Preventing & Treating Recurrent Plugged Milk Ducts

March 10, 2013

I personally had a heck of a time with recurrent plugged ducts after the birth of my older son. Through my professional training as a Lactation Educator and Counselor and experimenting with different approaches, I came up with a multi-pronged plan of attack to prevent and treat these little (or not so little) buggers.

  • Proper latch. An improper latch is the culprit for most breastfeeding issues. It can result in insufficient emptying of the breast, which can in turn contribute to plugged ducts. This is a very helpful video I share with students and clients to demonstrate how to achieve a proper latch. Sometimes an improper latch is due to a lip or tongue tie and can be diagnosed by a lactation consultant, pediatrician or pediatric dentist. Please read here for further information.
  • Frequent & thorough emptying of the breasts. The longer milk sits in the breast, the thicker it becomes, making it more likely to cause a plugged duct. Don’t wait too long in between feeds and/or expressing milk (every 1-2 hours with a plug present) and be sure the breast is thoroughly drained. Be sure not to neglect the unaffected breast – you want to make sure it’s also being thoroughly drained to avoid a potential issue.
  • Breastfeeding Positions. Start each feed on the side with the plug (when baby’s suck is the strongest) and aim baby’s chin in the direction of the plug. For example, if the plugged duct is in the bottom outside area of the breast (8 o’clock), then feeding the baby in the football or clutch position will be most effective. It’s also a good idea to change breastfeeding positions each time you feed so the different milk ducts can each flow and drain. This sounds silly, but many women have been able to release a plug by using gravity. Lay baby down on the bed and hover over baby on all fours and offer the affected dangling breast.
  • Apply heat. You can do this with a heating pad, hot water bottle, rice sock or basin of hot water. Use caution not to burn your skin by using too much heat for too long. I found moist heat to be most effective particularly before a feed or expressing milk. Take frequent hot showers (as hot as you can tolerate) or soak in a hot bath while firmly massaging the plug towards the nipple and hand expressing the milk out.
  • Milk blister or bleb. Sometimes, but not always, a plugged duct is associated with a “bleb” or milk blister on the end of the nipple where the nipple pore is. It is usually painful and commonly due to a poor latch. A lactation professional can help open the blister with a sterile needle. She will gently puncture the top or side of the blister and squeeze just behind the blister to see if the plugged up milk will come out. This might result in the duct unblocking. Putting baby to the breast after puncturing the bleb may also result in the baby unblocking the duct.
  • Pressure Massage. This method of massage from Dr. Sears works by applying pressure to the edge of the lumpy area closest to your chest wall with the heel of your hand to the point just before it becomes too painful. Hold the pressure at that level until the pain eases off. Then increase the pressure again, (without moving your hand) and hold it until the pain eases. Continue to gradually increase pressure at that same site until you are pressing as hard as you can. Then pick your hand up, move it down toward your nipple about a half inch, and repeat the pressure massage in this area. Continue moving your hand a half inch and repeating the massage until you get all the way down to the nipple. You may see the dried milk come out from an opening in your nipple. Even if the plug doesn’t actually come out, you will at least have dislodged it and moved it toward the nipple so that when baby goes to the breast and sucks, it can be more readily removed by baby’s suction.
  • Rest, De-Stress  and “Babymoon.” It’s not always easy to get some rest with a baby. Get help with chores and errands or just let them be- this is not the time to fuss over the dishes. If you work outside the home, take the day off if you can. Take baby to bed with you (babymoon) and breastfeed there. Stress can also contribute to plugged ducts so as difficult as it may be, try to “keep calm and carry on.”
  • Holistic & Natural Approaches. B-complex vitamins, vitamin C, evening primrose oil, thyme, probiotics and consuming 3-4 raw garlic cloves (try taking with orange juice) have been known to help plugged ducts. Also, try eating wholesome, nutritious foods, reduce your intake of saturated fats and drink water to thirst or about 64 oz. daily. Soy Lecithin has helped some mothers prevent plugged ducts. It as been suggested that it decreases the viscosity or “stickiness” of the milk by increasing the percentage of polyunsaturated fatty acids in the milk. I have used Health Alliance Non-GMO Lecithin Powder. The dose is 1200 mg, 3-4 times a day. Traditional Chinese Medicine (TCM) typically views plugged ducts as an accumulation of toxic heat. Acupuncture can help clear the heat and toxicity while treating any underlying imbalance that may be causing or contributing to the condition. This homeopathic protocol has been effective: First, take 3 pellets of Hepar Sulphur 30C. Three hours later, take 3 pellets of Phytolacca Decandra 30C. Repeat until symptoms improve. Castor oil packs have also been effective.
  • Pain Relief. Ibuprofen is the preferred anti-inflammatory pain medication by lactation professionals for breastfeeding women and will help reduce swelling. I was stubborn about this one at first but I quickly learned that it really helps and gives you the relief you need to get a good milk letdown which is essential for good milk transfer and thorough emptying of the breast.
  • Ultrasound therapy. Most plugged ducts will be go away with these measures within 48 hours. For really stubborn plugs, therapeutic ultrasound treatments are painless and have been proven effective. It is especially effective when combined with lymphatic drainage massage. Most physiotherapy or sports medicine clinics can provide these treatments for you. However, few are aware of using ultrasound to treat plugged ducts so you may want to call around to find someone who is experienced. If you live in the Los Angeles area, Women’s Physical Therapy offers this service. Each treatment should last for about five continuous minutes on the affected area. If two consecutive treatments (for two days) don’t work, then it should be evaluated by a specialist. One of my “plugged ducts” actually turned out to be a lactating adenoma. At home, you can try using the flat end of an electric toothbrush or Clairisonic face brush to give yourself a mini “ultrasonic” treatment for less stubborn or smaller plugs.
  • Sneaky Offenders. Be mindful of the below ways which can obstruct the flow of milk through the ducts, thus causing a plug:
    1. Seatbelt Straps. Be aware of how your seatbelt fits across your chest and adjust it as needed to alleviate pressure on the breast itself.  Many vehicles have adjustable heights, but if yours does not you may want to use a folded washcloth or cloth diaper to place underneath where a belt presses against your breast to redistribute the pressure.
    2. Purses. Same as above.
    3. Bras. Wear a comfortable, loose fitting nursing bra without underwire. My personal fave is the Bravado Body Silk Seamless Nursing Bra. At home or out, consider “free-boobing” it 😉
    4. Sleeping Positions. A sleeping position that puts pressure on your breasts is likely to contribute to plugged ducts. If you are a tummy sleeper, try sleeping on your side with a pillow between your knees. I experienced my first plugged duct after a massage while laying on my stomach and have requested pre-natal massages in the side-lying position ever since.
  • Introspection. Louse Hay published a book called You Can Heal Your Life which describes “the mental causes for physical illness and the metaphysical way to overcome them.” It contains physical maladies plus the way to look at that condition spiritually. It also contains the positive affirmation you can meditate upon to help you work toward healing. The section on breast problems including cysts, lumps, soreness, plugged ducts and mastitis states: “A refusal to nourish the self. Putting everyone else first. Overmothering. Overprotection. Overbearing attitudes.” The positive affirmation associated with breast lumps and cysts reads: “I am important. I count. I now care for and nourish myself with love and with joy. I allow others the freedom to be who they are. We are all safe and free.”
  • Support. Plugged ducts are no day at the park. I would be lying if I said I didn’t want to give up when in the throes of a plugged duct attack. Get friends and family to help with chores and errands, have a good cry if you need to, enlist your partner to give you a relaxing foot massage and find a local breastfeeding support group such as La Leche League. I am here to offer breastfeeding support too!

