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Plugged ducts and mastitis

plugged ducts and mastitis


Plugged ducts and mastitis are common conditions that can appear in lactating people. If you’re experiencing a hard, painful spot or lump it could be a plugged or clogged duct. 

What is a plugged duct?

A plugged duct (also known as a blocked duct or a clogged duct) is a blockage in a milk duct that prevents or reduces the flow of milk from the breast resulting in poor drainage of breast milk and often presenting as tender or hard lumps in the breast tissue. 

Symptoms of plugged ducts

A plugged duct often feels like a tender or hard lump, often pea-sized but could be much larger and may be warm or hot to the touch and red. The exact location of the plug may be hard for the lactating parent to pinpoint as the sensation and actual location may shift due to the mobility of the breast tissue. Nursing may be painful on the side with the plugged duct. Nursing may also relieve some of the discomfort temporarily. Breast milk may be stringy or lumpy on the affected side and production may be noticeable lower on that side. Plugged ducts may resolve on their own (with the recommended at-home treatments) within a few days or may develop into mastitis. 

What is mastitis?

Mastitis is inflammation of the breast tissue usually caused by infection and most common in people who are lactating.  

Symptoms of mastitis

The symptoms are similar to a plugged duct but also often including feelings of malaise or general illness, may include fatigue, fever, chills, and/or body aches. The lump, swelling, pain, and redness is often more pronounced and may include red streaking on the skin. Mastitis most often requires medical treatment including antibiotics. 

What causes plugged ducts?

There are many possible causes including:

  • Engorgement due to insufficient milk removal from:
    • Poor latch technique. If your baby is unable to latch properly they may not be able to adequately remove all your milk.
    • Tongue Tie (ankyloglossia or “Tethered Oral Tissues”)
    • Oversupply
    • Limiting baby’s time at breast
    • Improper use of nipple shield use 
  • Infrequent feedings or skipped feedings
  • Sustained pressure on the milk duct due to overly tight bra or clothing, your diaper bag or a baby carrier can sometimes contribute to a plugged duct.
  • Rapid weaning

How to treat plugged ducts?

It is important to quickly treat plugged ducts so they don’t develop into mastitis or an abscess. When treated quickly, a plugged duct should go away in a few days. It is also important to continue to nurse or pump when you have plugged ducts. Rest, hydration and a strong immune system will also support healing. Most lactation professionals recommend these steps to treat plugged ducts. Check with your lactation consultant or health care professional to confirm the best course of treatment for you. 

  • Moist heat before nursing. Try one of the following:
    • Apply a warm compress to the area. 
    • Place your breast in a bowl of warm water
    • Take a warm shower
  • Gentle massage of the warmed breast tissue around the area of the plug.
  • Try to nurse on the affected breast first.
  • Use an ideal or deep latch (if you are struggling with latch or it has always been painful, book a consult with a lactation consultant). 
  • Massage downward from the affected area while nursing
  • Try dangle feeding (leaning down over the baby so that the breast is “dangling,” using gravity which may help bring the plug down
  • After nursing you still may need to pump if you have not been fully drained
  • Therapeutic ultrasound from a trained PT may help break up clogged ducts
  • If you are prone to plugged ducts your lactation consultant may recommend consuming lecithin

Things that may provide relief while you are treating your plugged ducts

  • Cold compresses may help after feeding if you are sore
  • Some people find pain relief from over the counter medications like ibuprofen or acetaminophen; ask your doctor or lactation consultant if this is right for you. 

How to prevent plugged ducts?

Frequent feeding is the ideal prevention. Do not skip feedings and do not wait too long in between feedings. Feed your baby when they show early signs of hunger. Avoid tight bras, clothing, and be mindful of how you carry your baby or diaper bag. When you begin to wean, do so gradually.

When to call your healthcare provider? 

Plugged ducts can turn into mastitis. Call your care provider if: 

  • the plug doesn’t get better within 3-4 days of your treating it on the own. You can be at risk of developing an abscess. 
  • you develop a fever
  • The lump gets bigger
  • the area is red and stays red or you begin to see red streaking.

Clogged or plugged milk ducts can be a part of breastfeeding/bodyfeeding. Continue to nurse and keep an eye on the situation to make sure it doesn’t get worse. If you notice increased redness, pain, swelling, or start to feel flu-like symptoms, contact your midwife or doctor immediately.

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