A small, tender lump in your breast usually sends up a major red flag. But if you're breastfeeding, there's a good chance you're dealing with a clogged or plugged milk duct.
Though they can be uncomfortable, clogged ducts aren't cause for panic. But you will need to take action to get things flowing again — and know the possible signs that your clog is getting worse.
What are clogged milk ducts?
When you're breastfeeding, milk flows through your breasts in a pipe-like system of ducts. If a duct gets blocked or milk has trouble flowing through, a clog can form, which is known as a clogged or plugged duct. The result is a small lump in your breast that might look a little red and may feel sore or tender when you touch it.[1]
What causes a clogged milk duct?
Clogged ducts aren't uncommon, and they ultimately form when milk isn't emptied from your breast effectively. That can happen if:
- Your baby is having trouble latching or sucking. Both can cause her to take in less milk and irritate the duct.
- You miss or skip feedings or pumping sessions. Sometimes it's just the result of forgetting or having your baby sleep through her normal feeding time. But clogs can also happen because of abrupt changes in feeding schedules, like going back to work or weaning too quickly. Think of it like a pipe backing up.
- Your baby is in the NICU. Being separated from your baby means you may not be able to nurse as often.
- Wearing a too-tight bra or clothes. Both can restrict the flow of milk.
What are the symptoms of clogged milk ducts?
If you have a plugged milk duct, one of the first things you might notice is a small, hard lump in your breast that you can feel close to your skin. The lump might feel sore or painful when you touch it. You might also notice the area around the lump feels warm or looks red. Another telltale sign is when the discomfort gets a little better right after you nurse.
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Can you spot a clogged duct from the outside of your breast? Sometimes. In certain cases, clogs can cause a small white dot at the opening of the duct on your nipple. You might also notice that your milk looks thicker, grainy, or stringy.
"I just had one that resolved in a couple of days," says What to Expect Community mom Polly96P. "It looked like a pea in size and shape [with a] hard area just outside the areola [and] redness in that area."
How do you unclog a milk duct?
Plugged ducts can be annoying and a little concerning if left untreated. The good news is that they tend to be easy to manage at home.
The key is acting quickly. Without treatment, a plugged duct can lead to a breast infection or worse, so take these steps to get the milk flowing again:[2]
- Nurse, but don't overnurse. The recommendation used to be to breastfeed often, but now experts say that overnursing can sometimes make the clogged milk duct worse. You should still breastfeed your baby normally, and sometimes breastfeeding can even help unclog it, but don't overdo it, as that can have the opposite effect.
- Pump when you need to, but don't overpump. If your baby isn't fully emptying your breast, finish the task by pumping until the milk comes out in slow drips instead of a steady stream. This should only take a few minutes. But just as you shouldn't overdo it with the breastfeeding, the same holds true for pumping on the affected side.
- Loosen it up a bit. Sometimes, plugged ducts are aggravated by external pressure (e.g., from a too-tight shirt or bra). Make sure your bra is snug but not binding, and consider steering clear of underwire for the time being.
- Apply a little ice. Placing an ice pack on the clogged duct before each feeding can help get milk flowing. Apply ice for 10 minutes while lying on your back, and repeat the process every half hour. Previously, the recommendation was to use heat, but those guidelines have since changed.
- Avoid massaging the area. Though earlier treatment guidelines called for massaging the area, that's no longer recommended, as deep massage on the affected breast can exacerbate the problem. However, you can try a very light, upward motion with the tips of your fingers on your breast.
- Try Motrin (Advil) and acetaminophen (Tylenol). You can take 800 milligrams of the former or 1,000 milligrams of the latter every eight hours for 48 hours.
- Rest. Try to sneak in some naps when your baby is napping or get help so you can get some sleep. Resting will help you heal.
- Eat well. Drink plenty of water and eat nutritious foods to help you stay healthy.
- Make an appointment to see your doctor. Talk to your practitioner if the lump gets bigger or lasts for more than a few days, or if you develop a fever or significant discomfort.
Clogged milk duct vs. mastitis: How can you tell the difference?
Clogged ducts that aren't treated can turn into mastitis, a painful infection. Mastitis needs medical treatment, so it's important to know which issue you might be dealing with. Fortunately, it's usually pretty easy to tell the difference.
You likely have a clogged duct if:
- You're not in pain, or the pain is only confined to the area around the lump.
- The area around the lump might be red, but your whole breast isn't red.
- Aside from the lump, you generally feel fine.
You likely have mastitis if:
- Your entire breast is tender, painful, swollen, or red.
- You also have flu-like symptoms including a fever, achiness, and fatigue.[3]
Call your health care provider right away if you suspect you have mastitis, since the infection usually needs treatment with antibiotics.
Can you continue breastfeeding if you have a plugged milk duct?
You can continue breastfeeding and should feed your baby as normally as possible with a plugged milk duct. However, be careful not to overnurse, as that can make the problem worse.
How can you prevent clogged milk ducts?
Some women seem to be more prone to plugged ducts than others, and there's no surefire way to avoid them completely. But there are plenty of steps you can take to lower your risk as much as possible.
- Breastfeed often. Nursing at regular intervals — every two to three hours or so — prevents your breasts from becoming engorged, keeping potential clogs at bay. If you're away from your baby for longer or she sleeps through a feed, pump regularly to prevent a backup.
- Ease into schedule changes. If you're weaning (or partially weaning), focus on dropping one feed and waiting a few days before moving on to the next one. If you're getting engorged, pump enough to get relief and continue with your wean plan.
- Keep it low-pressure. Steer clear of tight bras or tops and avoid sleeping on your stomach, which can put pressure on your breasts and set the stage for clogs.
- Change up your nursing position. Switching it up regularly helps drain all of your ducts equally.
- Wash your nipples. If it seems like dried milk is blocking the openings of your nipples after a feeding, wipe them clean with a warm cloth. Avoid lotions that might clog the duct as well.
- Ask your doctor about taking lecithin supplements. The fatty substance, derived from soybeans or egg yolks, is thought to possibly make milk thinner and less "sticky," so it's less prone to clogging. While there's not much research to back this up, many nursing moms who are prone to clogs say that it helps, and lecithin is considered safe to take while breastfeeding.[4] Of course, you should always get the green light from your doctor before taking any new supplement.
- See a lactation consultant. Frequent clogs could be a sign that your baby isn't latching or sucking as well as she should be.
Clogged or plugged milk ducts can be a part of breastfeeding. But they're fairly easy to treat at home. As you work to drain the clog, just keep an eye on the situation to make sure it doesn't get worse. If you notice increased redness, pain, or swelling, or start to feel flu-like symptoms, you should give your doctor a call right away.
Clogged milk ducts are common but manageable. If you feel a tender lump in your breast while breastfeeding, it’s likely a clogged duct, which can happen if milk isn’t being fully emptied. While it can be uncomfortable, you don’t need to panic —acting quickly with some simple home remedies can usually fix the problem.
You can usually treat a clogged milk duct at home. To unclog the duct, continue breastfeeding, but don’t overdo it. Avoid tight bras, apply ice before feedings, and rest when you can. If the pain or lump doesn’t improve or gets worse, don’t hesitate to reach out to your doctor.
While clogged milk ducts can be annoying, mastitis is an infection that requires medical treatment. If you develop flu-like symptoms, or if your whole breast becomes red, swollen, and painful, it could be mastitis, and you should contact your health care provider immediately.
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