Note: When you finally do break up the blockage, you may not be able to tell until for a day or so as the area will remain tender. Plugged ducts can also lead to mastitis. If left untreated, mastitis can result in a breast abscess. If you think you have an infection or are experiencing flu-like symptoms, consult an IBCLC.

Please consult with your health-care provider or naturopath before starting any treatment plans or taking any supplements. Image source:

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  • Reply Jill @ The Daily Tonic March 18, 2013 at 2:19 pm

    Great post! Very concise and informative. My son was born tongue tied and we went through the gamut of breastfeeding issues, and constant plugged ducts was one of them. Thanks for putting the info out there to help other women that might be in the same boat and not have access to lactation support.

    • Reply Natureal Mom April 11, 2013 at 12:10 am

      Thanks for the positive feedback! I’m sorry you also struggled through breastfeeding issues. Having info and support is so important. I’m planning to write more posts about breastfeeding in hopes to help the other mamas out there.

  • Reply Liz June 19, 2013 at 5:55 pm

    What a great informative post! I found this through google as I search for info on blocked ducts after having ANOTHER one last night. My daughter is one and I can’t count how many times I’ve had a blockage since starting breastfeeding. I do get fly like symptoms that come on very fast, virtually a few hours after I notice the blockage. Ill feel fluey and hot/cold etc for a few hours and then it goes away and I’m just left with a tender boob for a couple of days. So I’m unsure, is it mastitis? If it was wouldn’t it not go away by itself?
    So confusing. I live breastfeeding so much but this really takes some of the joy away.
    Thanks so much for such a great article :)

    • Reply Natureal Mom June 20, 2013 at 4:04 pm

      Hang in there mama! Hopefully the info in this post will help you through the next one or better yet dodge it to begin with. It’s hard to say but it’s possible the blocked duct was causing mastitis to develop and you if the plug unblocked early enough and you rested, it could have gone away. The thing to look out for with full blown mastitis is a fever and/or red streaks on the breast. That’s when it’s time to call the doctor or Lactation Consultant as it is likely antibiotics will be needed. I agree, this does take some of the joy away from breastfeeding but once you figure out how to deal with them it’s worlds better. It took me a year to figure it out, but I didn’t have any after that 😉

  • Reply Liz June 19, 2013 at 5:56 pm

    Ah auto correct!

  • Reply Michelle Tyson September 11, 2013 at 11:19 pm

    Hello from Adelaide in Australia! and thankyou, wow this is the BEST info I’ve come across on blocked ducts. Believe me, I’ve done my fair share of googling too!
    I have that Louise Hay book too…freaky….so I’ll be re-reading that, I bought that book nearly 20years ago!
    My daughter is now 8 months old and I have struggled with blocked ducts since she was 7 weeks old. Many, many tears, stressful and tired nights (and days!) as a result. I’m still bf and will continue to do so now until she is 12months. May as well, I’ve come this far. Thankfully a friend is a physio and I can get ultrasound done by her. I would be lost without it! I’ve seen a breast specialist too and will be going back after I finish bf to have my breasts thoroughly examined.
    I’ve had blockages at least 20 times ~ its crazy! Always in the same breast and almost always in the same position. and not little ones, huge masses. I have done everything you recommend. They always do eventually go but I never really feel like I can completely empty that breast.
    I’ve recently reduced all saturated fats from my diet now, completely, no cheese, dairy, zlich…its funny, I have always wanted to become a vegan…maybe these blockages are telling my body something, no animal fats or products. I dunno :)
    Now my daughter is sleeping through the night (11hours bliss) I am having the manage my boobs and potential blockages overnight. I express (I have an electric pump) but I only express enough to provide relief but my boobs always seem to block up after I’ve expressed, perhaps I am not expressing enough? but I am cautious of sending the wrong signal to my boobs, saying make more milk. Its a constant juggle….with the jugs lol
    Do you have any advice on how to manage the overnights and eventual weaning process? with someone who has recurrent blocked ducts.
    Thanks so much, I love your page.
    Warm regards,
    Michelle x

    • Reply Natureal Mom September 12, 2013 at 8:17 am

      Hi Michelle, I’m so glad you found the information useful! I struggled with plugged ducts for a long time and it was my hope to help other mamas dealing with the same issue. My babe was an active night nurser and didn’t start sleeping through the night until he was two and a half (yep) but I had an oversupply and had to pump in order to prevent plugged ducts. At first I pumped just a little but would also get plugs right after. I was advised by my IBCLC to pump to thoroughly empty the breast (or close to it). I was also concerned that doing so would cause my body to produce more milk so I understand where you’re coming from, however, this is the bigger priority at the moment and you have to deal with one thing at a time. If your babe just started sleeping through the night for an 11 hour stretch, it’s too long to go without getting a blockage. You can try pumping less and less gradually over time. It might take some trial and error to find the right balance of how much to pump and how long to go in between. If you plan to wean at 12 months, you will want to start the process sooner and do it gradually to help avoid plugged ducts. I have some tips to help you through that when it’s time. In the meantime, hang in there and feel free to reach out for support anytime you need it. You’re doing a good job mama! Xx

  • Reply Kate September 14, 2013 at 10:07 am

    What an awesome article! Thank you for the great information. My daughter is 4 weeks old and we have already had a crazy, difficult time breast feeding and I am determined, though, to make it work. At a week I had horribly cracked nipples and had already had plugged ducts TWICE! I got plugged ducts again at 2 weeks which quickly turned into mastitis. When I had plugged ducts, I had many of the mastitis symptoms, but my symptoms of mastitis were much more severe. I pump, but have huge over supply issues. Now, we’re struggling with latching issues and breast feeding is an extremely painful process. Everything I try, I can’t seem to get the pain to go away. I cant seem to get my daughter to open her mouth wide enough. I meet with the LC on Monday, but I am so disappointed because its just been one thing after another. I am also terrified of getting plugged ducts and/or mastitis again… It is NOT fun.

    • Reply Natureal Mom September 14, 2013 at 10:29 am

      Congrats on your baby girl! I’m sorry breastfeeding has gotten off to a rocky start. Even though breastfeeding is natural, it can be a learning process for both mama and baby, but the good news is that it usually gets better by the second or third month. It sounds like most of the issues you are experiencing are due to an improper latch – the damaged nipples and painful nursing and the plugged ducts from the breasts not thoroughly being drained. It’s so important to get help early! I’m glad you are meeting with the LC on Monday. In the meantime, if you haven’t already, check out the Latch-on video by Ameda (link is in the forst bullet point on the post). Hang in there mama! Keep in touch and let me know how you’re doing.

  • Reply Christina November 1, 2013 at 3:31 pm

    Thanks for the info!
    I am battling the worst plug at the moment, and am typing while warm compressing & massaging. My daughter is 11 weeks old and this is my second time dealing with this. No fever or flu symptoms, but the lump keeps getting bigger. It’s about as big as a nickel above the skin and a bit bigger below. It’s been about a week since I felt it for the first time. I’m doing the compress, massages, hot baths, nursing on all fours… Nothing seems to be working. :( I have a dr appt on Monday (today is Friday) and an acupuncture appt tomorrow morning. The other issue now is that the skin on the actual lump on my skin has started to break and bleed a little. Any advice on why I should/shouldn’t do until my appts? Is everything I’m doing making the breakage of the skin worse?

    • Reply Natureal Mom November 1, 2013 at 4:13 pm

      This actually sounds like it could be a breast abscess. I would seek help from your doctor immediately and not wait until Monday. Sending you a private message now.

  • Reply Kitty November 24, 2013 at 5:02 pm

    Thanks for a very informative post! My baby is 7 months old and we’ve had a great breast feeding relationship after a rocky first few months (didn’t find out until 10 weeks she was tongue tied). But for the past few weeks I have been getting clogged ducts every few days. Thank goodness for an understanding and helpful husband because the baby has no patience for clogs! I’m going to start evening primrose in addition to the lecithin I started the other day so hopefully that helps put an end to the madness!

    • Reply Natureal Mom November 26, 2013 at 7:48 am

      Hi Kitty, I’m glad you found this post to be informative and hope the plugs resolve quickly. Get some rest and hang in there mama!

  • Reply Vicky January 27, 2014 at 2:29 pm

    Really helpful article, thank you! My baby (my third) is tongue tied, and it’s caused so many feeding problems, endless blocked ducts, mastitis and engorgement. She’s 10 months now, and the only way I’ve found that seems to help prevent the blocked ducts is to express a feed or two every day-if I massage while pumping it seems to empty the breast properly where she can’t. It’s a pain but worth it not to have blocked ducts every week! Also means I can carry on breastfeeding her a little longer-have been on the verge of giving up so many times.

  • Reply Amanda January 31, 2014 at 1:24 pm

    Love this post! So detailed! It helped me a few times. I struggled through multiple plugged duct per week for almost 10 months. Finally, I discovered my daughter’s un-diagnosed lip tie. She had a frenectomy on her tongue tie a few days after birth, but no one noticed her lip tie (class 4!). Now that she has had that treated breastfeeding is a totally different experience.

    Just thought I’d share in case anyone else could be toughing it out like I did.

  • Reply kiyoko March 3, 2014 at 7:10 pm

    Thank you so much for your insightful article. I have also been struggling with plugged ducts. As my daughter is approaching her one year birthday, I seem to be having more problems with them. I would like to start the process of weaning her but I don’t know how I can do it without causing more plugged ducts. I never had this problem with my other two children. My breasts just naturally produced less but this time around, it is not going smoothly. Do you have any advise how to drop a feeding without getting a plugged duct? I have been drinking sage tea to reduce my milk supply and have resorted to wearing cabbage leaves in my bra but I still have a lot of milk. I currently feed 3 times a day. In the morning, in the afternoon, and before bed. I know that the next feeding to go is probably the mid day one but I don’t think my breasts can last till night time without getting plugged. Any advise would be great.

    • Reply Natureal Mom March 5, 2014 at 10:35 am

      I get asked about this a lot so I will probably write a post about it at some point. In the meantime, I just sent you a private email with my suggestions.

  • Reply Tara March 18, 2014 at 4:31 pm

    Hello from England! I have been breastfeeding for 6 months and for the first 4 I had a little white spot on my nipple that seemed to fade between feeds and practically glow after a feed. It was painful, and if I messed with it at all I would get a horrible lump in my breast. Just as that started to clear up another white spot appeared in a different place and now I’ve had that for two months and I rarely feel like that area is draining. I’m so fed up with this breast. My other one is perfect. I hope it’s not anything more serious. Thanks for writing this piece on breastfeeding. I have tried everything except the affirmations which I will be trying soon.

    • Reply Natureal Mom March 19, 2014 at 4:11 pm

      Hello Tara, I just sent you a private message!

  • Reply Januice April 1, 2014 at 3:29 pm

    This is a wonderful article. My baby girl is 7 weeks. I have exclusively pumped due to a painful latch. Turns out she was tongue tied, however after having it corrected she refused to nurse. I have been experiencing what I believe are plugged ducts for about 3 weeks now. I pump on average 40-50 ounces per day give or take, and normally feel empty after. The plugs just keep coming back. I have massaged and applied moist heat, which usually helps. Can you provide anymore advice?

