If you’re reading this right now, I’d just like to say I’m sorry! You’ve likely stumbled upon this article because you are experiencing some localized breast soreness or tenderness, with some fullness or firmness, and you’re trying to figure out what you can do to fix it! In this article we’ll go over what clogged milk ducts are, things that can make your symptoms worse, and most importantly different strategies to make your symptoms better!
What is a clogged milk duct?
Milk ducts are very tiny tubes within breast tissue that are responsible for transporting breast milk from the milk producing glands, known as lobules, to the nipple pores, where milk is released.
When we think of a clogged milk duct, we used to believe one duct was “clogged” or “plugged”, similar to a clogged drain. The problem with this comparison is our breasts don’t work like that because there are so many tiny milk ducts, and they all interlace and intersect. Instead, think about clogged ducts like flexible tubing getting pinched, resulting in a disruption of milk flow. This happens because the breast tissue becomes congested and inflamed from an oversupply of milk, excess lymphatic fluid in the breast, and/or an imbalance in your milk microbiome which applies pressure to the milk ducts, making them narrower.
What things should I avoid?
If you google home remedies and treatment for clogged milk ducts, you may see some of these suggestions: expressing milk more frequently, breast massage, heat, and vibration. This is what lactation professionals have recommended for years because it was believed a physical plug needed to get pushed through the milk duct. What we’ve learned over time is these types of interventions are actually going to increase your milk supply and exacerbate the issue. The best and most effective form of treatment is to remove milk per your typical routine, not in excess, and use anti-inflammatory measures.
A special note on engorgement
As your milk is transitioning and increasing in volume, it’s totally normal for your breasts to feel a bit different. They may feel a little “lumpy” and tender when they are full of milk which goes away after your breasts have been drained either by hand expressing, pumping, or nursing your baby. This differs from clogged milk ducts because clogged ducts generally appear on one breast at a time. Excess fluid from labor and delivery may also find a place to settle in your breasts immediately postpartum, resulting in even more fullness. In the treatment section, I’ll share some tips on how gentle lymphatic massage can help alleviate some of that fullness and make you feel more comfortable!
Treatment strategies
Medical Interventions
In 2022, the Academy of Breastfeeding Medicine revised Protocol #36, which discusses current evidence based strategies and medical interventions used to successfully reduce inflammation and treat clogged milk ducts. We’ll delve into these strategies next, but if you’re experiencing clogged milk ducts it’s important to work with a lactation consultant and your healthcare provider to get to the root cause of why you’re experiencing clogged ducts. You should receive a treatment plan individualized to you, and they’ll also keep a close eye on your progress, so symptoms don’t get worse.
- Nurse on demand or remove milk using hand expression or a breast pump per your usual routine. Additional pumping and nursing sessions from the affected side are not recommended because by removing more milk you are communicating with your body to produce more milk which can lead to more swelling and inflammation, making the issue worse.
- Ice the affected area every hour or more often as needed.
- NSAIDS, such as ibuprofen, can help reduce inflammation. The recommended dosage is 800mg every 8 hours.
- Acetaminophen can help with general pain relief. The recommended dosage is 1000 mg every 8 hours.
Additional treatment strategies:
Try switching up your nursing position to make sure all four quadrants of your breast are getting empty.
Breast gymnastics (credit: Maya Bolman, IBCLC). The purpose of breast gymnastics is to mobilize your breast tissue and get fluid moving in your breasts. Women who use breast gymnastics report decreased pain and achiness and improvements in latch and feeding, especially in those early days postpartum when the breasts are more engorged. Here is a video showing how to do breast gymnastics:
Another helpful technique to move fluid is manual lymphatic massage, intended to reduce swelling by assisting movement of lymph fluid from the breast into the lymph nodes. Learn more about breast lymphatic drainage:
Using a well-fitted supportive bra may be helpful if you tend to get clogged ducts on the underside of your breast.
Final thoughts
Your breasts go through lots of changes during pregnancy and lactation and deserve to be treated with kindness, especially when they are swollen, inflamed, and achy. If you start to notice a tender spot forming on the breast and you suspect you have clogged milk ducts, the best way to treat them is to remove milk per your typical routine and incorporate more anti-inflammatory measures. Work with a lactation consultant and your healthcare team to pinpoint the source of your clogged milk ducts, come up with a treatment plan specific to your needs, and monitor your symptoms to make sure the interventions you use are effective.
This site is intended for informational purposes only and does not provide medical advice. Please consult your physician or other health-care professional.
