Ask the IBCLC: Plugged Ducts

If as a breastfeeding mom, you are not sure if you have ever had a plugged duct, I can tell you- you haven't. Plugged ducts are incredibly painful and can be downright stubborn to release. As a lactation consultant in the greater Cincinnati area for several years now (and 6x nursing mom myself!) I can share with you the best ways to prevent a plug from developing- and how to quickly find relief if one does!

Prevention is key.

1. Breastfeed or express your milk regularly. Aim for every 2-3 hours (or 3-4 hours overnight). Going too long in between feedings and pumping sessions can increase the likelihood of developing a plugged duct.

2. Remove milk efficiently. If your little one isn't breastfeeding well- causing nipple soreness or bleeding, slow weight gain, and poor diaper output- meet with an IBCLC ASAP. The IBCLC can help you target problem areas and get breastfeeding back on track. A quality IBCLC can equally support pumping moms who are facing challenges with pain and poor milk removal. A shallow latch or improperly fitting pump flanges are more likely to lead to plugged ducts (and decreased milk supply). For pumping moms, a new flange size may be in order. In most cases we find women need to size down for best fit. Additionally, women with elastic nipples may benefit especially from flanges such as Pumpin Pals.
​
3. Wear properly fitting clothing and undergarments. Not all nursing bras are created equal. Some common troublemakers include underwires, cups that do not provide full coverage (and allow for the breasts to spill out in the middle), and additional flaps inside the cup that can put pressure on breast tissue. Be mindful of tight shirts and dresses, as well as the placement and fit of baby wraps/carriers, backpacks, and purses. 
​

Comfort measures when a plugged duct develops.

1. Rest. Hydrate. Nurse. A plugged duct can also be a sign your body is under stress and needs a break. Get in bed and truly rest and nurse on the affected breast as much as possible. Stay well hydrated.

2. Resist the urge to be aggressive! Let me say it again: Do NOT use force! Deep, forceful massage or even vibration tools marketed toward nursing moms only increase inflammation and increase the risk of mastitis or breast abscess.1 

3. Hand express. While you may feel a knot farther back in your breast, it often starts at the nipple and/or areola. Now think of when you have a tangle when brushing your hair. What's the best way to get the knot out? You start at the ends and work your way up. Do the same thing with your breast if you have a plugged duct. Now is a time when hand-expression is a very good skill to practice. Do this in addition to breastfeeding or pumping. 

4. Try sunflower lecithin. (Ask your pharmacist or care provider first, of course.) While we don't have evidence supporting its use, many parents have reported lecithin as being effective for busting up clogs. 

Signs you should check in with your care provider.

If you note the following signs or symptoms, it's prudent to give a call to your care provider, as you may be developing mastitis and require medical treatment:

• Fever
• Body aches or chills
• Splitting headache
• Fatigue
• Bright red area of breast, usually hot to the touch

Have you ever had a plugged duct? What tips worked best for you?

---

1. ​Hey, Baby! Why Can’t I Massage Out My Blocked Milk Ducts or Mastitis? | Possums for Parents With Babies TM - Official Site. 25 Mar. 2022, possumsonline.com/blog/hey-baby-why-cant-i-massage-out-my-blocked-milk-ducts-or-mastitis.

Last updated November 21, 2022