    • Reply Natureal Mom April 2, 2014 at 10:40 am

      Thanks, Januice. If you’re following the tips in this post and are still experiencing persistent plugs, I would recommend meeting with a Lactation Consultant who may also be able to help your babe take the breast. At 7 weeks, it is still possible. In the meantime, since babies are more efficient than the pump at draining the breast, I would massage/hand express (preferably in a hot shower) after pumping to reach those areas of blocked milk the pump can’t access.

  • Reply T April 16, 2014 at 5:44 pm

    Hello, I had contacted you for an ultrasound therapy treatment referral in the Los Angeles area a few days ago, and hadn’t heard back, and I’m getting desperate, so I wanted to try contracting you again before I just go to some sports clinic place. I’m currently taking antibiotics for mastitis, and I have clogs in both breasts that I cannot seem to shift, so it just feels like such an uphill battle.
    I live inland from Los Angeles, but any recommendations on places to go near LA or the Inland Empire would be great!

    • Reply Natureal Mom April 16, 2014 at 6:49 pm

      Hello, I didn’t receive a message from you. How did you contact me? I will private message you with some referrals now.

  • Reply Hannah May 17, 2014 at 1:30 pm

    I have a 3 week old and have been dealing with what I think is a plugged duct for almost a week now. The blockage is very close to my nipple on the top of my breast. It’s about the size of a quarter now. I’ve tried just about every thing, soaking, massaging, heating, castor oil packs and so on. I feel like I’m reaching the end of my rope dealing with this.

    • Reply Natureal Mom May 17, 2014 at 4:19 pm

      Hi Hannah, I recommend being assessed by a board certified Lactation Consultant who can do an in-person evaluation. To locate one in your area, please visit

  • Reply Melanie May 30, 2014 at 1:33 pm

    I am thankful that you answer these comments people post! This is a very good article. I am currently having clogged ducts with my 15 month-old daughter. She nurses quite a bit, so not nursing enough isn’t the issue. She is my fourth child, and I have breastfed all of them. My first I had no problems with. My last three I’ve had so many clogged duct and mastitis problems with, but this one I just started having problems with about two months ago. I get a clog on the same spot every week or so. I have tried EVERYTHING I have read to do, including lecithin, which I take 6000 mg of every day. I wear soft cup bras, I don’t wear a baby carrier, there is no pressure on that spot., I have a healthy diet, I change breastfeeding positions, etc. I am not trying to wean her. The only thing I can think of is I am kind of stressed out, with 4 kids, I don’t get alot of sleep. But I don’t think that would cause me to get a clog in the same spot every week. I have been to a LC but she didn’t help (she told me things I already knew). when this happens, it makes me feel awful. I have to cancel any plans I may have, and just sit at home and nurse and massage all day. The clogs always go away within 24-36 hours, but until they go away, it’s horrible! What else can I do?

    • Reply Natureal Mom June 2, 2014 at 10:43 am

      Hi Melanie, I can empathize with your frustration. Sometimes it’s not just how often you are nursing, but how long you are nursing per session. Is she ended the feeding sessions and completely draining the breast? If the clog keeps happening in the same spot then the milk isn’t isn’t being removed efficiently from that particular duct. I would make sure she is latching on properly. Also, if you suspect a possible lip or tongue tie to have it evaluated. It could also very well be related to stress and your body is telling you to slow down. Hope this helps! Hang in there mama, you’re doing a good job!

  • Reply Brandi June 21, 2014 at 3:05 pm

    Wow!! I soley pump breast milk and dealt with recurrent clogged ducts with my daughter. I know it was due to oversupply and not pumping frequently enough, but as a night shift nurse, I HAD to get some sleep during the day so I could only wake up a few times to pump. It was just something I dealt with for an ENTIRE year. Now, I am 5 1/2 weeks post partum and in the same boat. I decided I was not going to put up with clogged ducts this time around so I have been researching. I have had a clogged duct now for several days, no amount of pumping, massaging, ibuprofen, heat, cold, hot showers, etc would relieve it. I read up top about pressure massage so I just tried it and low and behold a stream of milk come shooting out of the duct that was clogged!!! I couldn’t believe how much more powerful using the heel of your hand is than the thumbs. I could not visualize the clogged duct (no obvious white dot or dried milk), but due to several hard lumps, I knew I had one. I cannot believe that his worked, thank you so much!!

    • Reply Natureal Mom September 14, 2015 at 10:59 pm

      Yeah!! That’s awesome!!! Thanks for sharing :)

  • Reply Meghna July 1, 2014 at 8:55 pm

    Thanks for your article. I have a 18 month old son, and I nurse him 4-5 times a day. I have a clogged duct with dried milk plug in one of my breasts for over 3 weeks now that is just not going away. The milk has started to drain from the duct after my repeated efforts with hot showers, massages, and puncturing the white spot on the nipple (rubbing the skin on the nipple with wet washcloth and also trying to remove the upper skin with a sterile needle) a few times. But the white spot is just not going away. And it is quite painful to nurse on that side. Hot shower before nursing helps with the pain, which radiates to my back. I do not have fever or redness on the breast. I have had problems with clogged ducts every few months with the first child and now the second one too. It is typically associated with forgetting to drink water frequently and stress. But, most of the time I am able to resolve it with massage and hot showers in a 3-4 days. But this time, it has lasted a lot time because I was very sick with flu and could not tend to it right away. Is there anything else I can do?

    • Reply Natureal Mom July 2, 2014 at 7:24 am

      You mentioned being very sick with the flu- sometimes mastitis exhibits similar flu-like symptoms. Since you have had this milk blister and plugged duct for 3 weeks it is possible it could have escalated to mastitis. Have you seen a Lactation Consultant?

