Chronic Plugged Ducts and How I’m Fighting Them

I think it’s finally time to admit to myself that I’m having an issue with plugged ducts. A plugged duct is when one of the milk ducts becomes blocked and milk can’t exit the breast.  A hard, painful lump can form as the milk backs up.  If the milk isn’t removed, a plug has the potential to develop into mastitis, which is an infection of the breast.  Think fever, chills, nausea, etc.  Plugged ducts are not fun.

I’ve had six instances of plugged ducts in the last month and a half, which is more than I had the entire three and a half years of nursing the Grasshopper.  Twice now, the plugs have been especially exciting because I’ve gotten a bleb along with them.  A bleb is a hardened bit of milk that forms a blister right at the nipple. Once, I got a mild case of mastitis and ended up missing work because of it.  Obviously, there’s something going on.

I brought it up the last La Leche League meeting, and I got some great help.  We really thought together about what kinds of things I notice before a plug occurs.  Here’s what I came up with.  My plugged ducts coincide with:

  • My husband travelling for work
  • Eating fast food
  • Especially wakeful periods for Cricket
  • Missed pumping sessions at work
  • Feelings of stress, anger, and disconnect
  • Allowing Cricket to roll her lips in for a lazy latch

In doing some online reading, it seems like these items play into the risk factors for developing plugged ducts: sleep deprivation, stress, poor diet, bad latch, failure to remove milk.

Priority number one with all of this is to clear the plug and remove the milk.  Easier said than done.  My old stand-by trick is to lay the baby on her back on bed, turn myself around so that her chin points at the plug, and nurse over her so that her suction and gravity can clear the plug.  Trouble is, that hasn’t worked the last two times.  The resulting let-downs from the nursing just seemed to make the plug worse.

At this point, hand expression seems to work best.  I express most of the milk out (or have her nurse for a while).  Then I start hand expressing very gently over the area.  If you don’t know how to hand express, here’s a YouTube video.  This is an incredibly valuable skill.

Once I get to the point where I can look really closely and see the pore that is clogged (I typically see a bit of white that just isn’t coming out), I gently squeeze on the nipple to work that bit out.  A warm wet washcloth or even getting into a warm bath really helps with this.  Typically, that bit will come out with a POW! and I’ll be able to very easily hand express the backed up milk out.  Massaging at the front of the plug, instead of trying to push it from the back), can also help loosen things up and get it moving.

If you have a clog that you just can’t get out, get help!  Find a lactation consultant.  Ask for help from (dare I say?) your husband.  Don’t let it sit around.  Having a plug long-term is not only really painful, but it can lead to mastitis.

At this point, I’ve got my plug clearing routine down.  But how do I keep from getting them in the first place?

Here’s what I’m doing to try to prevent plugs from forming:

  • Removing milk often (as in, no more skipping pumping sessions)
  • Taking a lecithin supplement
  • Trying to eat healthier, whole foods
  • Paying careful attention to Cricket’s latch
  • Taking a few minutes each day to relax and have some time for myself

So far, this seems to be helping, but I think to a certain extent, the occasional plug may just be part of my landscape right now with my oversupply.  I’m okay with it happening once every few months, but I’m looking forward to a few plug-free weeks.

Here are some more resources that I found on plugged ducts.

Have you had plugged ducts?  How did you deal with them?  Do you have any tricks for getting rid of them?

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30 thoughts on “Chronic Plugged Ducts and How I’m Fighting Them

  1. I experienced recurrent clogged ducts for about a year. After a few months of trying the usual recommended methods for getting rid of clogs, I finally found a trick that worked religiously for me, thanks to a lactation consultant in the know! The LC told me that the literature hasn’t caught up with actual practice yet & still advises using heat to help work out clogs. She told me this is no longer a practice recommended by LCs because heat can actually increase inflammation (and inflamed ducts can make it harder to work out the clog). So she advised me to do this:

    20 minutes prior to nursing or pumping, take one green cabbage leaf and put it directly over the clog. Then place an ice pack on top of the cabbage leaf. Leave these in place for the whole 20 minutes, then immediately pump or nurse as usual. She said to massage while nursing or pumping. She also advised me to take a daily lecithin capsule.

    The cabbage & ice pack worked for me without fail. Typically I did it 3 or 4 times a day for only a day or two and then the clog resolved. I wasn’t the best at remembering the lecithin capsule, but I tried to take it at least when I felt like a clog was forming or on a day when Jax wasn’t nursing so much, and then for at least a few days after that.

