions.