Breastfeeding: Plugged Milk Ducts/Mastitis

The specific cause of plugged ducts is not known, but incomplete drainage of the breast caused by skipped feedings, a constricting bra, poor nutrition and stress may lead to plugged ducts.

Symptoms of a plugged duct

• Symptoms develop gradually, and a specific area of one breast may be tender.
• The area may feel warm, and you may notice slight redness or feel a lump in your breast which may become smaller after feeding.
• If the plugged duct is in the nipple, you may notice a white spot on the tip of your nipple, which may result in nipple pain or pressure. Generally, you feel well except for the breast or nipple tenderness.

To prevent plugged ducts

• Avoid wearing clothing such as an underwire bras or tight straps on a baby carrier.
• Avoid skipping feedings or delaying feedings.
• Be sure your baby drains the breasts at feedings, particularly if a nipple shield is used.
• Gently massage your breast/chest during feedings. Hand express or pump after feeding if necessary to drain the breast.

Treatment for plugged ducts

• Prior to feeding, apply a warm, moist compress to the affected area or soak the breast by leaning into a basin of warm water or take a warm shower. After feedings, apply cold compresses to your breast/chest for 15 – 20 minutes to reduce swelling and inflammation.
• Feed often, at least 8 – 12 times or more in 24 hours, and begin feeding on the breast that has the plugged duct, and for at least one feeding, position your baby with his/her nose pointing toward the plugged duct.
• Try different feeding positions to find the most effective positions for draining the breast.
• While nursing, gently, but firmly massage forward from the affected area of your breast while your baby is nursing.
• Try massaging the breast in a warm shower or bath.
• Use an electric vibrator on a low setting on the affected breast. Do not use in the shower or near water.
• Talk with your healthcare provider about use of lecithin which may prevent plugged ducts.

Mastitis

Mastitis is a breast infection. The breast may be red, hot, painful, and swollen. You may have flu-like symptoms, such as aching joints and muscles, fatigue, severe headache, nausea, vomiting, fever and chills. The onset is usually sudden and can result from:

• Cracked and damaged nipples, engorgement, or plugged ducts.
• Abundant milk supply with poor breast drainage, rapid weaning, and stress or fatigue.

Treatment for Mastitis

• Contact your healthcare provider immediately to determine whether antibiotics are needed. Do not stop antibiotics until you have finished the full course even if feeling better. Ibuprofen or acetaminophen may be taken as directed by your provider to reduce fever and breast pain. Breast pain and redness often peak on the 2nd or the 3rd day and return to normal by the 5th day. Contact your provider if your symptoms are not improving.
• Rest often, and increase fluids, and continue to breastfeed or pump 8 – 12 times daily to keep your breast well drained. Hand express as needed for complete drainage. Breastfeeding while you have mastitis will NOT harm your baby.
• Your milk supply in the affected breast may be reduced for several weeks after mastitis, but will return to normal with stimulation from your baby.

Works Cited

Lawrence, Ruth A. & Lawrence, Robert M. “Breastfeeding, A Guide for the Medical Professional”, Ninth edition, ELSEVIER, 2022.

Wambach, Karen and Spencer, Becky “Breastfeeding and Human Lactation”, Sixth edition, Jones & Bartlett, 2021.