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Most breastfeeding moms will experience a clogged duct at some point during their breastfeeding journey! A clogged milk duct can be uncomfortable and frustrating, but fortunately, there are effective ways to ease clogged milk ducts.

Understanding Milk Duct Clogs: Symptoms, Causes, and New Guidelines

A “clogged milk duct” usually presents as a tender, hardened spot in the breast, indicating a constriction within the milk ducts. Formerly referred to as a ‘plugged’ or ‘clogged’ duct, this symptom is now recognized as ‘ductal narrowing,’ and the start of inflammatory mastitis. During this process, the milk ducts, which carry milk through the breast to the nipple, become narrowed due to inflammation and an imbalance in the breast microbiome. Because of this ‘ductal narrowing’, the milk will back up in the breast because it cannot flow as freely through these, typically feeling like there is a “clog” in your breast.

Current treatment plans now focus on minimizing inflammation rather than dislodging the blockage. Traditional remedies like warm compresses and vigorous massage are discouraged as they can exacerbate the condition.

Previously endorsed practices such as frequent milk removal (nursing more frequently or extra pumping to “remove the clog”) may actually aggravate the issue by increasing milk production. Likewise, vigorous massage is discouraged due to its potential to harm breast tissue.

So, What Can You Do to Ease Clogged Milk Ducts?

What can you do? When you notice symptoms of a clogged duct, try these 7 tips to ease that clog and get on with breastfeeding!

1. On-demand Feeding: An oversupply is thought to be the start of this ductal narrowing, so you want to make sure that you are not doing anything that would increase your milk supply. During this time you’ll want to breastfeed on demand from both breasts as you normally would and eliminate any extra pumping as this may increase your supply and exacerbate the problem.

2. Ice Packs: Rather than warm compresses, apply ice packs between feedings to alleviate swelling and inflammation. Ice packs can be applied as frequently as every hour or more often if desired.

3. Ibuprofen and Acetaminophen: Anti-inflammatory medication like Ibuprofen can reduce inflammation and can be dosed at 800mg every 8 hours. Acetaminophen can help with pain and can be dosed at 1,000 mg every 8 hours.

4. Gentle Hand Expression: If needed, gently hand express milk between feedings for comfort. Here is a great video on how to hand express your breastmilk.

5. Sunflower Lecithin Supplements: Sunflower or soy lecithin supplements 5–10g (5,000-10,000mg) daily by mouth may be taken to reduce inflammation in ducts and emulsify milk.

6. Gentle Breast Massage: Gentle breast massage focusing on lymphatic drainage is advised. Avoid forceful techniques and opt for a sweeping motion towards the armpit using coconut oil for comfort.

7. Probiotics: Probiotics, especially strains like Limosilactobacillus fermentum and Ligilactobacillus salivarius, show promise in the treatment and prevention of mastitis and early symptoms. Target B2 by Klaire Labs is a good probiotic for breastfeeding moms.

Are Antibiotics Necessary for a Clogged Duct?

Antibiotics are only recommended for “bacterial mastitis” and not “inflammatory mastitis” which we have been discussing in this blog post. According to the latest guidelines the “use of antibiotics for inflammatory mastitis disrupts the breast microbiome and increases the risk of progression to bacterial mastitis.” Antibiotics also should not be used for mastitis prevention.

Bottom line – if your clogged ducts are not treated properly it can progress to bacterial mastitis, which is the mastitis you are probably already familiar with. The signs and symptoms of bacterial mastitis remain the same as always and may require antibiotics (check with your healthcare provider):

  • swelling or redness in the breast
  • painful area or hardened area in the breast
  • breast that is hot or warm to the touch
  • malaise or flu-like symptoms
  • chills
  • fatigue
  • fever

When to Seek Help for a Clogged Duct

Tried these tips and the clogged duct still not getting better after 1-2 days? Reach out to an IBCLC or medical provider for an evaluation to make sure it isn’t something else. If you’re local to Scottsale / Phoenix, AZ, book an appointment with one of our IBCLC-certified lactation consultants.

Here’s a link to the new mastitis protocol referenced in this blog post: Protocol #36.pdf