Breastfeeding And Plugged Ducts

What is a plugged duct?

A plugged duct is a milk duct in your breast that is blocked. Milk ducts carry breast milk from the glands (small sacs) where it is made, down to your nipple. When a duct is blocked, the flow of milk to your nipple may decrease or stop. Milk may build up and cause a tender (painful when touched) lump to form in your breast.

What increases my risk for a plugged duct?

Ask your caregiver for more information about these and other factors that may increase your risk for a plugged duct:

• Incomplete breast emptying. Anything that keeps your breasts from emptying completely may increase your risk for a plugged duct. This includes sore or damaged nipples that cause you to breastfeed less often. You may breastfeed less if you are tired or stressed. Your breasts may not empty completely if you hurry through breastfeeding sessions with your baby. Limiting how long your baby feeds each time or switching breasts to feed your baby too early also increases your risk. As your baby gets older, he may get distracted easily and stop suckling sooner than usual. He may sleep longer or look around more instead of focusing on feeding. Missed feedings may also cause milk to build up and lead to a plugged duct.
  
  
• Pressure on your breasts. Carrying heavy diaper bags, infant carriers, purses, or wearing tight clothes can squeeze and put pressure on your breasts. This may pinch your milk ducts and trap milk inside your breasts.
  
  
• Engorged breasts. This is when your breasts are very full with milk. Milk may leak from your breasts between feedings. Milk may spray from one of your breasts as let-down occurs in the other. Let-down is when the milk flows from the glands through the milk ducts to your nipple.
  
  
• Breast milk that seems thicker than usual.
  
  
• Breastfeeding history. You may be at higher risk if you have had a plugged duct before.

What are the signs and symptoms of a plugged duct?

When your baby has trouble getting milk from your breast he may pull or twist your nipple. You may also have any of the following signs and symptoms:

• A tender breast lump that grows slowly and usually forms on one side of your breast.
  
  
• Pink or red skin over the tender area.
  
  
• Your breast may feel warmer than usual.
  
  
• A small, white bump at the nipple of the breast.
  
  
• Pain in your nipple or shooting pains in your breast.

How is a plugged duct treated?

The best treatment for a plugged duct is to empty your breast completely during breastfeeding.

• Breastfeed as often as your baby wants. Your baby can feed 8 to 12 times a day, or more. Frequent breastfeeding may remove the blockage in your milk duct. To help remove excess milk, give your baby the breast with the plugged duct first. Breastfeeding often may also help prevent plugged ducts from occurring.
  
  
• Position your baby to help empty your breast. Hold your baby so that his nose is pointing towards the swollen area of your breast. This helps drain breast milk from the plugged duct. Ask your caregiver for more information about how to hold and breastfeed your baby.
  
  
• Massage the breast with plugged ducts before and during breastfeeding. You may also do this while taking a hot shower or bath. Massage your breast in front of and behind the lump. Massage your breast from the area of the lump to the nipple.
  
  
• Express milk after breastfeeding. If your baby is not emptying your breasts fully when he feeds, expressing or pumping may help. Use a breast pump or your hand to drain extra milk and help prevent breast swelling. You can also do this if your breasts are too full for your baby to latch on. Ask your caregiver for more information about expressing, collecting, and storing breast milk.
  
  
• Apply warmth to your breasts before breastfeeding. Put a warm, wet cloth on your breasts or take a warm shower or bath. You can also lean over a sink or basin of warm water and place your breasts in it. This may help remove the blockage and increase your milk flow. Putting warmth on your breasts before breastfeeding may also help prevent plugged ducts.
  
  
• Apply a cold pack to your breasts after breastfeeding. This may help decrease swelling and pain.
  
  
• Talk to your caregiver before taking any medicines. This includes all prescription and nonprescription (over-the-counter) medicines. Ibuprofen and acetaminophen are common nonprescription medicines to help decrease pain and swelling. Follow your caregiver's advice on how to take them.

What are the risks of having a plugged duct?

When milk cannot be drained out of your breast, it will build up inside your breast. Too much milk inside your breast may be painful. If a plugged duct is not treated, it may lead to mastitis. Mastitis is an infection in your breast. An abscess (pus pocket) may form in the same area as the plugged duct. You may have a mild infection in your duct if it becomes plugged again. A plugged duct may make breastfeeding painful and cause you to stop breastfeeding completely. Ask your caregiver for more information about the risks of having a plugged duct.

What can I do to help prevent a plugged duct?

• Allow enough time for each feeding. Do not rush your baby so he is able to empty your breast completely.
  
  
• Check your breasts for lumps, pain, or redness.
  
  
• Get enough rest. If you notice any signs or symptoms of a plugged duct, rest as much as possible. Try not to sleep on your stomach because the pressure on your breasts may increase your risk for a plugged duct.
  
  
• Wash your hands and your breast pump often. This will help prevent the spread of germs and decrease your risk for infection. Encourage everyone in your house to wash their hands with soap and water after going to the bathroom. Also, wash your hands after changing diapers and before preparing or eating food. Wash your breast pump with soap and hot water after you use it.
  
  
• Eat a healthy diet and drink plenty of liquids, such as water. Ask your caregiver for more information about breastfeeding and your diet.

When should I call my caregiver?

Call your caregiver if:

• You have a fever of 101°F (38.4°C) or higher, and chills.
  
  
• Your body feels very achy.
  
  
• Your breast is red, very swollen or hard, painful, and feels warm or hot.
  
  
• You have a new tender lump in the same area that you have had a lump before.
  
  
• You have nipple soreness or cracked or bleeding nipples.
  
  
• You have pus draining from one or both of your nipples.
  
  
• You have nausea (upset stomach).
  
  
• Your signs and symptoms are not getting better within 24 hours.

Where can I find more information about breastfeeding and plugged ducts?

Contact the following:

• Academy of Breastfeeding Medicine
  140 Huguenot
  New Rochelle , NY 10801
  Phone: 1- 914 - 740-2115
  Phone: 1- 800 - 990-4226
  Web Address: www.bfmed.org
  

Care Agreement

You have the right to help plan how you are going to feed your baby. To help with this plan, you must learn as much as you can about breastfeeding. Ask your caregiver questions about breastfeeding. Talk with your caregiver about the best way to feed your baby.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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