How to Fight a Plugged Duct

If you are or have ever been a nursing mama, you know how painful breastfeeding can be.  We deal with latch issues, sore nipples, biting, engorgement, plugged milk ducts and the worst of the bunch, mastitis.  I have been there and experienced ALL of it.  I am so grateful that I had a really wonderful support system and a lot of professionals and other mamas to get advice from.  Occasionally mamas get something called a plugged duct which is when an obstruction prevents proper milk flow, basically one of your milk ducts becomes clogged.


photo by Molly Lou

Unlike most women, I didn’t get my first plugged duct in the 3 months after birth.  The first came along when I was nursing for 5 months. Even with my outrageous oversupply early on I never got plugged, only engorged.   The good news is, if you’ve been nursing for 3 months already you will likely not have to deal with often, if at all.  How do you know if you have a plugged duct?  TRUST ME, you will know.  It starts as a type of a soreness which then turns into a serious pain, almost like you’ve been punched in the boob.  The pain may be targeted or may spread to a few different areas.  It can feel like a small or big knot in your breast or a whole section can be engorged.  Your breast may also be hot or sensitive to the touch & will more than likely be very sore while nursing.  Most of the time it’s hard to pinpoint exactly where the specific duct is, especially since the location may shift, making it hard to release the plug.

Let’s start with a few helpful hints on how to AVOID a plugged duct:

-Wear loose bras and clothing as much as possible, especially if you won’t be nursing for awhile

-Make sure your diaper bag or purse isn’t in one position resting along your breast or armpit for too long, the pressure can also cause a plug

-If you sleep on your side or stomach, be careful positioning yourself and try to limit how much you squish your breast on the bed.

-Try to stick to your regular feeding schedule but if you can’t try to pump in replacement

-If you’re stuck somewhere without your baby or your pump, you can hand express into a sink or a container just enough to keep from getting engorged.

-Switch breasts during your feedings and if possible try to massage your breasts a bit to help the milk get out of all the pockets.  I typically get congested in my upper side near my armpits so I am always careful to push on those while Lily is nursing.

-Be aware that any inflammation can cause plugged ducts so if you are sick, have allergies, an injury or get an infection, you will be more prone to a plug.

Now, if you do happen to get a plugged duct, it is really important you try to clear it.  If you don’t, your plugged duct can get infected causing Mastitis which is a whole other very miserable ball game.

Here’s what to do if you get a plugged duct:

-Nurse or pump as much as possible!  It will probably hurt but it is truly the best solution and WILL NOT harm your baby. Some research says you should try to have baby’s chin pointing in the same direction as the duct but that can be really difficult especially if the plug is on the top half of your breast! It can be helpful to use a warm compress on the affected area before nursing.  I fill up a diaper with really warm water and hold it against my breast before nursing or pumping.  The diaper stays warmer longer than a towel would!

-Nursing while leaning over the top of your baby (dangling your breasts) can also help the milk flow which can help you get unplugged.

-If nursing isn’t draining your breast, pump or hand express.  The key is to keep your breast emptied as much as possible.

-DON’T forget your other breast! You don’t want to work so hard clearing the affected breast that your other breast begins to have the same problem!  Empty both as much as possible.

-Warm compresses, or better yet, warm water helps A TON!  My go-to solution is to fill up my bathtub with as warm of water as I can stand, add some Epsom salts (the salts can also help draw the milk out) and keep my breast fully submerged in the water.  While my breast is under the water, I hand express and continuously massage the area in the direction of the nipple.

-Breast massages with lavender oil mixed in coconut oil.

-If you don’t know where the plugged duct is, massage your breast in an upward direction to release the milk.

-Wear loose clothing and/or go braless as much as possible.  Compression will make the plugged duct worse

-My other go-to solution is lecithin. I prefer sunflower lecithin to soy lecithin because I try to avoid soy as much as I can.  Lecithin is an emulsifier and is used to treat many different ailments.  Clearing plugged milk ducts is an “off-label” usage for lecithin and it’s not totally clear why it helps.  You can find sunflower lecithin in soft gels which is how I prefer to take it.  Most IBCLCS will recommend taking a 1200 mg tablet 3-4 times a day.  I typically take the lecithin as soon as I start feeling the plug & for a few days after its unplugged and then I stop until I need it again.  Occasionally if I feel a plug coming on I will take the lecithin to help prevent it.-Eat well, rest & drink a ton of water!

*UPDATE* Here’s a new tip I learned that has helped me SO MUCH

  • Get a silicone hand pump and fill it with HOT water and stir in a good amount of Epsom salts.  Suction it on your breast and massage or use a lactation massager to squeeze the milk out.  You’ll have to start over a few times.  Bonus points if you do this while sitting in a hot bath or shower!  It REALLY works!

You probably won’t notice right away if the duct clears out because your breast is already inflamed and painful.  After nursing, it will usually feel a lot less clogged but be aware that it may fill right back up.  Being a new mama is exhausting and all of the stress can affect your immune system making your more susceptible to plugged ducts and mastitis.  Take it seriously when you think you feel one coming on and do the work to clear it before it gets worse and affects your whole week! If you’re concerned about pain in your breast finding an IBCLC or talking to your OBGYN can help.  I have always been able to treat my plugged ducts & 3 bouts of mastitis without antibiotics or medication.  That doesn’t mean that you will, but I really believe that early detection and consistency make all the difference!  I’m always here to troubleshoot with your or if you need to vent about how awful it is!  Let me know if you have heard of or have tested any other methods to treat plugged ducts!


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