Treating A Clogged Milk Duct: Short-Term Solutions and Long-Term Prevention
Clogged milk ducts and mastitis are often related to inflammation in the breast, and unfortunately many people are still getting outdated advice that focuses on trying to “force the clog out.” Instead, we know that more gentle strategies like lymphatic drainage massage, therapeutic ultrasound with a physical therapist, and anti-inflammatory strategies such as ice and NSAIDS may be more beneficial. There are also things you can do to prevent clogged ducts more long term such as addressing any milk oversupply, keeping good mobility in your upper back and chest, taking supplements, and taking care of yourself physically and mentally.
When Lactating Becomes a Real Pain in the Boob
Breastfeeding or pumping can be challenging for a number of reasons, but when you add clogged milk ducts into the mix, it can feel like altogether too much. Yes, your body is incredible in its ability to make milk and sustain your baby. Lactating is a beautiful, complex system that can have so many benefits for mom and baby, but when it starts getting derailed with something like a clogged duct, the experience is unpleasant at best and often overwhelming and exhausting to new moms who already have so much to navigate in early parenthood.
This topic is near and dear to my heart, because if I had even heard about clogged milk ducts before having my own babies, I simply envisioned a little lump that would eventually pass. No big deal. But with my firstborn, before I knew what I was actually doing, I ended up having countless clogged ducts and a total of 7 bouts of mastitis in my first year postpartum. It was brutal. I realized after the fact that so much of the commonly suggested remedies either don’t work or can make the situation worse, which I experienced firsthand. But I now know that there are effective strategies to both treat and prevent clogged ducts and mastitis and I am here to try to make other parents’ experience a little more comfortable.
What is a clogged milk duct and/or mastitis?
A clogged duct describes an area in breast tissue where milk has a hard time passing through, leading to a backup that can cause a lump in the breast that can also be tender and swollen. Contrary to the common picture of an open tube with a piece of hardened milk blocking the way, a clogged duct actually occurs because of inflammation which can narrow the tube itself (this info is super important when deciding which treatment options are going to work!)
Mastitis is when this condition worsens and can lead to more intense pain, redness, and even full body symptoms that can feel like the flu such as a fever or chills. While this may be indicative of an actual infection that needs antibiotics, it is often just part of the clogged duct spectrum and with appropriate treatment, can resolve without the need for medication. Of course, if things are not progressing as you expect or you have other concerns, you may want to consult with a physician.
Treating A Clogged Milk Duct: Short Term Strategies
The dread I remember feeling when I first felt an inkling of a clogged duct brewing is one of the defining memories of my breastfeeding journey. I knew how tender it could get to the point I didn’t even want to hold my baby and I remember distinct anxiety and dread that I may be completely knocked out with flu like symptoms in a short amount of time if I couldn’t resolve it. Boy did I wish I knew some of these research-backed strategies to actually take care of it instead of the “wait and see” approach or things that I realize now were old school ways of thinking such as aggressive massage, extra feedings and pumping on the affected side, or even having a partner suck as hard as they can on the breast (UGH, I’m not kidding when I say all of these were recommended to me). Here is a better approach:
Very gentle, lymphatic drainage massage: Instead of trying to “push out” the clog, it is actually a much better strategy to use gentle strokes away from the nipple toward the armpit or collarbone where we have major lymph drainage sites. You can think of the amount of pressure as approximately what you’d use to pet a cat. This is like clearing a traffic jam so things can more naturally flow. Hard, aggressive massage will likely increase the inflammation which is the whole problem in the first place.
Continue feeding your baby on demand and don’t aim to “empty the breast”: It is perfectly safe to continue feeding your baby with mastitis or a clogged duct, but don’t change your typical routine to try to feed more from the clogged side. In fact, sometimes too much milk flow/production can be a contributing factor to the problem, and because our breastmilk production works on supply and demand, you would be giving your body cues to make even more milk
Consider ice and/or anti-inflammatory medications like NSAIDS: Either of these things may help with the discomfort associated with a clogged milk duct and can help address the underlying inflammation
Seek out therapeutic ultrasound: This is not imaging ultrasound, but an ultrasound machine that uses thermal energy that can reduce the inflammation that contributes to clogged ducts. It is often recommended to follow up with feeding your baby or pumping directly after a treatment. It can do wonders!
Work with a pelvic floor therapist or physical therapist who specializes in postpartum care: Likely, this provider can provide the ultrasound for you, perform and instruct you on hands-on techniques to support your body, and work on other body components that may be influencing your tendency to develop clogged milk ducts while lactating
Treating A Clogged Milk Duct: Long Term Strategies and Prevention
Keep your upper back and chest mobile: This helps keep good drainage throughout your upper body to minimize risk of a clogged duct
Treat any underlying hyperlactation or milk oversupply: Working with a lactation consultant can be especially helpful to figure out what you and your baby need and make a plan to make sure your baby is getting adequate nutrition while supporting your own body in the process too.
Avoid tight fitting bras or garments: This can put too much compression or pressure on your body which may decrease the good lymphatic drainage and flow in the region.
Stay well hydrated, nourished, and rested: Lactating can take a toll on your body, and you need to fuel it and rest it well for good function. Don’t let a clogged duct be the thing that forces you to take a step back.
Minimize use of pumping or nipple shields as able: I totally understand that this is not accessible to everyone, and we have these options for a reason, so please don’t feel any sort of shame about using them! However, they can be linked to an increased chance of developing a clogged duct because they limit the full extraction that an infant can do and reduce the positive bacterial exchange between mom and baby when an infant makes direct contact with the nipple. Important note: If you are pumping, please make sure you have a properly fitting flange! This can make such a huge difference!
Consider probiotic use: Evidence is mixed on this one, but Limosilactobacillus fermentum or Ligolactobacillus salivarius may be helpful.
Consider taking sunflower or soy lecithin (5-10g daily) to reduce inflammation and potentially emulsify milk.
Address any underlying perinatal mood or anxiety disorders: When our minds or bodies are depleted, sometimes there are real physical symptoms and issues that come right along with it. In this case, we do have data that shows women with a history of anxiety and depression experience higher rates of mastitis symptoms. So, if you identify with this, please know that you deserve to get help for so many reasons, including that it can impact your lactation journey.
Get postpartum care from a pelvic health therapist: Good pelvic floor therapists do so much more than work on the pelvic floor! In the case of clogged duct or mastitis support, they should be able to look at you head to toe to identify areas that may be impacting your body and your lactation experience. They can give you tailored interventions to work on those things and also help you get pointed to any additional resources you may need too.
Where to Find Support in Treating Clogged Milk Ducts
If you are located in Richland, WA, Tri Cities Pelvic Health provides pelvic health therapy for a number of conditions that postpartum parents face including clogged duct and mastitis care. We can perform therapeutic ultrasound, do hands-on work, show you exercises and stretches to support your body, and provide education and support around positioning, body mechanics, and more. We do our best to get you seen as soon as possible, especially if you are experiencing an active issue because we know how much you are juggling in this season of life and want to support you in feeling your best along the way.