Help! How do I clear a plugged duct?

You may have a plugged duct if you’re experiencing a sharp pain while nursing or pumping, soreness of the breast in just one area, or if your breast is tender to touch in just one area. Many pumping mamas will experience a plugged duct at least once along their pumping journey. It’s very important to know how to treat a plugged duct because it can turn into mastitis – or worse, abscess – very quickly. If you are experiencing symptoms of sudden fever, chills, or loss of appetite please contact your healthcare provider immediately.

 

What are the symptoms of a plugged duct?

A plugged duct occurs when fatty solids in the milk build up, causing the milk duct to become blocked. A plugged duct can occur in the nipple (and you may see a milk blister) or further back in the breast. A plugged duct will occur gradually and affect only one breast.

 

Symptoms of a plugged duct:

• Hard lump or isolated area of engorgement of the breast.
• Feeling of tenderness, heat, swelling, or appearance of red in an isolated area.
• Localised tenderness or pain without an obvious lump or engorgement, often intensified with breastfeeding or pumping.
• Pain that is present or more intense while nursing or pumping the affected breast.

A plugged duct can be confused for other problems such as mastitis and thrush, or vice versa, so if you are unsure or if this is the first time you’re experiencing a clog we do encourage you to contact your healthcare provider to help rule out something more serious. Plugged ducts can also turn into mastitis rather quickly, so if you’re unable to unclog it after two days, or are experiencing symptoms of sudden fever, chills, or loss of appetite please see a doctor.

 

How can I treat a plugged duct at home?

When you have a plugged duct, you’ll feel immediate relief when the plug is removed. It’s very important to get the clog out of the duct because it can quickly turn to infection. Unclogging a duct usually takes several attempts over the course of a few hours to a day or two. Here are some methods you can try to help the plug out…

 

Feed first on the affected breast

If you’re nursing, feed first from the affected side. Baby tends to have a stronger or more aggressive suction when he or she first starts nursing, so applying that extra suction to the effected breast will help move the plug. If you’re pumping, be sure to keep expressing from the effected side too, and you may consider expressing for longer on the effected side. Do not turn the vacuum level up on the pump higher than your normal comfort level as that can actually hinder milk flow.

 

Use an electric toothbrush or vibrator to massage a plugged duct

Breast massages are effective for removing plugged ducts. To massage your breast, start above the affected area and apply gentle pressure with your two forefingers in a circular motion. Begin at the top of the breast (don’t forget the mammary tissue in the armpit area) and slowly work your way down toward the plug. Be careful not to press too hard as it can cause inflammation or swelling. You will likely feel the plug, and it will feel like a hard lump or grain under the skin. You can try gently rolling your fingers around the plug too.

You can massage your breast while you’re expressing or nursing. Sometimes the combination of suction and massage is all you need to remove the plug.

You can also massage in the shower. One method that works is taking a wide-tooth comb and running a bar of soap over it to make it slick. Then, gently use the comb to massage in motions downward from the top of the breast.

Tip: try massaging with an electric toothbrush or facial massager in-hand; some women swear the vibrations help. Plus, these products are typically waterproof, so you can bring them in the shower.

 

Dangle pump or dangle feed to remove a clog

You can use gravity combined with suction to help relieve a clogged duct. If you’re pumping, lean all the way forward so that your breasts are hanging straight toward the floor.

If you’re nursing, lay baby in your lap or do a football hold while leaning forward as if you were going to touch your toes. Baby’s face should be facing up toward the ceiling and your breast should be dangling down toward the floor.

Even better if you can combine a breast massage with this method.

Tip: put a towel down under you when you dangle pump because pumping in this position is prone to leaking. Breastshields are meant to work in a seated position while sending the milk downward, so leaning forward could send expressed milk elsewhere!

 

Heat compress to remove a plugged duct

Applying heat to the effected area will help loosen up the clog. You can use a hot water bottle (follow the manufacturer’s directions), a cloth sack of rice heated in the microwave (do not heat for more than 90 seconds), or a dish rag run under hot water.

Tip: Take a hot shower and bring a rag with you, that way you can keep refreshing the rag with hot water.

Warning: if you’re heating in the microwave, test to make sure it’s not too hot before using.

