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Clogged Milk Duct

Breastfeeding is truly a miracle. Everything your baby needs in this one substance, often referred to as “liquid gold.” It gives nutrients, fat, protein, and immunity to your growing baby, and our bodies intuitively know how much to make. The composition of our breast milk will change depending on the needs of the baby, and can wax and wane based on life events (think return to work, stress, change in diet, sickness, etc). In these moments, the ducts that carry the milk can become clogged, or blocked.

A clogged or plugged milk duct is a common problem when breastfeeding. When you’re lactating, milk flows through your breasts in a pipe-like system of ducts to be excreted by the nipple. If a duct gets blocked or milk has trouble flowing through, a clog can form. The result is a small lump in the breast that might appear red and may be sore to the touch. If you’re lactating and experience breast tenderness, redness, or feel a lump in the breast tissue you should contact a pelvic floor physical therapist trained in treatment for clogged ducts right away. If you’re experiencing fever, nipple discharge, streaking on the breast tissue or the tissue is hot to the touch you should contact your physician, as these are signs of mastitis -- an infection of the breast tissue that requires antibiotic treatment.

If you are not showing signs of mastitis and think you have a clogged duct, quickly treating the area is key. Call your pelvic floor PT/OT and while you wait for your appointment, try these things at home:

  • Use heat on the breast tissue prior to nursing, and cold on the breast after nursing to help with the pain. Heat can include a hot pack, warm towel, or warm water in the shower

  • Nurse or pump at least once every 2-3 hours. Do not go longer than 3 hours without emptying the breast

  • Massage the breast, starting at the base and working down towards the nipple, to clear the duct.

  • Apply gentle vibration over the clogged duct (electric toothbrush) to promote movement of the milk.

  • Avoid garments that compress the breast tissue, i.e. tight tank tops or bras.

When you come in to see the therapist, she will examine your breast and obtain a quick lactation history from you. If they determine that you have a clogged duct, treatment includes placing a heating pad over the affected area, using ultrasound to help clear the clog, followed by manual breast massage to restore milk flow through the breast. We also recommend you bring your infant or breast pump to more fully clear the breast after the session. The clog may clear in a single visit, or may require 2 to 3 successive visits.

If clogged ducts continue to be a problem, try these things:

  • Continue seeing your PT/OT each time. We don’t want the duct to become infected

  • Be sure you are nursing or pumping every 2-3 hours

  • If you are exclusively pumping, make sure your falange sizes are correct. If they are too big or too small you may not be completely emptying the breast, which can lead to clogged ducts. @milkymamma on Instagram has a free consultation online to determine appropriate size.

  • Drink at least 8 oz of water every time you nurse/pump. Breast milk is mostly water. If we’re dehydrated the milk becomes thicker, making it harder to be emptied.

  • Avoid tight fitting tank tops or bras during all hours of the day

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