First, it’s important to know what clogged ducts feel like. It’s most often described as a hard and/or tender lump in your breast that remains after nursing or pumping. Clogged ducts occur when there is a change in the feeding frequency, inadequate draining of breasts, or use of tight clothing. Some women can be more prone to clogged ducts. Overproduction can lead to more clogged ducts due to hyperactive ducts. There is ongoing research to determine if gut health has an impact – since this is considered an inflammatory process, and the gut affects the inflammatory processes in the body.
I think I have a clogged duct – What should I do?
Remember – clogged ducts are an inflammatory process, so treatment is guided as such.
- Rest as much as possible. I know it’s hard with a baby, but this is a time to ask for and accept help.
- Continue feeding, but don’t add more pumping or feeding sessions than you already do.
- Hand express as much as possible. This is gentler than a baby or pump. Attempt to hand express before feeds/pumps.
- Stay hydrated!
- Reduce Inflammation with ice packs on the breast every two hours for ten minutes. You can do this more often if you can.
- Anti-inflammatory medication to reduce the swelling, inflammation, and discomfort.
- Breast gymnastics: This is gentle mobilization of the breast to move lymphatics and help with inflammation reduction. As often as possible, take the affected breast, gently lift it, and move it around. Think of this as giving your breast a massage. Lift it up and down, to the side, to the other side, etc. It should not hurt. With light fingers, tickle your breasts from the nipple outwards to move fluid. Breast gymnastics can be used as often as you like (even when you do not have a clogged duct).
What if I’m prone to clogged ducts?
Some women are more prone to clogged ducts – it could be a combination of production and genetics. If you think you are, consider the tips below.
- Evaluate your pumping and/or feeding schedule to see if the timing can be adjusted.
- When breastfeeding, make sure the latch is appropriate for your baby. When pumping, make sure you use a proper flange on the pumps. Inadequate removal of milk can lead to more clogged ducts.
- Consider sunflower lecithin – this allows the milk to flow freely and can help prevent clogged ducts and recurrent clogged ducts. Your breasts will empty better when taking sunflower lecithin. Sunflower lecithin does have some reported side effects of palpitations, headache, and upset stomach, so evaluate the benefits and risks for you.
- Consider probiotics – studies show that some probiotic strains, L. Salivarius and L. Fermentum impact the breast microbiome, specifically during cases of clogged ducts and mastitis. These probiotics can decrease the likelihood of breast dysbiosis leading to recurrent mastitis. Supporting a healthy gut microbiome also helps to reduce inflammation in your whole body. Check out these probiotics.
What if Mastitis develops?
Managing clogged ducts is crucial because it can be uncomfortable and can lead to mastitis. When a clogged duct progresses to mastitis, there is inflammation in the breast tissue that may require antibiotics for treatment. You may experience a fever, flu-like symptoms, abnormal swelling or a wedge of redness on the breast, and/or a bright red streak on the breast, chills, and fatigue. Mastitis is most common in the upper outer quadrant of the breast. Are you wondering what to do if you think you have mastitis?
- Call your doctor to see if you need antibiotics.
- Don’t stop breastfeeding.
- If your baby does not drain the affected breast, hand express or pump that side to drain it. Don’t add more pumping or feeding sessions to your typical routine.
- Try other positions, such as football hold or cradle hold.
- Wear loose clothing (bra).
- Follow similar guidelines for clogged ducts: ice, pain medications, and empty the breast!
Note: these recommendations are from the guidelines from the Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022.