 

Get plenty of rest and stay hydrated

Make sure you get plenty of rest and don’t over-exert yourself when you’re dealing with a plugged duct. Stay hydrated to keep milk production up, as you may be expressing or feeding more often to help clear the duct. It’s important to focus on clearing the duct as it can quickly turn to mastitis.

Anti-inflammatory medicine

Oftentimes plugged ducts are accompanied by inflammation or swelling, which can actually make it more difficult to remove the plug. There are many over-the-counter options for anti-inflammatory medication. Talk to your healthcare provider or pharmacist about anti-inflammatory medication that’s safe to use while breastfeeding.

Remember, once the duct is unplugged, you will experience immediate relief.

 

Head to your physio for an ultrasound

If you’re finding at-home treatment for a plugged duct isn’t working, or this is your first time with a plugged duct, you may consider seeing your physio for an ultrasound. A recent study found ultrasound treatments were effective in breaking up milk plugs.

 

Side effects of a plugged duct:

• Milk output from the effected breast may decrease temporarily. Remember that it’s important to keep expressing from the effected breast – even if you aren’t getting much output!
• If you’re pumping you may notice small strings or chunks in the milk. This solidified milk fat is totally normal and safe for baby.
• It’s common for the area to remain reddened or have a bruised feeling for a few days after the plug has been removed, but remember that you will feel immediate relief when the duct becomes unplugged so this will be a much duller sensation.

How can I prevent plugged ducts in the future?

Plugged ducts are unpleasant to say the least. Here are some methods you can try to prevent clogged ducts in the future…

 

Don’t skip pumping sessions

Engorgement or inadequate milk removal is a major cause for plugged ducts. It’s very important that you don’t miss a pumping or feeding session, and if you notice you’re engorged (for example if baby sleeps extra long) it’s important to empty some of the milk from the breast by pumping or feeding. If you think you’ll be away from your baby for several hours, take a breast pump with you just in case.

 

Don’t rush feeding or pumping sessions

For the same reasons as stated about skipping pumping sessions, it’s important not to limit feeding or pumping sessions. Not adequately removing milk from your breasts can cause clogs. If you have a plugged duct, it’s especially important that you keep to your regular pumping/feeding schedule and duration.

 Make sure your breast pump is adequately removing milk

Are you not feeling emptied after pumping? If you rely on your breast pump to express milk for some or all of your feedings, it’s very important to make sure your breast pump is effectively expressing milk. Make sure you using the correct flange size and you’re replacing your pump accessories regularly. Play around with different settings to find out what works best for you – and as always, if you need help, contact our expert customer support team!

 

Wear loose comfortable clothing and soft bras

Pressure on the breasts can cause clogged ducts. Your clothing choices can put pressure on ducts, so we recommend avoiding wearing tight clothing such as sports bras or too-small bras, or poorly-fitted bras or bras that have underwire digging into the breast while you’re lactating. We encourage you to wear bras designed for lactating, like nursing bras and nursing tanks, and to make sure they’re properly fitted to avoid pressure on the milk ducts.

Pay attention to things like backpack straps or seatbelts that could be putting pressure on your breasts and adjust the straps as needed.

 

Don’t sleep on your stomach

Just like stated above about wearing loose clothing, it’s important to keep pressure off the breasts while you’re sleeping as well. Try not to sleep on your stomach, and if you sleep on your side bring your arms above your head or in front of you to keep them from pressing into the breasts.

 

Drink plenty of water

Drinking plenty of water is very important for milk production, and also keeps things moving in the breastmilk department. Staying hydrated is essential to keep moving milk through your breasts to prevent plugs from occurring.

 

Sunflower lecithin and soy lecithin to prevent clogged ducts

Some women swear by lecithin for preventing plugged ducts. If you’re experiencing chronic plugged ducts, you may wish to work lecithin into your daily regimen. Lecithin can change the consistency of the milk to be more slick. You can purchase sunflower or soy lecithin at a regular grocery store.

You can also buy soy lecithin tablets to take as daily supplements at a drugstore. Be sure to discuss the use of lecithin with your healthcare provider if you have any questions or concerns.

Remember to follow your care provider’s advice. If you are experiencing fever, chills, or if your plugged duct hasn’t cleared in two days, please seek help from a medical professional.

What other methods have you used to treat or prevent plugged ducts? Let us know in the comments below!