Breastfeeding mommas go through a lot. From lack of sleep to leaky boobs to fussy babies, they endure all of these just to give their little ones what they need. And as if these challenges aren’t enough, add to the list the problem of a clogged milk duct and the possibility of mastitis.

What is a clogged milk duct?

A clogged milk duct is what you experience when your milk flow is obstructed. To better explain this, let’s first understand what a milk duct is.

Milk ducts, also called mammary ducts, are tubes in your breasts that transport the milk from your glandular tissues to your nipples. Each nipple has around nine (9) of these ducts, and any of these can get blocked and cause you problems like boob discomfort, mild to intense pain, milk bleb, or poor milk flow.

RELATED: Beating the Milk Bleb (How to Treat & Avoid Milk Blisters)

How do you know if you have a clogged milk duct?

There are a few telltale signs that you should watch out for, including:

• A hard lump on your breast
• Swelling or pain near the lump
• Redness and a warm feeling around the lump
• Feeling pain during milk letdown
• Low milk supply or slow milk letdown 
• Abnormally unequal amount of milk between breasts
• Pain subsiding after feeding or pumping

Sometimes, a clogged milk duct can occur at the same time as a milk bleb. This may be because the bleb caused the blockage in the first place or it’s the result of the clog in your milk duct.

What causes clogged milk ducts?

Several things can cause clogged milk ducts. But, one of the most common causes is when the breasts aren’t being drained completely of their milk. Breast engorgement is painful and could be even more painful when your ducts get clogged. Here are some of its risk factors:

• Your baby won’t latch properly
• Your baby is skipping feeding sessions
• Changes in feeding schedule
• Not pumping on schedule
• Not pumping properly
• You weaned your baby too early or abruptly (cold turkey)
• Applying pressure on your nipple area (by wearing tight clothes or a tight bra, sleeping on your stomach, etc.)
• Breast inflammation due to infection or injury
• Stress and fatigue

If your baby has latching problems, they wouldn’t be able to drain your breasts of all the milk in them. Latching difficulties may be caused by various things, like lip and tongue ties, Down syndrome, or because the baby was born prematurely. 

RELATED: Why Your Baby Won’t Latch (Expert Advice on Lip & Tongue Ties, Cleft Lip, and High Arched Palate)

There’s also a chance that your milk is too thick, which increases the risk of recurrent plugged ducts. I personally experienced this and had to consume sunflower lecithin to help emulsify my milk.

Meanwhile, your baby skipping a feeding session (because they slept through it or because they’re sick) could result also in an obstructed milk flow and clogged milk ducts. The same thing happens when you miss or suddenly change your breast-pumping routine!

It’s very important that you drain your boobies properly and thoroughly. If frequent feeding isn’t possible, frequent or power pumping is a good alternative. Just make sure that you’re using the right flange size and suction power. If no pumping trick helps, hand expression is your best bet!

How do you treat a clogged milk duct?

To treat a clogged milk duct, you need to remove whatever it is that’s causing the blockage. Locate the lump that indicates a blocked milk duct is in your breast. Next, do any of these home remedies on how to unclog milk ducts naturally:  

Remedy 1. Apply warm compress before feeding or pumping

Before you feed your baby or pump your milk, you should get a warm and damp face towel, then place it over the breast with the lump. Massage the area where the lump is for a few minutes to break up whatever is clogging the duct while the warm towel is on top of it. Proceed to pumping or feeding after this.

Remedy 2. Use a heating pad

An alternative to the warm compress remedy is this one that uses a heating pad on the lump. Just like the warm compress remedy, place the heat pad on the lump and massage around it to loosen the blockage. Do this for 20-minute stretches, pumping after each stretch to try and remove the clog.

Remedy 3. Soak in a hot bath while massaging your breast

Fill a tub with warm water and soak in it for a few minutes, massaging the area of your breast with the clogged milk duct while you soak. Being a form of physical therapy intervention, massages are known to be effective in treating clogged milk ducts.

You can also do this while taking a hot shower.

Remedy 4. Massage the clog towards your nipple

Try to move the lump towards your nipple so you can express it better and remove the blockage. If hand expressing doesn’t remove the plug after you move it closer to your nipple, try using your breast pump to help it along.

Remedy 5. Change your breastfeeding position

Try to position your baby in such a way that their chin is pointing towards the lump in your breast. This position is said to help loosen the blockage in the duct together with the suction of breastfeeding.

