A plugged duct can occur when one of your milk ducts is not draining properly. Factors that may contribute to a plugged duct include:
- Skipping a breastfeeding
- Constricting milk flow like wearing a too-tight bra
- You are fatigued or stressed
- Your diet includes high amounts of dairy products, saturated fats or sodium
When a milk duct is not draining properly, pressure builds up and the surrounding tissues become inflamed. This can lead to a breast infection, called mastitis.
Pain from a plugged duct often comes on gradually. You will usually have a tender spot in your breast that feels like a swollen lump. The location of the lump may change. You may also have mild redness or warmth in the affected area. In most cases, you’ll feel well overall and have no fever.
Sometimes, you may notice a small white plug at the duct opening on the nipple. This is probably a plugged nipple pore, also known as a white bleb.
The best treatment for a plugged duct is continued, regular breastfeeding, which promotes drainage. It’s important that you empty the affected breast completely by nursing or expression at least every two hours. Whenever possible, begin breastfeeding on the affected breast.
Changing breastfeeding positions during the feeding may help ensure that all the milk drains from the milk ducts. Feeding positions with baby's nose or chin pointing to the area of the plug can also help drain the affected area. If the breast is especially tender, it may be better to start nursing on the other breast first. This will help the affected breast to let down without the pressure of the baby suckling. If the breast is not fully drained by nursing, you should pump it for five to ten minutes at the end of the feeding.
When the duct becomes unplugged, you may see a thick, stringy mass, possibly green or brown. Your baby may spit this out or swallow it. It will not harm the baby to swallow a milk plug during breastfeeding.
If you have a plugged duct that persists for longer then 48 hours after you begin the measures described above, it can be treated with therapeutic ultrasound. This treatment also helps prevent recurrent blocked ducts that appear in the same place.
For recurring blocked ducts, talk to your doctor about possibly adding a lecithin supplement to your diet. In addition, be sure to get plenty of rest and drink more fluids.
Here are some ways you can help prevent a plugged duct:
- Breastfeed frequently on an unrestricted schedule, such as 8 to 12 times a day, around the clock.
- Pay careful attention to achieving a deep latch every time you breastfeed.
- Massage your breasts during breastfeeding and/or pump your breasts. This should soften your breasts and help baby remove the milk. Massage and/or manual expression before breastfeeding can also stimulate milk let-down. When massaging your breasts, use your thumb and fingers, starting in the outer area of the breast and working toward the areola.
- Make sure one breast is completely softened before offering baby the second breast.
- If possible, alternate the breast you offer first with each feeding.
- Don’t take supplements unless they are medically necessary.