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Avoiding and Managing Blocked Ducts while Breastfeeding
Read time: 6 minutes
What should I know about blocked or clogged milk ducts?
Know the signs and causes of a blocked duct
Learn how to treat both occasional as well as recurrent blocked ducts
Understand how to help prevent blocked ducts from forming
Blocked ducts, also called plugged or clogged ducts, are an all-too common frustration for breastfeeding moms. A blocked duct occurs when the flow of milk through your breast becomes obstructed (also known as milk stasis).1,
While these can usually be resolved quickly, some may be tougher to get out. A persistent blocked duct that results in engorgement may lead to an infection, so it’s important to work on clearing the plugged duct.
Read on to learn different methods that may help treat a clogged duct.
Symptoms of a blocked duct
The most common sign is a hard lump in the affected breast. The area near the block may be sore/tender, red, or swollen.2, You may see a slight decrease in supply (since milk can't pass through that area), but milk may flow from the surrounding milk ducts.3
Some women experience strings of thickened milk when they express, which is usually a sign that the block is being cleared.
Most blocked ducts will resolve within 24 hours.6,
Are you having trouble with blocked ducts? Our team of registered dietitian nutritionists and lactation specialists are available from Monday – Friday 8 am – 6 pm (ET) to help figure out what may be going on. Chat now!
What Causes Blocked Ducts?
The two main causes of blocked ducts are inadequate removal of milk and pressure on the breast.1,
Inadequate removal of milk may stem from:
If your baby has a sub-optimal latch, weak suck, or tongue tie, they might not be removing milk efficiently.4
Infrequent feedings, long separations from baby (without pumping), or abrupt weaning can also all cause engorgement and put you at risk for blocked ducts.2,
External pressure on your breasts may be from:
A tight bra, diaper bag strap, or seat belt that puts pressure on one area of the breast and restricts milk flow.
Lying on your stomach for extended periods may also cause problematic pressure.6,
In addition to supporting adequate milk release and avoiding undue pressure on your breasts, rest and proper nutrition are also important to keep milk flowing.7,8
Maternal stress and fatigue are factors for developing a clogged duct.8 Additionally, good nutrition can help support your immune system, which is thought to help ward off progression to mastitis (an infection of the breast).7,8
Learn about:
Causes and Symptoms of Mastitis
What to do about Sore Nipples while Breastfeeding
At-home treatment of blocked ducts
If you do have a blocked duct, don't fret. You will likely be able to dislodge the blockage and relieve your symptoms at home with one or more of the following treatments:
Heat: A warm shower or compress before a feeding and/or while massaging the area may help.9
You can use a disposable diaper as a compress as it often holds heat longer than a cloth. Pour warm water into the diaper, then place the inside of the diaper on the affected area. 10 You can also fill a clean sock with dry, uncooked rice and sew the end shut. This works as a reusable heating pad: warm in the microwave for 10 to 20 seconds at a time until it is an acceptable temperature.
Massage: Gently massaging the affected breast before and during feedings can improve milk drainage and help with pain relief.11,12
Start just behind the blockage and massage towards the nipple.2, Massage in small circles or long strokes. You can also massage in the shower using the blunt side of a comb to gently stroke from the blockage down toward the nipple.10
Empty your breasts: Feed your baby frequently, about every 2 hours. Starting each feeding on the affected breast may help draw out the clog better since baby will be hungrier.1,4
If this is too painful, try feeding on the other breast until letdown is initiated (baby will start audibly swallowing and you may feel a slight pins-and-needles sensation). Then switch to the breast with the clog.
Pump or hand express after feeding to ensure optimal milk removal.13
Breastfeed in a new position: Switching positions may help drain the breast better, helping to empty the breast from other angles.2,4
Read more:
Additional treatments to try if your blocked duct is recurrent or particularly difficult to dislodge
Reduce saturated fat in the diet: Sometimes eating too much saturated fat may play a role in recurrent blocked ducts.7, It is hypothesized that saturated fat may make breastmilk more viscous (or ‘stickier’), leading to plugged ducts.
Try limiting saturated fat (which is mostly found in animal products) by choosing low fat or fat free dairy products; leaner ground beef and turkey; and choosing fish and skinless poultry more often and fattier proteins. Try vegetarian days when beans, legumes, tofu, nuts, and seeds are your primary sources of protein - this helps boost healthy fats in your diet as well.
Instead of using butter, shortening, or lard, consider using unsaturated fats such as olive, avocado, and canola oils. Replace saturated fats with unsaturated fats such as those from nut butters, avocado, oils, nuts, seeds, and fatty fish such as salmon.
Lecithin supplement: Some studies indicate that lecithin, a naturally-occurring phospholipid, may help dissolve clogged ducts.6,7,14
Speak with your doctor and lactation consultant before taking any new supplements.
Therapeutic Ultrasound: There is some evidence that ultrasound may help break up clogged ducts, and is recommended when all else has failed to remove the blockage.6,7,
Many different practitioners, from physical therapists to chiropractors, may perform this type of therapy. Be sure that the issue is in-fact a blocked duct before seeking this therapy. Speak with your doctor and/or lactation consultant to find out more about therapeutic ultrasound.
Read more: Meal Plan for Trading Up Your Fats
Bottom Line
If you suspect you have a blocked duct, there is no need to stop breastfeeding (though the associated pain may make continuing a challenge).2, Emptying your breasts frequently and thoroughly is the best way to both prevent and treat blocked ducts.4 Taking quick action can bring relief and prevent further complications like mastitis.
How can I prevent blocked ducts?
Empty your breasts regularly
To prevent a blocked duct, feed your baby frequently and make plans to pump or hand express if you know you will miss a feeding.2,4 Take care to correct any feeding issues, such as latching problems, promptly by consulting a lactation consultant or your pediatrician.
Learn about: Top Breastfeeding Latching Tips
Support your breasts from below during feeds
If you are having recurrent clogged ducts, it could be that milk is not draining well from the bottom of the breast.10 Use your free hand to lift up the underside of the breast during feedings, helping to better empty the breast.
Avoid pressure across your chest
Avoid underwire bras or tight sports bras. Be mindful of any clothing, straps, or activities (such as sleeping on your stomach) that may be putting pressure on your breasts repeatedly or for prolonged periods of time.2,6,
Pump efficiently
Sometimes pumps are not as good as baby at emptying the breast. So women who pump more often are occasionally more prone to clogged ducts. While pumping, massage the breast on all sides to help empty the breast, then hand express after.
Read more: Top Tips for Pumping Breastmilk
Clear plugged nipple pores
Dry skin or milk in the nipple may lead to engorgement and then blocked ducts.2, If you notice this starting to happen, soak the nipple in warm water then gently rub it with a clean cloth. Then hand express some milk to help ensure the duct is open. To help prevent plugged nipple pores, gently wipe your nipple with warm water after each feeding.
Read more: How Do I Avoid and Manage Blocked Nipple Pores?
Rest up and eat well
You can only be your best for baby if you take care of yourself, too. Try to make time for rest and proper meals.
Now is the time to call on the friends and family that offered help when your bundle of joy arrived. Consider cuddling up in bed with your baby to spend some quality time resting and nursing.
Read more: Getting the Right Nutrition While Breastfeeding
Contact a lactation consultant
A lactation specialist can help you correct any issues with positioning or latch that affect your baby's ability to empty your breast efficiently, a major factor in preventing blocked ducts. They can also provide support if you already have a clog to get you back on track with breastfeeding.
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For more on this topic, check out the following articles:
Which Foods Should I Avoid While Breastfeeding?
Breastfeeding: How and When to Use a Nipple Shield
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