How to Unclog a Milk Duct

By Laura Silvas, RN IBCLC

Clogged milk ducts, while common, are uncomfortable and can quickly develop into mastitis. Most women (especially with their first baby) experience clogged ducts within the first six weeks after birth. Clogged ducts may also develop following missed nursing or pumping sessions, wearing constrictive bras, or when the infant begins sleeping for longer stretches.


According to the Academy of Breastfeeding Medicine: Ducts in the breast are innumerable and interlacing and it is not physiologically or anatomically possible for a single duct to become obstructed with a macroscopic milk ‘‘plug.’’ Meaning, that it isn’t a singular duct causing the issue, rather the region. 

A “clogged duct” often feels like a hard spot in the breast. Some women refer to them as tiny rocks or pebbles. They are usually semi-tender to touch, soften after emptying the breasts, and re-hard when the breast refills milk.

Previously, the common advice was to frequently empty, add heat, and massage. However, with new research we’ve learned that increasing the frequency of emptying, massage and heat exacerbate inflammation and ductal narrowing further damaging ducts. Below we cover the proper ways to assist with clogged or plugged ducts: 



Steps to Unclog a Milk Duct

  • Cold therapy: Ice packs over the affected area hourly or as desired will help with discomfort and swelling.

  • Anti-inflammatories: Over-the-counter medication such as ibuprofen will help with inflammation surrounding the breast tissue (especially in the engorgement phase) and can also help with discomfort.

  • Continuing nursing: Feed the baby, not the clock. Continue with hunger based feeds, and avoid over stimulation of the breasts. It is now recommended to start with the unaffected breast to not further increase inflammation in the affected breast. Don’t aim to “empty the breast” simply, feed the baby.

  • Avoid pumping: Even with the best pumps on the market, your pump will not empty your breasts as well as your baby. Try to exclusively breastfeed if able. 

  • Lymphatic drainage: gentle sweeping motions up towards your neck, armpits, and collar and massaging your lymph nodes are now recommended over massage of the clogged area. 

  • If you continue to experience discomfort, recurring clogged ducts, or signs and symptoms of mastitis (red streaks, inflammation, flu-like symptoms, fever over 100.4 for over 24 hours), seek help from a lactation consultant or medical professional. With the development of mastitis, antibiotics maybe necessary. However, even if mastitis develops, mothers are encouraged to continue nursing.


Overall, working alongside a lactation consultant can help ensure that breastfeeding is going well, the baby is latching correctly, whether the breast pump flange size is correct, and whether or not medications are required. 

Reference:



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Cracked and Painful Nipples