Clogged milk ducts are painful and sometimes progress to mastitis if they aren’t resolved. Here is everything you need to know, including how to tell if you have a blocked duct, how to treat it, and how to prevent them in the future.
This post may contain affiliate links, which means if you click a link and purchase something, I may make a small commission at no additional cost to you. I only recommend products I love! More information here.
What is a clogged duct?
A clogged milk duct is also called a blocked duct or a plugged duct.
It occurs when the flow out of your milk ducts has narrowed or been obstructed in a certain spot. The area may get inflamed, and milk flow out of this area may slow.
What causes blocked ducts?
Inflammation and swelling in the milk ducts may narrow the space the milk has to travel out of your breast. This can be caused by genetics, medical conditions you may have, recent use of antibiotics, or other reasons.
Clogged ducts can also occur if your breast tissue is irritated for other reasons – for example, if your bra is too tight, if you are sleeping on your breast, if your diaper bag is rubbing against your chest, etc.
Another theory is that clogged ducts may occur when milk isn’t removed on a regular basis from the breast, such as if a feeding or pumping session is missed.
Sometimes, blocked ducts seem to occur for no obvious reason.
What are the symptoms of a clogged duct? How can I tell if I have one?
Common symptoms include:
- A small, hard, painful lump in your breast.
- The area around the lump might be red, warm to the touch, and sore.
- The breast may be more tender before pumping or feeding, with some relief afterwards.
- Usually, only one breast is affected.
- The flow of milk out of the affected breast can be slower, because the pressure from the clogged duct may collapse the other ducts around it.
Clogged duct vs mastitis
You may have mastitis if you have any of the following symptoms in addition to the painful lump:
- Fever
- Chills
- Flu-like aching
- Headache
- General malaise (you just don’t feel well)
More on mastitis symptoms and treatment here.
How do I treat a clogged milk duct?
Here are nine strategies to clear plugged ducts with a breast pump (everything from obvious to last resort).
1. Continue pumping on your normal schedule
Sometimes it can be painful to pump on the side that has a clog, and it can be worse at the beginning of a pumping session, before and during letdown.
One way to manage this is to start pumping only on your “good,” unaffected side until your milk lets down. Then, start pumping on the clogged side and empty the affected breast as much as possible.
2. Try vibration/lactation massager
Many people have found that gentle vibration helps break with blocked ducts.
You can try an electric toothbrush, but if you are prone to clogs, a lactation massager that is shaped to help you work out plugged ducts with vibration is a good investment. It’s also waterproof, so you can use it in the shower!
(*The lactation massager I recommend is available on amazon, or you can also get a 10% discount buying directly from LaVie with the promo code EPUMP.)
3. Do gentle breast compressions while you pump
While you pump, do gentle breast compressions on the affected side. You can try and massage the milk in affected duct towards the nipple.
Be careful not to massage too forcefully, as you don’t want to inflame the tissue further.
4. Use a warm compress before pumping, and alternate with ice
A warm compress (such as a warm washcloth or Booby Tubes on your breast prior to pumping may help with pain.
Be careful not to overdo the heat, and alternate with ice after pumping. It may be helpful for reducing the inflammation.
5. Take ibuprofen
It will both help with the pain and reduce the inflammation the clogged duct is causing in your breast.
Ibuprofen is considered safe to take when breastfeeding. The Academy of Breastfeeding Medicine recommends 800mg every eight hours.
Other options for clearing a clogged duct
The Academy of Breastfeeding Medicine recently changed their guidelines on mastitis and ductal narrowing, and the above suggestions reflect that guidance.
Below are some things that had been recommended prior to these changes for women struggling with clogged ducts (and many sources still recommend). I’m going to list them here, and you can make an informed decision on whether you want to consider trying any of these.
6. Put epsom salt in a Haakaa pump
Some women in our Facebook group have seen success with putting 1-2 tablespoons of epsom salt and warm water into a Haakaa pump (a manual breast pump that you can attach to your breast with suction).
To do this, put the epsom salt into the pump, and fill it a little more than halfway with warm water. Your nipple should be submerged when you suction it on. Keep it on for about 10 minutes.
This should be done gently and sparingly in order to avoid inflaming breast tissue further. Additionally, this should not be done if you have any open wounds (such as a cracked nipple).
7. Try dangle pumping
Lots of people will suggest “dangle feeding” (nursing while leaning over your baby, so that gravity can help free the blockage) to help get out a clog, but that’s not helpful when you’re exclusively pumping.
Instead, you can try dangle pumping. Dangle pumping means pumping while you’re leaning over so that your nipples are pointed towards the floor. (While there’s no evidence that it works, some have seen success this way.)
Here is a great overview of how to do it in different positions.
8. Use a comb in the shower
Kellymom suggests using a comb on top of the area where the plugged duct in order to work the clog out.
Take a wide-toothed comb into the shower with you, draw it through a bar of soap, and gently massage it over the clogged area towards the nipple.
Gentle is the key word here – this shouldn’t hurt or be forceful; you don’t want to inflame your breast tissue.
9. Ask your partner to help you
Some women have success with having their partner provide suction on the affected breast.
(Mine was a hard pass on this, but if you’re desperate and your partner is willing, it might work.)
How long do plugged ducts last?
Blocked ducts usually resolve within 24-48 hours.
If you have a lump that lasts longer than a few days, see your doctor to rule out any other potential issues besides clogged ducts (such as a galactocele).
Clogged ducts may affect your milk supply as well, reducing output in the affected breast. It may also take a little time for your supply to recover after the clog is cleared.
How can I prevent clogged milk ducts in the future?
1. Stick to your schedule
Sometimes women notice that they get a clogged duct when their pumping schedule suddenly changes (for example, if they skip their middle of the night pumping session).
It’s a good idea to be consistent when you can, and to make changes to your schedule gradually.
2. Consider lecithin
If you are prone to getting plugged ducts, you can also try taking lecithin.
It may help in reducing the “stickiness” of milk by increasing the amount of fatty acids in the breast milk; the less sticky milk is better able to flow out of the milk ducts. The recommended dose is 1200mg, taken 4 times per day.
(Legendairy Milk reached out and gave me a discount code for their sunflower lecithin. Take 15% off with the code 15EPUMP!)
More information on lecithin and clogged ducts here.
3. Make sure your breast shields are the right size
Another thing to watch out for when it comes to avoiding clogged ducts is making sure that your breast shields are the right size.
Having flanges that are too big or too small can cause irritation and inflame breast tissue.
Need help with exclusive pumping? Use EPUMP30 for 30% off
4. Check to make sure there’s nothing else irritating your breast
The last thing to do is to make sure that your bra is comfortable and not too tight, that you aren’t sleeping on the affected breast, that there isn’t a diaper bag that rubs against your breast, that kind of thing.
Hopefully this helps you clear your clogged duct and prevent them in the future! Let me know in the comments if you have any questions.
References
- Katrina B. Mitchell, Helen M. Johnson, Juan Miguel Rodríguez, Anne Eglash, Charlotte Scherzinger, Kyle Widmer, Pamela Berens, Brooke Miller, and the Academy of Breastfeeding Medicine.Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022.Breastfeeding Medicine.May 2022.360-376. http://doi.org/10.1089/bfm.2022.29207.kbm
- Newman, Jack. “Blocked Ducts and Mastitis.” https://www.canadianbreastfeedingfoundation.org/basics/mastitis.shtml