RELATED: Best Benefits of Breastfeeding For You & Your Child

Remedy 6. Breastfeed your baby while you’re on all fours

This may seem like a weird position to breastfeed your baby but doing this may help move the blockage along. The logic behind this position (also called dangle breastfeeding) is that gravity, together with the suction of your baby breastfeeding, can help move the clog down and out your nipple.

Remedy 7. Get your baby to start feeding on the breast with the clog

Babies tend to suck more on the first breast they’re put on. They’re still pretty hungry at the start of a feeding session, so it’s a good idea to let them start feeding on the boob with the clog. When your baby is breastfeeding, massage the area where the blockage is located to loosen it up and to help expel it.

If none of these natural remedies work for you, please consult your doctor right away. Your doctor might prescribe you antibiotics, so make sure to ask questions about their risks. A general precaution when treating mastitis with antibiotics is that the medication could kill all bacteria (including the good ones) and cause an imbalance in the gut. This may then lead to another breastfeeding problem: thrush.

Mastitis vs clogged duct: What’s the difference?

What exactly differentiates a clogged milk duct from mastitis? Mastitis is usually the result of a blocked milk duct that is left alone, resulting in inflammation and pain. In short, mastitis is worse than a clogged milk duct.

Mastitis can also happen due to bacteria entering the breast via bleeding or cracked nipples. It can also result from stagnant milk that is left in the breast (this can happen when you don’t fully express or remove all your breast milk after a feeding).

Some of the symptoms that can indicate mastitis are:

• Tenderness, redness, or swelling over the breast (usually unilateral)
• Fever of over 101 degrees F (38.5 degrees C)
• Hot to touch breast/s
• Intense pain at the site
• Fatigue and body pains
• Chills and flu-like symptoms
• Edema
• Lumpy or gelatin-like milk
• Milk may occasionally contain mucus, pus, or blood
• Baby refusing breast milk (breasts infected with mastitis usually produces salty or high-sodium milk)

When you suspect that you have mastitis, contact your doctor immediately. You should also continue breastfeeding to help relieve the pain, reduce the swelling, and continue expressing your milk—much like what you would do if you had a clogged milk duct.

Mastitis & clogged milk duct FAQs

Will a clogged milk duct unclog itself?

As long as you feed your baby first from the breast with a clogged milk duct, the blockage will usually resolve itself in a day or two without the need for special treatments.

What does a blocked duct feel like? 

A blocked duct feels like a lump that is firm, warm, and tender to the touch. It can also look red and lumpy. In my experience, it felt like having a sunburn in your breast.

Does mastitis start with a clogged duct? 

Mastitis can start with a clogged duct, but it can also happen due to other reasons. 

How do you unclog a duct with mastitis? 

Having your baby feed frequently on the breast with mastitis will help unclog it. This will also help relieve the pain that comes with this problem. Also, don’t believe the myth that milk from a breast with mastitis is unhealthy—it’s not, and your breast milk has antibacterial properties that keep your baby safe from infection. It would have higher sodium content and a salty taste, but it’s super safe to take!

Can you have a clogged duct without mastitis? 

Since mastitis occurs after a clogged duct has been left alone for two weeks or more, then yes, you can have a clogged duct but not have mastitis.

How to prevent clogged milk ducts?

If you’ve experienced a clogged milk duct and the pain that comes with it, you will surely want to prevent it from ever happening again! Unfortunately, studies show that clogged milk ducts can recur. If you want to avoid it, here are some tips that you can use to do just that:

Don’t wear tight clothes or bras

Since pressure on the breast can cause clogged milk ducts, wearing loose shirts and ditching the underwire bra is a good idea. You can go without a bra when you’re at home (or even outside your home if you’re comfortable with that) or simply choose to wear one that is a few sizes larger.

Breastfeed constantly

Breastfeeding helps prevent the formation of blockages in your milk ducts. Doing this regularly will help keep milk flowing and keep your ducts free from clogs.

Fully express your milk if your baby leaves some in your breast after feeding

Make sure to remove all of the milk in your breast after every feeding by pumping any leftovers. To ensure that your baby drains both breasts properly, move your little one from one breast to the other every few minutes.

Try sunflower lecithin supplements

Lecithin is said to help make your milk less sticky, making your nippies less prone to clogging. But of course, it’s best to talk to your lactation consultant or doctor about it first.

Change feeding positions regularly

When you change your feeding positions on a regular basis, you end up draining all your milk ducts equally. This can help prevent the buildup of leftover milk on any of these ducts and this can prevent the problem of a blocked milk duct.