It can be common to hear about someone who experienced a plugged duct (sometimes called a clogged duct) while breastfeeding but what does that actually mean? And what do you do if you find yourself with a plugged duct?
Before jumping right to what to do, it’s important to understand a little more about breast anatomy. This helps you understand why what is happening in your body is happening and when I share the tips to helping relieve and prevent them, they will make more sense.
The (absolute) basics
To be able to understand what is happening when you have a plugged duct you should first understand basic breast anatomy. During the second trimester of pregnancy, your body is already preparing for breastfeeding by growing a network of milk ducts. In simplest terms, the milk ducts are tubes and they carry milk from the milk sacs (where milk is made) to the nipple. Milk then exits from multiple pores in the nipple. When milk cannot be removed (due to an obstruction) or sits in the duct for a long period of time it can coagulate. Essentially, it starts to stick together and forms a lump.
So what is a plugged duct/clogged duct?
In short, a plugged duct is a palpable lump in the breast due to coagulated milk. The lump you feel is actually the milk sacs. They become engorged with milk and form a firm spot. This spot can be a small as a pea or as large as a golf ball! Plugged ducts should be promptly looked after. If they’re not, there’s an increased risk of mastitis which is an inflammatory condition that can quickly become infective. If you notice a red, shiny streak on your breast paired with a fever, chills or body aches, these are signs mastitis which as mentioned, is a more serious concern because it can become infective.
Why did I get a plugged duct/clogged duct?
Plugged ducts can occur when milk flow is obstructed or milk is not being removed. They can happen for a number of reasons. Plugged ducts can happen:
- If you miss a feeding or a pumping session
- If you space out the time between feedings (whether intentionally or unintentionally)
- If your baby isn’t effectively removing milk at the breast. This could be due to their latch or poor positioning at the breast
- If you are using the wrong flange size when pumping
- If you have an abundant milk supply
- If there’s lots of pressure against your breast such as with a tight fitting bra
How do I know if I have a plugged duct/clogged duct?
Get familiar with your breasts. Regularly feeling your breasts after a feeding or in the shower will help you become familiar with their normal landscape and quickly allow you to recognize changes. You will be able to feel a firm lump or knot in your breast. The lump should be palpable which means you should be able to located the edges of it. It may decrease in size after milk is removed. A lack of symptoms is also helpful when thinking about plugged ducts. If you do not have a fever, redness on the breast, chills or body aches, that’s a good sign it’s more likely to be a plugged duct. When locating a plugged duct use the pads of your fingers to feel for the border of the plug so you know where it begins and ends. This will be important when you begin some of the massage techniques to remove the plug.
How can I remove a plugged duct/clogged duct?
There are several ways you can care for a plugged duct. With any of the methods, it’s always about milk removal. My four personal favourites that I use with families are the following. These are not meant to all be used. Start with one method first. Using all of these at once can created unwanted inflammation in the breast and quickly escalate a plug to something worse. If you have a plug that you would describe as stubborn, always reach out to a lactation consultant to they can get to the bottom of the issue with you.
The most effective way to treat a plugged duct is to remove milk from the breast. Your baby can actually remove the plug (it’s safe!). You can position your baby so their chin is lined up with the plug and allow them to feed as usual. Gentle breast massage or warm heat prior to breastfeeding is helpful. If you’re pumping, ensure the flanges fit correctly. You can also use a little bit of coconut oil to lubricate the flanges. Using the hands on pumping technique which is combining pumping with gentle massage and following up with hand expression is a helpful way to ensure the plug is removed and the breast is drained. ⠀
WARM MOIST HEAT AND GENTLE MASSAGE
Warm moist heat includes a washcloth (or wet towel), a shower or a bath. The heat helps to assist with the plug removal. Before massaging, you need to locate the plug. As previously mentioned, use the pads of your fingers to feel for the borders of the plug. Locate the front of the plug which is the part closest to the nipple. Gently massage in a circular motion in front of the clog. Breast tissue is not the same as muscle tissue and needs to be treated very gently. Think about using just enough pressure to bruise a peach. ⠀
EPSOM SALT AND HAAKAA HACK ⠀
A more unconventional method that works well is an epsom salt soak. If you have a haakaa or similar product on hand, you can add 1-2 tbsp of Epsom salt and about 3-4 tbsp of warm water. The temperature should be about the same as a comfortable bath. There should be enough water cover your nipple. Carefully apply the haakaa. The combination of warm heat, epsom salt and suction will help remove the plug. You may need to wait 10 – 15 minutes. You may even see the plug itself come out (it will be clumpy and stringy). You can follow up this technique with hand expression.
ELECTRIC TOOTHBRUSH ⠀
While this tip might sound a little out there, the vibration actually helps to break up the plug. If you own an electric toothbrush, this is a great technique you can try. After you have felt for and located the front of the plug, position the bottom of the toothbrush at the front. Use a gentle circular motion to break up the plug. Again, being sure not to put too much pressure on your breast. This technique can also be followed by hand expression.
How do I prevent a plugged duct/clogged duct?⠀
Frequent and effective milk removal are the keys to preventing plugged ducts from reoccurring. If you are frequently experiencing plugged ducts, go back to the list at the beginning. Can make any changes to your baby’s latch and/or positioning, the frequency of feedings, your bra type or pump flanges? If you have and you are still always experiencing plugged ducts, get in touch with a lactation consultant. You can connect with me HERE.
Guide to Breast Challenges
Have a painful blocked duct? Concerned it might be something worse like mastitis?
This digital guide will walk you through how to manage some very common breast challenges.
$12 CAD + applicable tax