Blocked Ducts

A blocked duct is also called a clogged duct and some experts are trying to name it something else. It is inflammation inside your breast. Milk can sometimes not flow around the inflammation to the nipple opening. You may have an ongoing tender or painful lump, or an ongoing firm area inside your breast. This inflammation is NOT the same as a firm area in your breast that goes away with feeding.

You may already know you have a blocked duct. You feel the pain. You feel the lump. You may even be discouraged and are understandably keen to feel better. And, you may not know but need confirmation. You are not alone.

A consistent message from our clients is to get help early. Often, we see clients who know they have a blocked duct, get rid of it, and then get another. The cause was never identified nor worked on. This resource can help and do not hesitate to book a consult. That way the care will be exactly about you and your situation. 

Blockages do not happen often, but we still see them regularly. Blockages can lead to mastitis or breast abscess, so it needs to be cleared.

Let’s talk about causes, what you would notice, and what to do about it.

Causes:

• Poor latch affects how well your baby is emptying your breasts.

• A rapid change in how you empty your breasts or feed. Examples:

  • You are using a bottle instead of breastfeeding or pumping.

  • Your baby has short or skipped breastfeeds, often in relation to the company or a change in your schedule like travelling.

  • You are feeding or pumping erratically.

  • Your baby suddenly sleeps longer at night, so you are going longer than normal between feeds.

  • Your baby is suddenly only feeding on one breast instead of both.

• A lot of IV fluids in labour

• Oversupply.

• A bra that is tight or an underwire, or other objects blocking flow like a purse or baby carrier.

• A finger that is constantly blocking one area of your breast while feeding.

• Tongue-tie that is undiagnosed by a knowledgeable provider.
  

What you would notice:

• A lump: A lump forms from the build-up of milk that is not being released.

• Pain: A milk lump that doesn’t go away and gets sore.

• Side: Usually just on one side.

• Slower flow: You may notice a slower milk flow on one side, even a temporary decrease in your supply.

• Feel & See: May feel warmth or see redness over the lump.

• Temperature: No fever or possibly a low-grade fever. It can lead to a mastitis and then you have a fever and feel sick.

How to get rid of the blockage:

• KEEP FEEDING

• Work with an LC to tailor this to you, especially if you have already tried for 24 hours or more!

• Work on the cause:

  • Get a great latch. An effective latch is important.

  • Ensure your baby can transfer milk well.

  • Change bra – no underwire, no restrictions from your bras.

  • Avoid tight clothing or accessories over your breast. Do your best with a seatbelt.

  • Change finger position if it is blocking the flow.

  • If you are pumping a lot, ensure the flange size is right for you. Do not pump to fill your freezer as oversupply can be part of the problem.

  • Downregulate the supply if needed.

• Work on blocked duct:

  • Use very light massage before breastfeeding.

  • Start breastfeeding on the affected side.

  • While feeding use light massage to keep more milk flowing. Use light pressure only.

  • A big help is often your baby. Feed creatively by feeding with their chin towards the lump. You may need to lay flat on your bed with someone else positioning your baby. The breast drains best near the location of your baby’s chin.

• Additional Tips:

  • Take antiinflammatories like Ibuprofen.

  • Apply ice or cool compress to the affected area. Watch your skin so you don’t damage it.

  • Just before feeding use a warmth such as a moist compress, a warm shower, tub bath using a warm and wet cloth covering your breast. Of course, be careful not to burn yourself.

  • Rest!

  • Shower and gently massage, hand express small volumes for comfort, soak your breast in an Epsom salt bath.

  • Lecithin as per Dr Jack Newman may help.

  • Therapeutic ultrasound can help but is rarely needed.

  • If you are on antibiotics, you may still need help to understand and work on the cause.

Reach out any time. We have had great success helping clients with this. You CAN breastfeed comfortably!

If you have a fever, chills, or body aches call Telehealth Ontario or your health care provider.

Regardless, email us to help you work on the cause and prevent this from recurring.

A big thank you to those who contributed to this resource!

Sonya Boersma MScN, RN, IBCLC, Lactation Care © 2022