Fixing A Clog

by Jessica Bower, IBCLC (lactation consultant)

What should you do if you have a "clogged duct" / "plugged duct"? The scientific term for this is ductal narrowing. This occurs when breast tissue becomes congested, swelling occurs, and the mother notices localized pain in one area of her breast, typically. It can feel full or firm and can sometimes be painful. This is not mastitis. However, if not treated appropriately, it can result in mastitis in some cases. You need to know what to do in this situation. These recommendations are a summary of what's found in the Academy of Breastfeeding Medicine Protocol 36:

DO:

✔ Breastfeed or pump as you were - do not overstimulate or under-stimulate your milk supply. Examples - if you breastfeed on demand and your baby is eating like normal - you should continue to allow your baby to eat like normal. However, sometimes babies realize that milk is not flowing well from the impacted breast. Sometimes these babies will refuse to breastfeed from that side or only feed a short time. If this happens - be sure to pump this side. If the milk is not flowing, the situation worsens. Best case scenario is to let me the baby help resolve the problem. Only pump if the baby will not eat like normal. If you are an exclusive pumper, then you should continue to pump on your regular routine.

✔ Be sure that latch and flange fit are ideal so that milk can flow appropriately and mother is as comfortable as possible. Watch my favorite video on latching.

✔ Cold is recommended over heat. Gentle lymphatic breast massage is recommended over any kind of aggressive massage / deep tissue massage / or using vibration. This can irritate the already congested breast tissue. This specific video of lymphatic massage has helped numerous mothers in this situation. It's simple and only takes a few minutes.

✔ Ibuprofen is recommended to reduce inflammation and decrease pain. Take dosage as directed by your provider. Sunflower lecithin and probiotics (specifically Limosilactobacilus fermented or Ligilactobacillus salivarius) are recommended in the Academy of Breastfeeding Medicine protocol 36 with some evidence showing that they help reduce the likelihood of mastitis or that they help treat it. Sunflower Lecithin is available at Target or on Amazon.

✔ Rest, hydration, and nourishment are always key!

DON'T:

✔ Pump just to "empty the breast"

✔ Use aggressive massage

✔ Stop pumping or breastfeeding

✔ Jump to taking antibiotics without a fever present. Also - don't ignore symptoms if a fever is present and breast is painful

✔ Give up on your breastfeeding / pumping goals.

If symptoms worsen over 24-48 hours and / or a fever develops, contact your OBGYN / Midwife right away. You should contact your OBGYN / Midwife through the after-hours / emergency line if their office is closed! Do not go to your PCP / urgent care / hospital unless your OBGYN tells you to do so or you can't get in touch with your OBGYN. Almost always, the OBGYN will be the fastest way to get treatment if mastitis develops.

If you do develop mastitis and need antibiotics - you should continue to do all of the things recommended in the "do" section. You can breastfeed your baby your milk while on antibiotics. You may also want to do a lactation visit to help understand why mastitis developed and how to avoid it in the future.