  • Reply Andrea October 12, 2014 at 2:19 am

    Hi thank you for info! I’m having trouble with a persistent clogged duct (maybe several hidden or further into breast). Anyways i ended up getting mastitis and while I am on antibiotics I’m worried this will keep happening as baby can’t seem to drain breast. I’ve tried pumping full speed and milk comes out 1 drop at a time(. I’m oretty certain enough milk as use to spray, I’m a stay at home mom who feeds on demand and I get a good a mount of milk on other breast. )I’ve tried feeding him like a cow, several hot showers, compresses, etc., the only way I can get milk to spray out is by twisting my breast in a circular motion and putting a lot of pressure on nipple . I still can’t drain it fully though and this is painful and very tiring . Also when I first started doing this a yellow substance oozed out along with milk. Do you know what that was? Infection? Backed up clog? Will I get mastitis again if my baby can’t drain my breast or the pump? I asked my doc to look for the hidden clog blister but he says he can’t do anything for what he can’t see and that baby looks healthy and to be gaining weight. This is all so frustrating and worrisome . I should also mention our baby has food intolerances (hoping temporary ) so I don’t eat soy dairy wheat corn eggs … He is 4 months old. Any tips you could offer is greatly appreciated. My local la lechwe league never answers the phone.

    • Reply Natureal Mom October 12, 2014 at 9:27 am

      Hi Andrea, I’m sorry you’re experiencing this. Hang in there and know that you’re doing a good job for yourself and baby by searching for the right information and seeking help. It’s difficult for me to say via email and I highly recommend seeing an IBCLC ASAP. Doctors and pediatricians don’t always know a lot about lactation and a Board Certified Lactation Consultant will be able to get to the root cause by observing a feeding session in-person and assess baby’s latch to see why he isn’t fully draining the breast. This will also include checking baby for a possible tongue and/or lip tie. An IBCLC will also evaluate you to see if there’s an infection present, etc. Under the ACA, these visits are often covered. In the meantime, I have found therapeutic ultrasound and lymphatic breast drainage massage to be very effective in clearing up deep plugs. Please let me know if you would like me to help locate an IBCLC in your area.

  • Reply Valeria October 15, 2014 at 8:43 pm

    Hello and thank you for the very informative article. My baby is 4 and 1/2 months but I already had mastitis and am dealing with plugged ducts every week (I am actually having one now that is still clogged for the past 2 days). I have been at the ER after 24 hours but they told me that I just have to go home am massage and apply flour with honey “johnnycake” on the lump. I am doing all these but nothing seems to help unclogging the ducts. I believe I have some kind of a weird duct on my right breast, because it always gets plugged on the same area. When I massage I feel multiple small round “beads” in my breast. A few of them feel like they are longer and are not directed towards the nipple. I tried unclogging this great with my baby, with the pump, with my husband, but nothing seems to help. And I had another blocked duct a few days ago on the other breast. These recur rents plugged ducts are a real nightmare. It’s been 4 months but it already seems like forever. I had gestational diabetes when I was pregnant and my dietitian advised me to breastfeed for 2 years to decrease the risk of getting GD later in life. But having recurrent plugged ducts make this sound like a nightmare. Is there a technique that would really help managing recurrent plugged ducts? I can’t take lecithin because my baby had multiple food allergies and I am on a very strict diet. And also, how long can it take for a plugged duct to dislodge; I found on-line that about 48 hours, is this information accurate? Thank you very much in advance! Good luck to all breastfeeding mothers!

    • Reply Natureal Mom October 18, 2014 at 6:33 am

      Have you tried any of the other suggestions in my post such as therapeutic ultrasound or lymphatic drainage breast massage?

  • Reply Kim November 26, 2014 at 5:23 pm

    Hi, thank you for all of the great info! My daughter is four months old and For the past month I have been having problems with a recurrent plugged duct I the same area. I’m able to resolve them within 24 hours but have had it three times already. Also, after I have one my breast seems to be sore/aches for a week or so. Is this common/normal with recurrent plugged ducts? Also, sometimes my nipple seems to be itchy after feeding. My doctor sent me for an ultrasound solely because my mom had breast cancer. Any info would be great!!

    • Reply Natureal Mom December 5, 2014 at 9:31 am

      It can be normal for the breast to be tender after resolving a plugged duct. As for the itchiness, that could be due to a number of things. If you are still experiencing symptoms or have any concerns I would recommend meeting with a board certified lactation consultant for an in-person evaluation.

  • Reply Jen December 11, 2014 at 7:29 am

    I tried contacting you last week via your contact form but I’m not sure you received it because I haven’t heard back. I would love any info about ultrasound therapy in the LA area. I have been getting recurrant plugged ducts almost every week since my now 9 month old daughter was 2 months. I’m trying to wean now because I am emotionally and physically ready to be done and I have a ton of frozen breast milk stored due to having to pump to clear the ducts. But I can’t seem to wean without getting another plug. Every time I think I’m making progress on weaning I get plugged ducts and have to pump and that builds up my supply again. I feel like i will need to pump forever. I don’t know what to do.

    • Reply Natureal Mom December 11, 2014 at 11:46 am

      Hi Jen, I didn’t receive your message – it could have gone to my spam folder. I’m sorry you’re struggling with this – I emailed you a referral and some info/recommendations. Best, Lacey

  • Reply Ashley December 18, 2014 at 9:39 am

    Thank you for this post! I went into breast-feeding with loads of knowledge and even supported other moms through breast-feeding challenges… I am a registered nurse and aspiring lactation consultant and I have taken many courses and thought that I would be “all set” when it came to breast-feeding. I didn’t imagine myself having any issues. My son was tongue-tied and I experienced severe nipple damage which led to vasospasms and an episode of mastitis. I never want mastitis ever again. It wasn’t until he was almost 3 months old where the pain had gotten better and my nipples were finally healed. At that time breast-feeding was enjoyable….. And then came the recurrent plugged ducts. He is just turning six months old and now has four teeth… I get one or two plug ducts per week. I have sacrificed a lot just so that he would drain my breast and learned the hard way that you can’t fix one problem and not create another. He latched so terrible that his teeth left open wounds that got infected. Plugged ducts frighten me every time because some are more severe than others and each of them haunt me with the word mastitis. I am to a point where I am afraid to leave my house because he doesn’t feed as well when we are out and about. I have tried so many things including lecithin, eliminating sugar and cleaning up my diet, decreasing my stress levels, eating raw cloves of garlic(yuck!)…. And more… I just want to get to the bottom of why I keep getting them.
    A few questions:
    I’m sorry if this is too much information but have you ever heard of any correlation between having intercourse and increasing your supply causing plugged ducts?
    Because I get them so frequently my son is always “off”…He refuses that breast now… And he gets up frequently through the night I imagine he’s hungry??? He has lots of wet diapers and he is pooping normally. I have tons of milk and I always hear him actively drinking at the breast. There are minimal nights where he won’t go longer than three hours without wanting to feed.
    I just want to solve rest because I see you when I am feeling good that he is much happier.
    I love this post and I hope to utilize all of the information… But if you have any further insight I would love to hear from you.

