A firm, tender area in the breast that occurs during lactation and is not accompanied by infection symptoms such as fever, is commonly referred to as a clogged or plugged milk duct. During lactation, milk flows through the ductal system in the breasts. When an area becomes congested or inflamed, narrowing of the ducts can inhibit the flow of milk and cause localized tenderness and inflammation of the breast. Depending on skin tone, some may note the skin on the breast appears pink or red. The best way to prevent plugged ducts is to encourage your baby to feed effectively and often. If you are exclusively pumping, ensure that your flanges fit comfortably and use gentle hands-on breast massage while you pump to promote milk removal.
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If plugged ducts do occur, try the following tips:
Breastfeed as usual. If exclusively pumping, pump as you normally would. Avoid reliance on the pump to try and move more milk. This can inflate milk supply and increase inflammation in the breast, both of which are not helpful in the setting of a plugged duct.
Apply ice or cold compresses to the area several times a day to reduce inflammation. Anti-inflammatories such as Advil or Motrin can help. Acetaminophen (Tylenol) can help with pain, if needed.
Gently massage the area towards the armpit when not nursing or pumping. Light, fingertip stroking along the plugged duct is recommended. A technique called lymphatic breast massage can work well.
What to avoid:
Deep massage, as this can contribute to more inflammation, pain, and possible injury of the breast tissue.
Excessive pumping or emptying of the breast beyond baby’s needs.
Use of tools such as vibrating devices, electric toothbrushes.
While heat may feel good, try to keep the focus on reducing swelling. Anything that adds to swelling (deep massage/heat) can work against you.
Soaks, such as Epsom salts, as this can further break down breast tissue.
Wendy Eson is an IBCLC and the Manager of the Breastfeeding Center of Pittsburgh.
