April 7, 2019
Reviewed by Kimberly Langdon M.D.
Plugged ducts. Clogged ducts. Blocked milk ducts. Whatever you want to call them, they’re awful. Comedian Ali Wong has equated them to being like “a kidney stone in your titty.”
But they’re very, very common for breastfeeding mothers. As I’m typing this, I have just gotten over my 10th clogged duct (always in the right breast) and if you’re reading this, I feel for you.
Typically it feels like a hard, very sensitive swollen spot in your breast. It can feel as small as a pea and as big as an apple. It might make breastfeeding more painful. Or your entire existence more painful - for me, personally, my plugged ducts last throughout the day.
The area may feel extremely tender, it may be hot or look reddened. And one of the crazier parts - the plug location may shift.
A plugged duct is different than mastitis. It can lead to mastitis but a plugged duct by itself shouldn’t be present with a fever. If you have a fever, you may already have mastitis. But unplugging a duct can help nip that in the bud.
In general, they occur when milk flow is restricted or there is poor drainage in your breast for some reason or another.
It’s important to think about what might be causing the plugged duct - it’s not what you want to hear right now (your main thought is probably HOW DO I FIX THIS MAKE IT STOP), but you want to think on this piece to prevent them in the future.
Some of the causes can be:
Nurse. Nurse aggressively. Pump if you cannot nurse. It is your best and fastest treatment plan to unplugging that duct.
It may be painful, but you need your baby to help unplug the duct to prevent mastitis and other complications.
If you can’t nurse, try to express milk either by hand or with a breast pump. If it’s too painful to nurse on the affected side, start on the other breast then have your baby switch to the plugged duct breast after let-down.
Try to feed every 2-3 hours (no more than 3 hours in between feedings) and get the breast with the plugged duct as empty as possible, but don’t forget about the other breast or else you’ll wind up with plugged ducts on both sides.
Other things to keep in mind:
Rest is one of the most important things but including rest on a list of suggestions for a new mom seems ridiculous to me. You’d be getting rest if you could…
For me, my right breast has been the angry plugged duct side for the entirety of my baby’s nursing time and I developed tricks to work around that issue. For instance, I ended up never carrying my son on my right shoulder because that would lead to too much pressure and plugged ducts. At night, I also went to sleep on the side that was emptied last. This also helped me in the middle of the night with remembering which side to feed on next - whichever side I woke up on, it was time to feed on the opposite side.
If you feel like you have a plugged duct that has escalated to mastitis or if you are worried about mastitis, contact a doctor immediately. Signs of mastitis may include:
Kimberly Langdon M.D. is a retired University-trained obstetrician/gynecologist with 19-years of clinical experience. She graduated from The Ohio State University College of Medicine and then completed her OB/GYN residency program at The Ohio State University Medical Center. Recently, she founded a medical device start-up company that focuses on non-drug treatment for common maladies.
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