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    1. Oh, now that is really interesting. You’re the second person to mention cabbage to me. I’m going to have to look into what it is about cabbage that makes it do what it does. I’ve never gotten on the cabbage bus because I always thought it was something to do with engorgement or what moms do when they wean, and I was worried that it might kill my supply. But that’s 100% my ignorance. I’m going to do some poking around about cabbage and see what I learn.

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      1. I was afraid to try it, having heard about it only for intentionally drying up your supply. But the LC told me that a mere 20 minutes a few times a day for 1-2 days wouldn’t affect my supply drastically–Jax was more than a year old at that point, and I was still nursing a lot, so I gave it a go. Whenever I had a clog, I pumped much less than my usual amount anyway, so I really don’t know whether the cabbage decreased my supply while I was using it. However, once the clog went away, I went right back to pumping my usual amount.

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  2. Often, for me, when I got clogged it was due to me getting lazy about changing up our feeding positions- I loved the laying down together position, because I could nap while she nursed. Changing to a football hold or a hold that put baby in a position closer to the clog helped a great deal.

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  3. So sorry to hear this! As you know, plugged ducts were the reason we stopped breastfeeding. I didn’t get help in time and even with my husband’s help clearing them I was suffering from at least one plugged duct every second day, sometimes more, for a good six weeks before I finally caved to the psin, exhaustion, and guilt as Oscar was getting colic all the time from the forceful letdown once a plugged duct cleared. I wish I had known more and got help earlier. The help I did get was poor and then it was too late. We comfort fed fo a while then Oscar got sick and went off the breast entirely and despite my best efforts to relactate he continued to forcefully refuse the breast. Broke my heart so I know how important it is to reduce the frequency of plugged ducts so your breastfeeding relationship continues going from strength to strength! I hope you get some relief from them soon x

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    1. I thought about you so much as I wrote this post. I wished that I had lived closer to you and could have helped you in person. Or refered you to this person I know, or that LC I know, or this other person I know. We have so many local resources that I wished you could have had, too.

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    2. Hi Amanda.
      We are unfortunately in the same boat. I’m about to give up on nursing due to the ridiculous amount of recurrent clogged ducts. Our issue is that baby has been off and on nursing strikes since 3 months. She is almost 6 months now and they are only getting worse. She completely refuses to nurse during the day, no matter what I try, and so I am super prone to getting these darn clogged ducts, and then I have to wait around in pain until the nighttime when she can nurse them out. I am mentally and physically exhausted from this constant battle. My question to you is, how did you manage to wean your baby without getting more clogs? Every time I attempt to skip a feeding/pumping, I get another clog, without fail. I feel like I am stuck in a cursed nursing rut that I cannot get out of!

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      1. Maria, Are you working with an IBCLC on this? Sometimes an adjustment to the latch can be a big help as can lecithin supplements and other tricks I mentioned above.

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  4. I’m so happy I found this! I’ve been getting blocked ducts so often and it’s agony! Right now half of my left breast is rock solid! I’m away to try this cabbage and fingers crossed it works for me too!

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  5. Im a frequent clogger as well. I’ve done all the above except cabbage, but the lecithin is extremely helpful coupled with a few ibuprofens to reduce inflammation. I most likely clog because my baby totally refuses the breast, a long (still heart breaking) story, so I exclusively pump. My Medea PIS won’t unclog the breast ASAP (it would take 24 hours of hot showers, massage, constant pumping..) but my medela manual pump will unclog it immediately… Hard lumps GONE!

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    1. Pumping was, for me, what I think was a major culprit for clogs. And I agree! It’s amazing what a manual pump can free up. I wish you the very best. EPing is a tough road and I so admire you for sticking it out. Hats off to you, my friend. You are doing something amazing.

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  6. I’m getting destroyed by clogged duct right now. My daughter is almost 9 months old. I had them maybe 3-4 times total with my first. But they’ve been getting more and more frequent with this one– from about once a month to every couple of weeks to weekly and now to every 2 days or so. I seem to have a plug for 48 hours, then it drains for 48, then it plugs again for 48. Several times the plug has progressed to mastitis.

    I so desperately do not want to wean, but I am SO tired of being sick. I take lecithin and do all the rest of the suggested normal things– massage, heat, etc. I have wondered about my daughter’s latch at times (it seems shallow sometimes), but I was watching it carefully the last two days when the breast was draining properly, and it seemed to be okay. She was draining me dry the past 2 days, so it’s not failure to truly drain the breast.