    • Reply Natureal Mom December 21, 2014 at 8:35 am

      Hi Ashley, I am so sorry you are going through this. I had a very similar experience with my older son (who has a posterior tongue tie) with the recurrent plus, vasospasms, etc and can empathize with not wanting to leave the house because baby will feed and drain the breast better at home. You mentioned that your son is tongue-tied. That is most likely the culprit which is causing the improper latch and subsequently, the nipple damage, inability to thoroughly drain the breast and “oversupply,” plugged ducts and mastitis. Has he been evaluated and diagnosed by an IBCLC, pediatric dentist or medical care provider? If so, have you considered having the tongue-tie revised? How old is he now?

  • Reply Ashley December 18, 2014 at 9:56 am

    I just want to breast-feed and not have to think about it… I just wanted to come naturally and not have to think about getting a plugged duct… Most of the people that I know don’t struggle with this. Although I am getting very good at treating them and knowing my body. They are very painful… I could do without them coming near as frequent.

  • Reply Ashlyn December 20, 2014 at 2:26 pm

    Thank you for this advice! My daughter is 5 months now and I’ve been struggling with plugged ducts almost once a week since she was 4 weeks. Rather than one lump, mine cause my entire breast to become hard, knotty and painful to the touch. She has been sleeping 8-9 hours since she was 2 months, and still does 9 hours, so I was hoping my breasts/supply would have regulated by now. Could this be the cause of my recurrent plugs? I take 4800 mg of Lecithin daily, cut out saturated fats from my diet, and use all the remedies you’ve listed above. I’m 3 days into taking antibiotics for my first bout of mastitis in my left breast and now I have a plugged duct in my right. I’m getting weary of breastfeeding, as it’s taking a toll on me physically and mentally. I had dreams of breastfeeding until she was at least one, but I also have a freezer stash of milk so I’m tempted to begin weaning. If I do decide to wean early, do you have any advice on weaning to avoid more plugged ducts/mastitis? To be honest, I’m afraid of both weaning and continuing breastfeeding! Thank you for your site. :)

    • Reply Natureal Mom December 21, 2014 at 8:19 am

      Hi Ashlyn, on the one hand, how nice that your daughter is sleeping for such a long stretch! However, this could absolutely contribute to plugged ducts. The longer breastmilk sits in the breast, the thicker it becomes. Technically your supply should adjust to baby’s demand, but nine hours is a very long time, especially for a five month old. How many times does baby breastfeed in 24 hours? If you wish to continue breastfeeding for a year, I encourage you to do so. There are benefits beyond the breastmilk itself. Have you considered waking once to express breastmilk? That would cut the stretch in half to 4 or 5 hours which would make a big difference. If you feel you are mentally and physically at your limit and want to wean, that is a different story. Only you can decide what it best for you and your baby ~ I am here to support you either way. I am currently writing a post with weaning guidelines to avoid potential plugged ducts and plan to post it in January.

      • Reply Ashlyn March 6, 2015 at 1:02 pm

        Thank you SO much for your advice to pump in the middle of the night to break up the length of time between feedings. Since I started doing it right before Christmas, I haven’t had a single clog! It’s changed my breastfeeding experience! :) My daughter is now 7 months old and she’s started solids, so I breastfeed her 5 times/day, with the first feeding around 7:00am and last feeding around 7:00pm. It’s very worth it to me to continue waking up to pump at around 2:00am every night to continue successfully breastfeeding as I am, but friends keep telling me that I’m teaching my breasts to make more milk than I need and that it will be difficult to eventually wean off the night pump. Do you have any advice on when/how to wean off this pump, or do you recommend continuing it for as long as I breastfeed (which I’m planning to as long as possible!). Again, thank you for your advice – it’s been a physical and mental lifesaver! :)

        • Reply Natureal Mom September 14, 2015 at 11:06 pm

          Hi Ashlyn, sorry I missed your reply and didn’t see this sooner. I’m pleased that this worked for you! Your friends are correct that DEMAND = SUPPLY so the more milk that is output, the more milk your breasts will produce. My recommendation is to gradually decrease the amount of time pumping and/or hand expressing in the middle of the night. How are things going now? I have a “Tips for Weaning” post in the works!

  • Reply jessica January 31, 2015 at 6:19 pm

    Very helpful tips, though I’m feeling like my pump is giving me plugged ducts? I’m on the lecithin, probiotics and a post partum vitamin. My mom used to be a lactation consultant and she says she hasn’t heard of pumping causing plugged ducts. Once I go back to work, I don’t have a choice…I’m wondering if using a manual hand held pump might prevent them? They did improve drastically once starting the lecithin but as soon as I pumped this morning, I have had multiple clogs by the evening. We did go way too long without feeding during the night but I didn’t clog a few nights ago while I was just bf. Seems to be the pump?

    • Reply Natureal Mom February 2, 2015 at 2:45 pm

      Hello, why do you feel like your pump is causing plugged ducts? Make sure you’re not applying too much pressure when you’re holding the flanges against your breasts. Also be sure to massage them before and after a pumping session to get the milk moving more freely and not getting stagnant. Going too long in between feeds will definitely contribute to plugged ducts whether they present soon after or a few days later. Good luck!

  • Reply Rebecca March 21, 2015 at 10:12 am

    I’ve spent a great deal of time researching plugged ducts and your advice seems to cover it all. I have a 4.5 month old, third child. Since he was about 3 weeks old I have had occasional plugged ducts (1 or 2 every two weeks or so). In the last month however I have one almost all the time. They often alternate between sides even though I make sure the unaffected breast is well drained. I can sometimes make it 8 hours between the end of one and beginning of another. I am on domperidome because I have always struggled with my supply. In the last week I’ve tried altering the dose (decreasing it or changing the hours that I take the medication) because I wonder if the domperidome is causing me to make more than my baby consumes. However, he is only in the 20 th percentile for weight and gains an avg of 1 pound per month. All my kids have been lean and long but I always worry whether he’s getting enough at each feeding. He is the first child I haven’t had to supplement with formula and I want to continue breastfeeding for as long as we can, but I am living in constant pain. I am going to try lecithin this week. I know and do all the other tricks mentioned above. The lactation consultant said he had a good latch and to just try leaning back more when I feed him to put pressure on the ducts. Do you have any other advice you can offer?

