A plugged duct is formed when some of the milk inside a duct dries up and stops the rest of the milk from flowing. It is mostly due to not thoroughly draining the breast; this usually happens in the early days of breastfeeding, when a mother is engorged.
A plugged duct happens progressively and is usually only found in one breast.
It is sometimes felt as a hard lump, that may be hot and tender.
A blocked milk duct usually feels worse before a feeding, while the breast is still full, and feels less sore after a breastfeeding session.
Nursing on the side that has the lump could be painful, especially during a let-down.
It is typically not associated with a fever. If you have a temperature of more than 38,5°C, you should contact your doctor. It could indicate a mastitis infection.
Milk supply may decrease temporarily.
You may notice some thick, grainy milk.
You may feel some bruising in the area for about a week after the lump has disappeared.
10 Ways to Treat Plugged Milk Ducts Naturally and Quickly
#1 Remove as Much Milk as Possible
Nurse and pump frequently to drain the breast (Pump at least every two hours). Breastfeeding on demand is best. If your breast is not completely drained after a feeding, you should try pumping.
If the breast is too painful to breastfeed, you could use an electric breast pump.
As mentioned more in detail below, a warm, moist compress will increase the flow of milk; this can be done before you nurse or pump.
Long breastfeeding sessions are recommended.
Breastfeeding sessions should start with the infected breast. If the breast is too painful to achieve a let-down, you can breastfeed from the unaffected breast first to accomplish a letdown, and then switch sides.
#2 Breast Massage
Take a warm shower and hand express your milk while massaging the swollen area from the top of the breast, towards the nipple.
The breast should be massaged before, during and after a feeding.
1. Before a feeding massage can soften a swollen, taut breast so that it is easy for baby to latch onto.
2. During a feeding, movement and compression towards the nipple will help the baby remove as much milk as possible.
3. After the feeding, you should massage the breast and express via hand expression or pumping; this will reduce the risk of another blockage or mastitis.
Other benefits include the following
In one study, therapeutic breast massage in lactation was found to help reduce breast pain associated with engorgement, plugged ducts, stasis, and mastitis.
Some babies may refuse the breast during infection, and this is because if the elevated levels of sodium in the milk. Breast massage can help to reduce levels of sodium in the milk.
As mentioned above, If the breast is too painful to achieve a let-down, you can breastfeed from the unaffected breast first to accomplish a letdown, and then switch sides.
“Dangle feeding" as seen in the picture, will pull the blocked ducts open, with the help of gravity. Also, trying different positions while breastfeeding might help the milk flow easier.
The baby should be positioned with the chin or nose pointing towards the affected area, this will help to drain the blocked region.
Latching on problems can prevent your baby from draining the breast efficiently. Tongue tie, cleft lip, and other sucking problems may cause issues. Deep attachment is extremely important. (1)
#4 Pain Relief
Pain relief is essential, because the more pain you have, the less likely your baby will spend enough time at the breast to remove sufficient milk.
You can use a cold compress after feedings for pain relief.
You can use Ibuprofen or Acetaminophen.
Breast massage, as mentioned above, helps to reduce pain associated with plugged ducts and breast infections.
#5 Clear Any Blocked Pores
If there is a little white spot or blister on your nipple, you can try puncturing it with a sterile needle, then allow your baby to drain it. Pores left unclogged can easily lead to blocked milk ducts.
#6 Hot and Cold
A heated compress can be applied to the breast before feeding to encourage milk flow, while a cold compress can be used after a feeding to reduce pain and swelling (edema).
# 7 Epsom Salts
Epsom salts are fantastic at reducing swelling and inflammation. You can soak your breasts in warm water with some Epsom salts added. (One handful of Epsoms with every 2L of water) Remember to rinse your breasts afterward, to remove the saltiness.
What about preventing recurrent plugged milk ducts?
For those struggling with chronic bouts of plugged ducts, it can help to add one tablespoon of Lecithin to your diet every day. Some women experience less blocked ducts when they decrease their consumption of saturated fats too.
#9 Therapeutic Ultrasound
If the plugged duct does not clear within two days, you can try therapeutic ultrasound at your local physiotherapy office. (2 watts/cm2, continuous, for five minutes to the affected area, once daily for two days.)
#10 Get Support
It would be a great idea to join a local La Leche League; they can offer helpful information and support. LLL support is free to all mothers and their families.
Causes & Prevention of Plugged Ducts
Tight bras or sleeping on your stomach will restrict the flow of milk, resulting in blocked milk ducts. Underwire bras should be avoided. Try to keep the pressure on the breasts to a minimal. Also, stay away from heavy arm exercises.
Dehydration, malnourishment and excessive stress can put a mother at risk.
Plugged ducts will often occur during weaning, this is why weaning should always be a gradual process.
A blocked nipple, if not treated can lead to blockages in the ducts.
Skin damage in the form of cracks and sores on the nipple may open the door to pathogens, which could lead to an infection.
Avoid the use of pacifiers, artificial nipples, and supplemental feedings. These things can decrease the flow of milk and, therefore, put a mother at risk. Skipping of feeds should be avoided.
A low immune system and smoking cigarettes can put a mother at risk for plugged ducts and mastitis.
During teething, a baby may refuse the breast, and this can cause milk stasis which could lead to blockages.
Women who have had previous breast surgery such as augmentation, breast reduction, tumor or cyst removal will be at increased risk.
Untreated yeast infections can lead to breast inflammation and possibly mastitis.
Women who return to work need to be aware of the risk of blocked ducts if they are not regularly emptying the breasts. They also need to make sure that they are getting an adequate amount of rest.
What About Mastitis & Medication Needed
Most of the time, if a mom continues to breastfeed on demand, a blocked duct will disappear within two days. With that being said, mothers should not ignore symptoms. A plugged duct if not treated, can turn into mastitis, which can turn into a breast infection (infected milk ducts) and ultimately into an abscess.
It is essential that a mother does not stop breastfeeding when she has a blocked duct as this could cause an increased build-up of fluid, making a mastitis infection more probable.
Mastitis is suspected if a mother starts to feel flu-like symptoms. In the case of a high fever of 38.5°C and above an ultrasound examination of the breast may be necessary. Abscesses need to be treated as quickly as possible because they can spread. If no improvement is seen after 2 days on antibiotics, a breast milk culture will be taken for sensitivity testing.
Breastfeeding can continue during milk stasis, mastitis and even with an abscess. It cannot harm the baby. The flow of milk will help to clear the ducts of infective organisms.