What is a plugged duct?
A plugged duct is a buildup of milk in the breast that may be caused by blockage of a nipple pore (perhaps from a milk blister or healing cracks), or may be deeper in a duct in the breast and cause by milk stasis.
Plugged ducts can be caused by a sudden decrease in milk removal or abrupt changes in nursing patterns, engorgement, thrush, and pressure on the breast (from a bra, for example). If you’ve recently been ill, your risk of a plugged duct increases.
What are the symptoms?
The soreness of a plugged duct typically starts gradually, and is only in one breast. You may feel a small lump in one area of the breast, or a wider area of unexplained engorgement. The area might be tender to the touch, or may feel like it’s bruised. Feeding on that side may be uncomfortable.
The plugged duct may feel smaller after a feeding or pumping session, and may increase in size as the breast fills again for the next feeding. You may be able to express ‘strings’ of milk from the affected breast, or you may notice your pumped milk looks stringy when the plug is expressed.
How can it be treated?
Be sure to keep feeding your baby frequently. This is the most important step you can take! If you are having problems nursing your baby, you may need to pump to keep the milk moving. Get plenty of rest during this time.
Use a warm compress on the area of the plugged duct briefly before feeding. You may want to position your baby with his chin pointing toward the plugged duct when he latches – his strong suction in that direction might help loosen the dried milk secretions stuck in the duct. Massage the breast gently before and during feeding. Over-the-counter pain relievers may help with your comfort until the plug is loosened. Get plenty of rest and stay well-hydrated.
If the plug is on the nipple, this might be called a ‘nipple bleb.’ You can treat a bleb or milk blister by applying moist heat and then trying to clear the skin from the opening (for example, by rubbing gently with a washcloth). Nurse or pump on that side first, and use breast compressions to get the milk moving. If this does not work to clear the bleb, check with your lactation consultant to see what other steps you might take.
What if I keep getting plugged ducts?
If the plugged duct doesn’t fully resolve, it may keep “coming back.” If the blockage is caused by a poor latch, tongue tie, restrictive clothing, oversupply of milk, or a nipple bleb, then treating these underlying problems should resolve the plugged duct recurrences.
Fatigue and stress can contribute to slow healing. Be sure you’re staying hydrated and getting plenty of rest. Some researchers have suggested eliminating saturated fats and adding lecithin to your diet may help.
Work closely with a lactation consultant if you continue having problems with plugged ducts.