Clogged Ducts

A clogged or plugged duct is a blockage of milk flow in a portion of the breast. It can either be in the nipple or further back in the breast. There are different types of clogs and can present in different areas too. One area this can happen is in the nipple pore. This would be either in the nipple or at the surface of the nipple and it could be a bleb or a blister. A bleb is a milk filled bubble typically at the tip of the nipple where the milk is clogged. A milk bleb/ blister, or blocked nipple pore, is simply “milk under the skin.” It can happen when a tiny bit of skin grows over a milk duct opening and milk backs up behind it. A milk blister usually shows up as a painful white, clear or yellow dot on the nipple or areola, and it can be very painful. A clogged duct usually happens gradually and will create a lump in the area that is tender to touch and sometimes can create a red spot. This typically occurs on one breast and happens after you've been engorged, went very long between feedings, or gave a bottle in replace of a feeding.  It can be painful before trying to drain and then less painful after. Ideally the best way to prevent a clogged duct is to breastfeed consistently and properly. This means, breastfeeding the baby on Q and not skipping any feedings especially in the first few weeks. The first 6-8 weeks is when your body is still adjusting and regulating with your baby's schedule. Focusing on establishing a good supply, a good schedule and breastfeeding relationship is very important. The best way to manage a clogged duct is to keep nursing! Draining the breast will help keep the flow going. Soaking the affected breast in hot water will help soften the breast tissue and help open the ducts. Using hand massage in the water will help get it moving. You can soak in a deep plastic bowl or mixing bowl, really whatever you can submerge the breast in. You can take a hot shower as well but typically, submerging the breast seems to be more effective. Doing this before each feeding and using massage will help get the clog drained. Another way to help get the clog moving is by warm castor oil on the effected spot with massage. Using a Haakaa on the opposite side when your nursing can also help to drain the breast and essentially draw out the clog too. It's important to work on the clog immediately so that it does not turn into an infection. Ideally, when you address the issue right away and consistently the breast will feel soft and should not feel any pain.There should be relief within a few days and should not have any other symptoms present. There are some homeopathic or herbal supplements that can be used during this time but should always be recommended by an IBCLC before using. If a clogged duct is left untreated or not properly drained, then it can become infected. This can lead to Mastitis, which is inflammation and infection of the breast. These conditions happen most often in the first six to eight weeks postpartum, but can occur at any time during breastfeeding. Mastitis infection can begin with the same symptoms of a clogged duct however, the pain/heat/swelling is usually more intense. There may be red streaks on the breast extending outward from the affected area. Typical symptoms also include, fever of 101.3°F (38.5°C) or greater, chills and flu-like body aches. If at any point you feel it's mastitis then your health care provider must be notified as you will likely need antibiotics for the infection. Clogged ducts can reoccur so being proactive with properly draining the breast and feeding the baby is crucial to help prevent it. Other ways to prevent, is by wearing a supportive nursing bra that is not tight or constrictive or has underwire. Making sure you have a good latch for the baby to drain milk well and ensuring your pump flange is the correct size to also drain milk is key. If any complications occur during breastfeeding it's always important to reach out to an IBCLC as soon as possible. The sooner you get help the sooner you can enjoy nursing your baby.