    • Reply Natureal Mom March 21, 2015 at 11:52 am

      You need to get to the root of the issue so you can treat it properly. I am not qualified to advise you on domperidome but I would consult your IBCLC before altering the dose. I wouldn’t worry about your son being in the 20th percentile for weight. Some ways to tell if he is getting enough milk at each feeding are: 1) He seems content and satisfied for 2-3 hours or until the next feed. 2) Diaper output 3) Your breast is full at the beginning of a feed and softer afterwards. How long is a feeding session? One or both breasts? How long in between feeding sessions including nighttime? I don’t know about putting pressure on the ducts during a feed because that can contribute to a plug, but have you tried gently massaging your breasts before a feed? Has your son been properly evaluated for a potential lip and/or tongue tie? That could be a reason for decreased milk supply and plugged ducts. If you have thicker/stickier milk, then the lecithin will help with the viscosity and help with the plugged ducts.

  • Reply Sara March 26, 2015 at 1:03 pm

    Thank you for the helpful info! My daughter is over 7 months old now and I have been exclusively pumping for 4 months (breastfeeding did not work for us even though I painfully hang on to it for over 3 months and finally gave up after 2 months of milk bleb). I have had a few clogged ducts when breastfeeding but I have been having a lot more since I started pumping. It always feels like one section (like a pie slice) of the same spot/breast wasn’t emptied/hard at the end of a pumping. after several let-downs and toward the end of a session, I can still feel a marble sized lump that requires further let-downs and a heck of pressure with my hand to get rid of it. I always tries to get rid of them at every session, as a consequence, my pumping session usually rang from 30 to 60 minutes. It has progressed to clogging at almost every pumping and I am pumping 5 times a day. that is a lot to deal with and too much time spent at the pump and not with my 2 kids. I want to decrease my pumping output since my daughter is not eating that much (I am pumping around 50 oz/day), but I cannot stop pumping at a more desirable amount because I need to get rid of the clogged duct. do you have any advice for this? should I just stop pumping even with a clog and let my breast get used to the clogs? I am thinking of weaning gradually by cutting down pumping session and space out longer, do you have any tips since I am clogged so often on a daily basis? Thanks!

    • Reply Natureal Mom March 30, 2015 at 8:53 pm

      Hi Sara, I would not let the clog go because your body will not “get used to it.” Unresolved clogged ducts can turn into mastitis or other breast infections. It sounds like this particular clog is very deep and persistent. Have you considered ultrasound treatment for it and/or other tips from my post? In addition to resolving the clog, yes, you will also need to manage your over supply from pumping too much. The over supply is most likely contributing to the clogged ducts. The more your milk lets down and the more milk that is expressed, the more milk your body will produce. Supply = Demand. Your output should be as close as possible to what your baby is consuming. Pumping should be mimicking your baby at the breast. You will need to find a balance which will allow you to pump for shorter periods of time per session and for less pumping sessions without getting any more clogged ducts. This should be done slowly and gradually. First start by reducing the amount of time you are at the pump. Ideally on average you want to work it down to a 15 minute session. You can also try dropping a pumping session. I was in a similar situation with my first child (oversupply and too much pumping). It’s going to take some time, patience, experimentation and being in tune with your body but you can do it!

      • Reply Sara April 21, 2015 at 11:49 am

        Thank you for your advice! I actually got rid of the last block which occurred at the usual surface area. However, another one developed 2-3 days ago. This one is deep behind the areola and I am not able to clear it by brutal messages and all other methods in the past few days. I am having the hardest time finding an ultrasound therapy service in my area (Raleigh, North Carolina). It does not hurt but uncomfortable and a bit itch and annoying and slow to drain. I do not know what to do…. I hope it does develop into mastitis….

        • Reply Natureal Mom September 14, 2015 at 11:09 pm

          Hi Sara, I’m going back through my comments and just saw this- how is everything? Let me know if you need assistance locating a practitioner in your area!

  • Reply Fran March 28, 2015 at 2:37 am

    I’ve had a tough time with blocked ducts for the past 6 weeks (baby is now 3 months), had latch etc checked and all fine so seeing my doctor to go back on iron tablets as I have a form of anaemia (thalassaemia carrier).
    Your blog post and comments have been so helpful so thankyou! I’m quite worried about weaning when the time comes and you mentioned a post about it in one of the previous comments. I can’t find the article so wondered if you could post a link here once you’ve posted it?

    • Reply Natureal Mom March 30, 2015 at 8:31 pm

      I’m sorry you’ve had a tough time but am glad you found my site to be helpful. I haven’t quite finished writing my post on weaning but there will be some helpful tips to avoid engorgement and blocked ducts. I am hoping to have it posted in the next few weeks so be sure to check back soon!

  • Reply Mandi April 10, 2015 at 12:29 pm

    Hi!! Thank you for this site, what a huge help! Here is a question for you – my babe is about 4 days old today and my milk came in on day 2, I have had clogged ducts constantly on my left side since it came in. I have been able to move them mostly (at least enough to have been able to prevent mastitis so far) but I am a bit fed up with it. Is this is how it’s going to be the whole time? I booked in to try ultrasound but can’t get in for a couple of days yet so hopefully I can keep on top of it till then but seriously! I am doing most everything you have suggested (I battled clogged ducts and mastitis several times with my last pregnancy as well). Any other tips or tricks for me? Or at least a reason why this is happening??? Lol thanks :)

    • Reply Natureal Mom April 10, 2015 at 3:31 pm

      Are you certain they are plugged ducts on Day 4? Engorgement usually begins on the 3rd to 5th day. Be sure to breastfeed 8-12 times every 24 hours, make sure the baby is properly latching on, avoid pacifiers and bottles, allow baby to start / stop feeding & don’t limit time at breast, use gentle massage / compression when baby pauses in between sucks to help drain milk. If you must miss a feeding or baby is not breastfeeding well, hand express or pump to remove milk. Make sure the baby finishes breastfeeding from one side before switching to the next ( this is called block feeding). Try different feeding positions suck as cross-cradle or football/clutch offer more control, better drainage from all ducts and easier latch. You can apply a warm compress to the breasts for 10-15 minutes before a feeding to help milk flow and apply a cool compresses for 10-20 minutes in between feedings to reduce inflammation and if the pain is severe, ibuprofen is generally considered safe for breastfeeding women, but check with your care provider first. If you’re in pain or uncomfortable, your milk ejection reflex and milk flow could be compromised. I hope you find these tips to be helpful. Good luck!

