Clogged ducts and preventing mastitis
What is a “clogged duct”?
A clogged duct is a hard, tender lump felt in the breast due to a backup of breastmilk. Clogged ducts are a direct result of inflammation in the breasts from the extra pressure that is being built up by milk that is left behind. This inflammation makes it hard for milk to leave the breast, leading to a backup of breastmilk behind the inflammation. This pressure build up is typically caused by ineffective or hurried emptying (missing or delaying a feeding or pumping session, or not removing as much milk as you typically do because you are in a rush). Clogs typically feel like a tender, hard lump in the breast and the skin of the breast may be reddened on that side.
Other potential causes of clogs: tight bras, clothing, baby carriers, bags, seat belts or anything that has the potential to add pressure to the breast externally and restrict flow of milk
What is “mastitis”?
Mastitis occurs when there is are sudden flu-like symptoms accompanied by a hard, tender lump in the breast. This can be caused by a clogged duct that is not cleared effectively.
What to watch out for:
fever or any other flu-like symptoms
reddened spot on the breast that worsens rather than resolving
severe pain or discomfort
potential medical emergency: both breasts are affected (reddened skin and flu-like symptoms)
mastitis/clogged ducts typically affect one breast at a time - if both breasts are affected it could be something more serious - please contact your medical provider
Treatment for mastitis typically includes rest, pain management (an NSAID like ibuprofen), inflammation reduction (ice) and in some cases an antibiotic course - if you think you have mastitis please contact your medical provider for a list of warning signs, management tips and next steps. This plan should be personalized to you are your symptoms.
You can and should continue breastfeeding or pumping through mastitis unless your medical provider specifies otherwise. Sudden changes in or cessation of milk removal can make mastitis worse.
What to do if you get a clogged duct:
How to treat a clogged duct:
Ice, ice, ice!
Consider taking an NSAID like ibuprofen for pain management and to help reduce swelling
Light breast massage to encourage lymphatic drainage (your breast tissue is fragile, be sure to do this very lightly) - you can do this by lightly stroking your breast from nipple to armpit
Maintain your current pumping or nursing schedule and do not deviate from it (either by increasing or decreasing sessions) until the clog is gone
Breast gymnastics are another gentle way to encourage lymphatic drainage - grab your breast with both hands and gently lift it up and down and move it side to side
Consider having baby start feedings on this side - typically at the beginning of a feeding baby will be the most efficient at removing milk
Consider changing baby’s position when feeding at the breast - if you typically feed in football hold try cross-cradle or vice versa - trying to target milk removal from other milk ducts
Light massage while pumping or breastfeeding - again tissue is very delicate and aggressive massaging can worsen the inflammation and the clog
If the clog does not clear within 24-48 hours or you develop a fever or any other symptoms of illness, please reach out to your medical provider
The clog may come out as stringy, clumpy milk - this is not harmful to baby
How to prevent a clogged duct:
Maintain your current breastfeeding/pumping schedule
Avoid skipping feeding or pumping sessions
Ensure you are fully emptying your breasts when you pump by:
using the correct flange size
replacing necessary pump pieces regularly to avoid any negative impact on the pump’s suction
Avoid tight or restricting clothing that may add external pressure to your breasts and restrict milk flow
If in the process of weaning, do so slowly by:
gradually increasing length between feedings
gradually decreasing length of pumping sessions
Resources:
WIC Breastfeeding Support: Plugged Ducts, Mastitis, and Thrush
