A Pain in the Boob: Clogged Milk Ducts and How to Clear Them

Clogged milk ducts are painful, make pumping unpleasant, and can lead to mastitis if they aren’t cleared quickly. Here is everything you need to know about them, including how to tell if you have a plugged duct, how to treat them, and how to prevent them in the future.

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What is a clogged duct?

A clogged milk duct, also called a blocked duct or a plugged duct, occurs when the milk flow out of your breast has been obstructed in a certain place.

A lot of the time, this can happen when milk isn’t removed quickly enough from the breast for whatever reason, such as if a feeding or pumping session is missed. They can also occur if your breast tissue is irritated for other reasons – if your bra is too tight, if you are sleeping on your breast, if your diaper bag is rubbing against your chest, etc. Sometimes, they seem to occur for no obvious reason.

How can I tell if I have one?

When you have a clogged milk duct, you generally can feel a hard, painful lump in your breast. The area around the lump might be red, warm to the touch, and tender. The breast may be more tender before feeding, with some relief after a feeding. Usually, only one breast is affected.

Additionally, the flow of milk out of the affected breast can be slower because the pressure from the duct with the clog may collapse the other ducts around it.

If you have other symptoms in addition to a painful lump, such as a fever, chills, flu-like aching, and malaise, you may also have mastitis. It’s really important to start treating a clog as soon as you notice it, before you develop mastitis. Mastitis is like having the a terrible flu but with a baby to care for 24/7; if you’re exclusively pumping, it’s even worse because you still have to be functional enough to pump instead of just lying down and nursing your baby a lot while you have it.

How do I treat a clogged milk duct?

Here are nine strategies for pumping moms to clear plugged ducts (everything from obvious to last resort).

1. Empty the affected breast as often and as completely as possible.

That means pump (at least the affected side) as often as you can.

Sometimes it can be painful to pump on the side that has a clog, and it can be worst at the beginning of a pumping session, before and during letdown.

One way to manage this is to hook yourself up to pump only on your “good,” unaffected side until your milk lets down. Then, hook yourself up on the clogged side and empty the affected breast as much as possible.

2. Use a warm compress

A warm compress (such as a warm washcloth or Booby Tubes) on your breast before you pump can help loosen the clog. Just make sure that it’s not so hot that you hurt yourself.

3. Do breast compressions

While you pump, do breast compressions on the affected side. You can try and massage the milk in affected duct towards the nipple.

4. Try vibration/lactation massager

Many women have found that the vibration helps break through the blocked duct.

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.)

5. 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.

6. 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. Here is a great overview of how to do it in different positions.

7. 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 hot 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 hot water. Your nipple should be submerged when you suction it on. Keep it on for 5-10 minutes.

8. 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.

9. Ask your partner to help you

Some women have success with having their partner provide the suction to get the clog out. (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.

As noted above, it’s a good idea to treat clogged ducts as quickly as possible in order to avoid mastitis.

How can I prevent clogged milk ducts in the future?

The best way to prevent clogged ducts is to empty your breasts completely and on a schedule. Breast milk production is a system of supply and demand, and clogged ducts often happen when supply suddenly exceeds demand. If you’re prone to clogged ducts, it’s best to not skip pumping sessions unless you have no choice; additionally, you should try to make sure that you empty your breasts as much as you can.

An exception to the “make sure you’re empty” rule would be if you were weaning or trying to decrease your milk supply.  In situations like this, you don’t want to empty all the way, but you do want to stick to a schedule and gradually decrease the amount of milk that you remove from your breasts, so that your body has time to catch up.

A few other things to watch out for when it comes to avoiding clogged ducts are making sure that your breast shields are the right size (not too big or too small), that your bra is comfortable and not too tight, and that you aren’t sleeping on the affected breast.

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. (More information on lecithin and clogged ducts here.)

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