If you are new parent trying to breastfeed, it is likely that at some point during your breastfeeding and pumping journey, you will run into a clogged duct or mastitis.
Mastitis and clogged ducts are most common in breastfeeding women, within the first 6 months postpartum. According to University of Michigan Health, for new parents the pain and stress of dealing with clogged ducts and mastitis, added to the pressure of taking care of a new baby, often lead to moms quitting breastfeeding and pumping altogether.
In order to give you the knowledge and tools to set yourself up for breastfeeding and pumping success, despite an eventual run-in with a clogged duct or mastitis, we spoke to LaShanda Dandrich, and International Board Certified Lactation Consultant, from Uptown Village Cooperative in New York City, to answer the most common questions related to clogged ducts and Mastitis.
How do I recognize clogged ducts?
Clogged ducts, also referred to as plugged ducts, happen from milk accumulating or being “stuck” in the milk ducts and not allowing milk to move freely through the ducts.
It may feel like a particular area of the breast is more firm than other parts of the breast or the breast may feel like “lumps” under the skin, or even concentrated in an area and feel like a “pea” or “grape” sized lump.
Plugged/clogged ducts can happen at any point in the ductal system. Blebs which occur closer to the nipple area, is clogging of the pores of the nipple. Sometimes they can appear white (that is trapped milk) and can be painful.
How do I treat a clogged duct quickly so it doesn’t get worse? What can you do right away to keep it from escalating?
When plugged or clogged ducts occur, the ultimate goal is to clear the milk through that area. If you are feeding the baby from the breast, feed the baby making sure baby has a deep latch and is actively engaged in the feeding, meaning the baby is swallowing and not just pacifying.
While the baby is feeding, you can gently massage/stroke your breast in the area that is clogged. Stroke toward the nipple, pushing milk through the ducts and helping the baby drain the breast well.
The clogged area should feel softer and cleared after the baby has fed or milk has been removed by hand expressing or pumping.
Placing a warm compress on the area that is clogged right before feeding or expressing milk can help clear the ducts as well.
I have recurring clogged ducts - why does this keep happening to me?
Plugged/clogged ducts can occur and reoccur for several reasons, how to treat them depends on what is causing them in the first place.
Shallow/inefficient latching & Blebs (clogging of the nipple pores)
Wide deep latch onto the breast. Baby has more breast tissue in the mouth and not just on the nipple.
Unlatch baby when you feel latch get shallow (baby has slipped to the tip of the nipple), re-latch so baby stays deeper on breast. Nipple should be round when baby unlatches
Pacifying and not actively feeding
Keep baby actively feeding, watch for swallows. Feel for tugging and pulling of breast tissue.
Abundant Milk Supply or Oversupply
Baby actively feeding and satisfied after feeding, but the breast still feels full or firm. Or leaking constantly, may indicate abundant milk supply.
Feed the baby for longer stretches to see if baby can drain the breast. Or feed more frequently to help baby regulate production.
Use milk collector (such as Haakaa) in between feeding to help keep breast soft and comfortable and milk ducts cleared.
Scheduled, Timed Feedings or Long Stretches Between Feedings/Pumping
Follow baby feeding cues, feed more frequently. Pump more often, when breast are starting to get firm or engorged. Do not wait until they become painful.
Poor Flange Fit
Make sure your flange is fitting correctly. A flange that is too small or too big can cause ducts to not drain efficiently.
Tight or Ill-Fitting Maternity or Nursing Bras
Wear comfortable clothing that is not too restricting in the breast area.
After milk has been removed from the breast, either by breastfeeding, hand expression or pumping, the breast should feel softer or “drained”. If areas are still feeling firm or lumpy after baby has fed, hand expressing or using a milk collector or pump (for 3-5 minutes) to help drain the breast a little more can reduce the recurring clogs. Sometimes applying gentle vibration or massage surrounding the clogged area can help loosen the clog.
In some cases, adding in a supplement to help “thin” the milk through the ducts can also be helpful. Consult an IBCLC, lactation consultant, to help figure out the initial cause of the recurring ducts.
I have a clogged duct and it hurts when I pump. What can I do to clear it?
