How to Clear a Clogged Milk Duct

Breast feeding your new baby is an experience that not only provides the best nutrients possible to your child, but is also a remarkable bonding ritual between a mother and her baby. Breastfeeding should be painless and comforting to a newborn.

Mother’s that tell you that breastfeeding is joyful 24 hours a day, 7 days a week are probably trying to put on a brave face. While nursing is not something that you should dread, breastfeeding does take a lot of patience, will interrupt your social time, dinner, and your sleep frequently.

If you continue to breastfeed long term, you may experience unusual pain from time to time. Usually this will pass on its own, but you should also pay attention to any symptoms that could indicate a clogged milk duct, or mastitis.

20% of nursing mothers will experience a blocked milk duct or mastitis. Both of which are completely treatable!

What Causes a Clogged Milk Duct

There are a few reasons why a milk duct will become clogged. Some of the causes are preventable, while others may not be.

Inadequate Milk Removal

Babies that suffer from latching problems can only achieve a weaker suckle. The volume of milk extracted can be far less than you would expect for a feeding session. A distracted or sleepy baby can also lead to a similar result, as can a reduced feeding time.

The buildup of excess milk can cause the breasts to feel tender and strained, and lead to engorgement in the breasts.

Skipped Feeding and/or Pumping Sessions

Many mothers can also suffer from a clogged milk duct when they return to work because they do not take enough time out to pump during the workday. It is easy to get distracted at work and forget to pump.

Once baby starts sleeping through the night and you are no longer pumping or feeding during this time, your milk supply can back up. It will take a few days for your body to adjust to the new feeding schedule and begin decreasing the supply naturally.

Pressure on the breasts

Pressure on the ducts and breasts can be caused from wearing a bra that is too tight or constricting, sleeping on your stomach, or carrying a heavy diaper bag that crossed over your chest. Imflammation is typically caused from injury, infection or allergic reaction.

Inflammation

With Mastitis, the duct that is blocked or obstructed becomes infected. Infections can also occur from cracked and bleeding nipples that offer an entry point for bacteria, hospital stays and other prolonged exposure to bacteria and infectious organisms.

Stress, fatigue, and anemia have also been said to increase a woman’s risk of developing mastitis. Women with a weakened immune system also have a much higher risk.

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Symptoms of a Clogged Milk Duct

A clogged milk duct occurs when the milk flow through the duct is obstructed causing the milk to back up in the ducts and pain while nursing. Sometimes the nipple pores may be obstructed, but most commonly the clog will be further back in the duct.

Typically, women will feel pain in only one breast and the clog will come on gradually, at first feeling just a little sore or a tugging sensation while the baby feeds. This becomes more painful as the clog builds up. The breasts will also become engorged or feel tender or hot.

Women will also sometimes present a low-grade fever when a milk duct is plugged.

Mastitis happens when the plugged duct becomes infected. Symptoms of Mastitis include a hard lump near the area of the blocked duct, engorgement of the breast, swelling, and tenderness or pain. There may also be red blotches or lines that look like veins that spread across the breast.

The pain will be the worst while the breasts are full and may subside slightly after feeding your baby when the breasts are not full or strained. The pain with Mastitis will be greater than just a typical plugged duct and is most common in the first 2-3 weeks postpartum.But can occur at any stage of breastfeeding.

Mastitis also tends to only affect one breast at a time. Women whose plugged ducts lead to Mastitis will also experience a fever, chills, and flu-like symptoms.

With both a blocked milk duct and mastitis there are some other more uncommon symptoms including expressed breastmilk that looks stringy or lumpy, a decrease in milk supply from the affected breast, and the area remaining tender or red even after the duct has been cleared.

With mastitis, there is also a risk of the breast milk containing mucus or blood when expressed. The milk may also suffer from a salty taste and babies may refuse to feed from that side.

Treatment of Clogged Milk Ducts

A clogged milk duct that has not developed into mastitis can usually be cured at home through natural methods including:

  • Rest
  • Increased fluids
  • A healthy diet with adequate nutrients
  • Heat and Massage
  • Emptying the breast

The best way to clear a plugged milk duct is to make sure that you are nursing frequently, at least every 2 hours. If the baby is older or refuses to nurse, moms should be diligently pumping or hand expressing milk. The affected breast should be kept as empty as possible while not neglecting the other breast.

To make nursing and pumping more bearable, moms can use heat and gently massage before putting the baby to nipple to increase the milk flow and activate the let down reflex.

Some moms may choose to shower before breastfeeding or use a warm compress. Warm compresses can be done with a heating pad, wash cloth submerged in warm water, submerging your breasts in a basin of water or soaking a diaper in hot water and placing it around your breast. A diaper stays warmer and keeps the hot moisture in longer than other methods. Some women also report that adding Epsom salt to the water helps with pain and tenderness as well.

Massage is best done when in the shower as this usually triggers the let down reflex and will cause your breast to leak. Much like hand expression, while standing in the shower, gently massage the affected area downward toward the nipple as though you were pushing the blockage out through the nipple pores.

Massaging the breasts will improve milk flow out of the breast and offer symptomatic relief.

Mothers should also be conscientious about the clothing that they wear and avoid ill-fitting bras and tight clothing that is restricting around the breast area. The best bras that a breastfeeding mother can wear are those made specifically for nursing, are cotton and do not have an underwire.

While nursing, mothers should always start on the affected breast side. If this breast is too painful, switch to the other side after the letdown reflex is activated. This may cause the breast to leak while you are nursing your child on the other breast, but the goal is drainage.

Consider meeting with a lactation consultant or physician’s nurse to ensure that your baby is latching, suckling, and feeding correctly. You may also want to massage the breast while baby is feeding, especially while feeding on the side with the plugged milk duct so that the milk flows more freely making the baby have to work less to drain the milk.

Leaning over the baby while nursing, sometimes referred to as dangle feeding, also allows gravity to assist in your feeding and aid in the letdown of the milk.

After the feeding is completed, pump or express any remaining milk in the breast to ensure emptying and use a cold compress in between feedings. Using a cold compress after feeding reduces inflammation and pain.

Remember to stay on schedule and try to feed or pump every two hours. If you are suffering from a clogged duct, even overnight you should wake up to pump regardless of whether baby is awake or not.

The treatment for mastitis is the same as a clogged milk duct. However, if symptoms persist or get worse after 24 hours doctors will typically prescribe an antibiotic. Common antibiotics such as penicillin don’t work because the mastitis infection, staphylococcus aureus, is resistant to it.

Your physician may prescribe erythromycin, Cephalexin or clindamycin, among others. Medication is usually prescribed for a 10-14 day regiment. Probiotics are also said to assist in the prevention and treatment of mastitis.

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