  • Reply Mandi April 11, 2015 at 5:31 am

    Yeah unfortunately I am certain that they are plugged. I can feel them, there are lots in there, some close to my chest wall, all the way out to my nipple. At times it feels like my entire nipple and Areola are one giant clog. They go all the way around it. I think I am getting pretty close to mastitis now, baby is starting to get frustrated on that side and sometimes is unwilling to latch but I keep trying. The heat helps keep things moving a bit as well as nursing in different positions. I will get relief for a bit but then in no time at all it feels hard, lumpy and painful again. The pump is actually doing less than the baby is at this point. I have a hard plastic water bottle that I have been using like a rolling pin, it seems to re shape my entire breast when I use it and move the fluid from one side to the other. Also, if I lift it with my hand so it isn’t hanging, it doesn’t feel quite as engorged and I can feel the individual clogs better. I will be heading to the doc today I guess but am at a loss as to what to do. I can’t wait to try ultrasound and wish I could have gotten in sooner!

  • Reply Kara May 1, 2015 at 6:21 pm

    Thank you so much for this wonderful post! I live in the LA area and have been struggling with a persistent clogged duct for over a month. I would love to get your recommendations for ultrasound therapy in the area.

  • Reply Ashlee August 26, 2015 at 9:57 pm

    Hi, this post has been so helpful to me as I’ve been dealing with plugged ducts almost every week since I started pumping when my son was 4 weeks (he’s now 15 weeks). I’m on lecithtin already but from reading these comments, I just learned that maybe I’m in fact giving myself these clogged ducts? If I squeeze my breasts while pumping to get as much milk out as possible, will that give me a clogged duct? I’m so beside myself because I really just want to make it until my baby is 6 months old but these clogs are so discouraging and I feel like I’m losing hope in being able to last that long. Thank you SO much for your time and help. I hope to hear from you soon.

    • Reply Natureal Mom August 29, 2015 at 9:41 am

      Hi Ashlee, I can empathize with the struggle. You’re so close to meeting your breastfeeding goal! More information is needed to help guide you in the right direction. If you would like to do a phone or email counseling session, please message me here. Hang in there, mama. You just need some guidance and support.

      • Reply Ashlee September 14, 2015 at 5:40 pm

        Hi, Thank you so much for getting back to me. I tried to message you but unfortunately when I click ‘submit’ it brings me to the Paypal login page. Is this correct?

        • Reply Natureal Mom September 14, 2015 at 10:53 pm

          Hi Ashley, Please email me here: lacey at natureal mom dot com

  • Reply gigi September 3, 2015 at 10:47 pm

    Hi this is probably the most up to date post i’ve seen for blocked ducts, thank you for all the info!!I’m solely breastfeeding and my son is now 5 months and I have had about 10 blocked ducts since he was born :/ I have tried everything from applying heat prior to a feeding to cold pack after feeding to taking antibiotics. The antibiotics worked for me, but to be honest i feel unless it’s a real case of mastitis I don’t want to be taking antibiotics while breastfeeding. However, I went to 2 different doctors and that’s always their solution to give you the antibiotics even when it’s just a blocked duct and not mastitis yet. I decided to follow your advice to go to Womens Physical Therapy since I’m from LA but when I called they didn’t have appointments today so I found another place here in LA and the physical therapist there got my blocked duct out which was the size of a small mango in less then an hour. She started by using a professional heating pad then she used ultrasound which I guess releases a type of heat that you can’t get from heating pads or heated diapers which only heat the surface. She then used massage starting from the nipple working her way up to the clogged duct which was different because most websites tell you to massage from behind the blocked duct and work your way to the nipple. She then had my baby feed right after while holding him from behind my shoulder so his chin faced my clogged duct. Within 45 minutes she completely got my blocked duct out! I’m so happy you referred my to physical therapy as an alternate method because I really do not want to be on antibiotics the whole time i’m breastfeeding especially if it’s just a blocked duct and not mastitis. My insurance didn’t cover it so I had to pay cash which was 150 dollars for the first visit and 100 after that if u still need to do a second day. Thank goodness I was good after one session. If you’re not from the LA area then I would research and see if they have Women’s Physical Therapists that deal with Clogged Ducts. I feel 100 percent better and i’m so happy I came here to get the idea to even try Physical Therapy! I’m also going to buy lecithin since I get so many recurring blocked ducts on the same breast. Hang in there to all you moms that are dealing with this issue, I feel your pain and hope u all find the right treatment to help you :)

    • Reply Natureal Mom September 4, 2015 at 8:40 am

      I’m so happy to hear that you were able to resolve it with these methods! Therapeutic ultrasound is a real game-changer for the stubborn ones. Thanks for sharing the other provider in LA, your experience and for encouraging all of the other mamas who struggle with plugged ducts!

  • Reply Amy September 17, 2015 at 10:36 am

    Great tips here! I’m breastfeeding my 5th baby who is 6 months old. I seem to have a clogged duct in my right armpit for the second time. It’s been sore for over a week and i’ve had fever/chills feelings and a sore breast and arm. I don’t have a temp or red streaks though as I’ve had in the past. I recently started solid foods and she is all over the place with night waking. Sometimes up often but sometimes sleeps through. I am dealing with bad anxiety and recently gave up dairy. The combo of all this has me confused as to what is what. I have a dr appt tomorrow, but in the meantime i am trying some of these tips. Are plugged ducts it the armpit common?

    • Reply Natureal Mom September 18, 2015 at 4:59 pm

      I’m glad you found these tips to be helpful! It’s not uncommon to hit a bump in the road when solid foods are introduced and the breastfeeding routine shifts. It’s tough to say if it’s a plugged duct or mastitis without doing an evaluation. Did you get in to see the doctor? Most doctors aren’t well-versed in lactation and I would highly recommend seeing a board certified lactation consultant. Keep me posted!

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