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Clogged ducts

If you’re breastfeeding or preparing to breastfeed, you’ve probably heard about clogged ducts. Looking for more information? You’ve come to the right place!

What are clogged ducts?

Inside your breast there are dozens of milk ducts. Imagine tiny strands of spaghetti that are the path from milk making cells deep in your breast all the way out to the tip of your nipple. When milk sits inside of these ducts, it can start to turn solid and cause a clog. Sometimes the clog feels like a hard pea, and sometimes it gets so backed up and 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 a clogged duct. Some people notice that less milk is coming out of the impacted breast. Pay close attention to it over the next few feeds and treat it as soon as you can.

What do I do first?

Identify the clog and try some easy maneuvers. Many clogs will move pretty quickly. Here are some tips:

  • Try changing your breastfeeding position. Side-lying and dangle feeding positions can both act as a very effective drain. In dangle feeding, you lie baby on their back and lean over them to offer them your breast. 
  • Give baby the clogged breast first for the most powerful suction OR give it to them second if you think they might fall asleep on the breast and offer some long-lasting suction. 
  • Gently massage around the clog and in front of the clog while they feed (or while you pump). Trying to squeeze the clog or harshly massage it out probably won’t work, and it will increase pain and swelling (which can make it harder for the clog to pass).

What if basic changes aren’t helping?

If your clog has been around for several feeds, or if it is getting more painful, it’s time to try a new strategy. Pain at the clog can often be worse at the start of feeds or pumps because of swelling related to let-down. Hang in there, it’s really important to keep milk moving!

Hot and cold

A few minutes of warmth before a feed or pump can help with milkflow, but too much heat can make inflammation worse — so limit it to about 5 minutes. After feeds, use cold for a few minutes to help decrease pain and inflammation.

Massage and vibration

Gentle massage or vibration near the clog can help it move. It’s best to try this during a pump or feed. Some people also try hand expression for clogs because their baby is distracted by the massage/vibration. There are products sold for this purpose, but you can use your hands or a toothbrush if you don’t want to buy new items!

Spa-time

If you have a silicone pump like a Hakaa, adding a tablespoon of Epsom Salts and very warm water until it’s full to make a “boob-spa” can help. Many people find that attaching their Hakka this way allows them to massage the clog and creates a great environment for healing. It does make a mess, so try it with a towel under you or in the bath. You can also just jump in the tub if you have one and that seems easier! Just increase the amount of Epsom salts and try hand expression under water.

What if I still have a clog?

Some clogs are really tough to move and will persist for days. Continue to try to move the clog as frequently as you can and monitor your breasts closely for signs of mastitis (redness, streaking, fever, or generally not feeling well). Contact your provider to talk about taking Ibuprofen, Sunflower Lecithin (choline), or a therapeutic ultrasound. Antibiotics will treat an infection if it develops, but they do not get rid of the clog. Keep trying!

How do I keep this from happening again?

Many people get clogs no matter what preventative steps they take — it’s not your fault! But checking your baby’s latch is always a great place to start for prevention. Teething, growth spurts or illness can all change a baby’s latch temporarily and cause a clog. If you’re pumping, it can help to check your flange size and fit. 

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? There is often swelling leftover after you clear a clog, so the area might be more prone to immediately getting another clog. Give it lots of love for 1-2 weeks after the clog has passed. Contacting breastfeeding support for frequent clogged ducts is another great idea.

Reviewed by the Ovia Health Clinical Team

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