Plugged ducts can be a common ailment experienced during breastfeeding.
There is a lot of information circulating on the internet and social media about how to treat it but we now know many of those remedies are not the best course of action. So what is a plugged duct and what is the best way to get rid of it? Read on to find out!
Understanding Plugged Ducts
A plugged duct is an area of the breast where milk flow becomes obstructed. Typically, this will come on gradually and only affect one breast. You might notice a hard lump in the area and it may be tender to the touch. It can be very painful when you nurse or pump, especially during a letdown.
Plugged ducts are actually ducts that have been narrowed, either from swelling of mammary tissue around the duct or narrowing resulting from the breast microbiome being out of balance.
It’s not an actual plug of hardened milk like commonly thought. This in fact is not physiologically or anatomically possible as the milk ducts are microscopic and interwoven.
Latest Guidelines and Treatment for Plugged Ducts
The Academy of Breastfeeding Medicine has recently updated its mastitis protocol and includes updated information on how to treat plugged ducts. (Plugged ducts actually fall along a spectrum of things that can occur when you have breast inflammation.)
So what do you do to treat it?
(It’s essential to treat plugs asap so they don’t persist and cause further inflammation that can turn into mastitis.)
- Continue normal milk removal: You don’t want to excessively breastfeed or try to pump or try to “empty” the breasts. All this will do is ramp up milk production and cause further congestion in the plugged area. You may notice a decrease in supply in the breast with the plug until it is resolved. Your supply will improve again once you resolve the inflammation in that area.
- Reduce inflammation: Use ice and anti-inflammatory OTC medications. You can apply moist heat to the area before breastfeeding or expressing if you would like, but over-using heat can actually increase inflammation in that area by increasing blood flow. The cold can be used for 20 minutes in between feedings and also helps to reduce pain.
- Therapeutic breast massage: Perform gentle breast massage to help excess fluid leave the breast. This isn’t a vigorous or hard pressure massage! Gentle touches (think using the same pressure you would to pet your dog or cat) moving towards the armpits. The aim of the massage is to reduce edema, not to get an actual “plug” of milk dislodged.
- Consult a doctor if symptoms worsen: If symptoms aren’t improving, worsen, or you develop a fever or body aches, call your doctor as this may mean it has progressed to mastitis.
Prevention and Long-Term Care
If you regularly get plugged ducts it’s important to work with an IBCLC to figure out the root cause. Some things that can lead to frequent plugged ducts include oversupply, a baby or pump that is not effectively removing milk, or a breast microbiome that is out of balance. Resolving the underlying issue can help you prevent future plugged ducts!
Written by Nicole Schwartz, IBCLC
