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Clogged or inflamed ducts

If you’re breastfeeding or preparing to breastfeed, you’ve probably heard about clogged ducts. Information about breastfeeding changes all of the time, and one recent change is a new way of looking at this idea. Through research and ultrasound imagery, experts now think that milk isn’t actually creating a clog and the pain you’re feeling. The pain, swelling and lumps are your milk ducts and surrounding breast tissue swelling and becoming inflamed. So we are updating our language and saying “swollen ducts” or “inflamed ducts.” Looking for more information? You’ve come to the right place!

What are inflamed ducts?

Inside your breast there are dozens of milk ducts. Imagine tiny strands of spaghetti that are crisscrossing and creating the pathways from milk making cells deep in your breast all the way out to the tip of your nipple. When your breast tissue gets overly full, irritated or injured, those tiny ducts can swell. It makes it harder for milk to comfortably let down and pass through your breast. Sometimes it feels like a hard pea, and sometimes the area gets so inflamed that it feels like multiple golf balls or a big lemon. If you notice lumps or bumps before a feeding — that could be okay. But if you have painful lumps and bumps after you’ve fed or pumped, it might be a sign of swollen ducts. Some people also notice that less milk is coming out of the impacted breast. 

What do I do first?

Identify the area and try some easy strategies. Most inflammation will improve  over 12-24 hours. Here are some tips:

  • Breastfeed directly or pump on a normal schedule. Don’t increase stimulation to that side by feeding or pumping more. Feed or pump for what your baby needs during this time, don’t follow advice to “empty” breasts.
  •  Keep things cool. Ice is your friend when it comes to inflammation. Apply cold or ice packs to the  swollen area for about 5 minutes every hour.  If it feels better to use cold during a feed or after, be flexible – the timing is up to you. 
  • Take an anti-inflammatory medication like Ibuprofen if it’s safe for you. Regular use can decrease inflammation overall and lessen your pain. A win-win.
  • Rest. Breast inflammation can progress to mastitis, and your body is working overtime right now. Extra rest, hydration and support can make a huge difference. 
  • Some older advice can actually be harmful. Deep massage, excessive suction (from person or machine), and lots of heat can actually make inflammation worse and prolong the problem.

Other Ideas:

  • Try changing your breastfeeding position. This may not decrease inflammation, but it may increase your comfort. Dangle feeding can be dangerous for very young infants.
  • Try therapeutic breast massage. This type of gentle massage can help elongate milk ducts temporarily and give relief. 
  • Ask your provider about therapeutic ultrasound. While it isn’t a common practice in the US, there is some research suggesting it can be helpful.
  • Consider a Lecithin supplement (discuss potential gut health impacts with your provider) or a probiotic. Both have benefits for certain people, you can check out specific info here as not all supplements are created equally!

What if I’m not getting better?

Sometimes inflammation takes time to improve. As long as you aren’t seeing symptoms of mastitis, continuing to monitor your breasts closely and sticking with the tips above is advisable. In many cases, inflammation is persistent because your body has an oversupply of milk. Working on managing the oversupply can also help relieve inflammation (especially if it happens frequently). A professional lactation consultant can help you do this safely while meeting your personal feeding goals. 

How do I keep this from happening again?

Many people experience swollen ducts no matter what preventative steps they take — it’s not your fault. In addition to checking for oversupply, looking for ways your breasts may be getting injured is helpful. Injury and trauma aren’t always visible! Checking your baby’s latch is a great place to start for prevention. Teething, growth spurts or illness can all change a baby’s latch temporarily and cause trauma. If you’re pumping, it can help to check your flange size, fit, and settings. Poor flange fit and too much suction can cause injury in the same way a poor latch can.

You might also want to consider any recent schedule changes. Did your baby recently start sleeping for much longer stretches of time or did you return to work? Are you wearing a new bra or baby carrier that is pinching or putting pressure on your breasts? Did you start sleeping on your stomach or go for a long car trip? It takes time for your breast to fully heal after a significant episode of inflammation. It’s not unusual to feel that lumps and bumps are gone, but pain or a “bruised” feeling remain. Contacting breastfeeding support for frequent swollen ducts is another great idea.

We know that it takes a long time for newer information to make its way into normal discussion when it comes to parenting. You may have been told by well-meaning friends, family or healthcare workers that you have a clog, and been given outdated advice. It’s also possible you’ve read the newest information and feel like it’s not for you – this can be especially true for exclusive pumpers or people with blebs. Your Ovia experts are here to help you navigate this time and all of your choices, and most importantly – to feel better!

Reviewed by the Ovia Health Clinical Team

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