If you are experiencing pain in the area of the clogged duct(s), try placing a warm compress over the area for 1-3 minutes. Gently massage or stroke the area toward the nipple and try to hand express to get the milk flowing.
You can use some olive or coconut oil on the breast area, use a baby comb and gently “comb” the area toward the nipple to help break up the clog. Also, consult with your medical professional for appropriate pain relievers, such as Ibuprofen, which can help reduce inflammation to the area and relieve pain.
Once the area feels more manageable, apply your pump on gentle suction to get milk to start to flow. Continue to pump to help clear the clogged ducts. This may take a 10-15 minute pumping session. If the area does not feel that it has cleared, repeat alternating gentle massage and pumping to help continue to clear the ducts.
My clogged duct isn’t going away, no matter what I try! At what point do I need to go to a doctor (what are the warning signs)?
If plugged/clogged duct is not clearing after trying the mentioned techniques AND continue to be painful AND you are developing a fever. Call your midwife or doctor.
It can be progressing to mastitis. Which can require antibiotics.
In some instances ultrasound therapy by a chiropractor or physical therapist can help clear ducts. And in more rare cases, seeing a breast surgeon to have the clog opened and drained with a sterile needle.
How do I know if my clogged ducts have turned into mastitis?
Mastitis is classified as an infection in the breast. Mastitis can develop from clogged/plugged ducts or from bacteria entering into the milk ducts from cracked nipples.
Mastitis presents an area of the breast (wedge-like area) that is tender, hot, swollen AND a fever is present. Overall flu-like feelings of being run down and body aches.
I was diagnosed with mastitis and I am bed ridden with fever and pain. How do I feed my child?
Even though it may not feel great to breastfeed while having Mastitis, it is still encouraged to feed if you can. Having a baby feed well and drain the breast can sometimes be the best way to help relieve the pain and drain/ clear the clogged ducts.
My mastitis keeps coming back - what should I do to prevent it?
Once you get Mastitis, it can easily reoccur if you are not careful to look for and manage the signs. Once an area of the breast gets clogged it can continue to clog. Take care to keep the ducts cleared. If the breast starts to fill and feel full or firm, you should release the milk by feeding baby, hand expressing or pumping. If you are hand expressing or pumping, it is only until the area feels softer or more clear. This may only take 3-5 minutes. Do not overly pump to keep draining the breast, which would encourage the body to continue to make milk and further contribute to the issue.
If Mastitis continues and you feel it is from inefficient latching or poor pumping routine, reach out to a lactation consultant for guidance to help pinpoint the true issue.
Meeting with an IBCLC, lactation consultant can help direct you to a medical professional such as a breast surgeon if an underlying infection may be present, causing the recurring Mastitis. It may require a culture of your milk to test for bacteria.
Consult with an IBCLC, lactation consultant to help make sure the baby is getting a deep latch. Try different positions such as side lying or laid back positions to help get rest while also breastfeeding.
The bottom line
Understanding clogged ducts and mastitis can help you prepare for a common issue breastfeeding and pumping moms face in their journeys. Knowing what to expect and how to treat it can be instrumental in allowing you to reach your breastfeeding and pumping goals, with the least amount of pain and discomfort.
Keep in mind that these recommendations are simply a guide, and do not substitute your general practitioner's or IBCLC's advice.
Our Lilu Massager + Bra can also help prevent and relieve clogged ducts and mastitis. It's gentle, yet effective compressions, work with your pump to empty your breasts more fully, so that you can make more milk per pumping session while also being more comfortable in between sessions.
Lashanda Dandrich is an International Board Certified Lactation Consultant and co-founder of Uptown Village Cooperative. After the birth of her daughter in 2009, her passion for breastfeeding and supporting mothers and families in the postpartum period blossomed. She became a trained postpartum doula while pursuing her IBCLC credential. She has supported familes of all diverse cultural and socio-economic backgrounds throughout NYC.Lashanda lives in Harlem with her daughter, Ava. When she is not busy being a mom and supporting other moms, she enjoys traveling, reading sci-fi, and trying new cuisines.
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