    I even had an ultrasound that showed nothing. I am getting really discouraged, and even my doctor is gently recommending that I wean.

    I tried cabbage about 5 months ago with one of my mastitis episodes. It’s hard to tell what helps when you are doing so many things at once. I guess I could try that again and see if it makes a difference.c

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  7. I’m getting destroyed by clogged duct right now. My daughter is almost 9 months old. I had them maybe 3-4 times total with my first. But they’ve been getting more and more frequent with this one– from about once a month to every couple of weeks to weekly and now to every 2 days or so. I seem to have a plug for 48 hours, then it drains for 48, then it plugs again for 48. Several times the plug has progressed to mastitis.

    I so desperately do not want to wean, but I am SO tired of being sick. I take lecithin and do all the rest of the suggested normal things– massage, heat, etc. I have wondered about my daughter’s latch at times (it seems shallow sometimes), but I was watching it carefully the last two days when the breast was draining properly, and it seemed to be okay. She was draining me dry the past 2 days, so it’s not failure to truly drain the breast.

    I even had an ultrasound that showed nothing. I am getting really discouraged, and even my doctor is gently recommending that I wean.

    I tried cabbage about 5 months ago with one of my mastitis episodes. It’s hard to tell what helps when you are doing so many things at once. I guess I could try that again and see if it makes a difference.

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      1. I haven’t worked with a lactation consultant yet. I’ve just scoured the web and talked to other moms. I’ve also seen a doctor several times and recently had an ultrasound to see if there was a polyp or cyst or some other issue. The ultrasound came back clear. I think it is time for me to try a LC.

        Here’s why I don’t think it’s latch– my problem is only on one side. Wouldn’t you have issues on both sides if it was latch? I’m going to try and contact a lactation consultant tomorrow. The current clog is SO painful. Worse than normal. 😦

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      2. It certainly still could be latch. Definitely do work with an IBCLC, and make sure she is an Internationally Board Certified Lactation Consultant and not a Lactation Counselor. Doctors simply don’t have the training and are not equipped always to deal with things like this. No knock on doctors, it’s just not their sphere of expertise.

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      3. Btw, I tried the cabbage and ice pack tonight. No change in the breast after nursing. I think I will do moist heat tonight. They are typically resolving in 24-48 hours regardless of what I do, it seems.

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      4. Try also getting on your hands and knees with baby laying on its back and its chin dialed to where the plug is. This may mean, his or her feet are pointing at your head. It seems crazy, but the gravity and the strange position can often get out a crazy plug. This was always my last ditch attempt. Filling up a tub and hand expressing with the breast underwater in hot water can help, too. As can advil.

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      5. I put in a call to an IBCLC last night. It’s the weekend, so we’ll see when I hear back from her. I used moist heat on the breast all night last night. No change this morning, although that isn’t uncommon. It usually takes about 48 hours to unplug. I’ve tried the hands and knees thing. Right now, she has no interest in nursing on that breast, I’m guessing because she’s not getting much out. I’m on Advil– I don’t think I’d be surviving this (and the horrid cold I have) without it.

        I’m going to try the cabbage and ice pack again today. I tried this deep, hard massage on it suggested by one expert. All I think that did is bruise my tissue and make things hurt more. Didn’t move the clog. 😦

        I’m not getting much of anything out with hand express right now. Did you ever try the hand pump? I don’t have one of those, but my automatic pump does not have very good suction and doesn’t do a thing. I’m trying to decide if it’s worth buying a manual pump.

        Thanks for commiserating and for your suggestions. It’s nice to have someone to run ideas by. Going to jump in a hot shower now and see if I can express some there.

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      6. Do you have a bathtub? Hand expressing underwater could help. Is it possible that the flanges on your pump are too small? That was an issue for me for a while. The pump was stimulating let down, but the flanges were too small and didn’t allow the milk to flow so it would clog.

        Also, the IBCLC I was working with when I was going through this told me the best way to work the beast out was to start at the front of the plug and try to chip away at it, rather than trying to push it all out from the back of the plug. Maybe that will help.

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  8. I have a 3 month old, and because of her GERD, she eats extremely small, extremely frequent meals (about 1-2 oz every 1-2 hrs on average). Because of this, I mostly pump and give her bottles (I pump every 3-4 hrs day and night). Also, I am back at work now, so I am nursing even less. The more bottles I give her, the less she wants to nurse. Anyway, I have been getting more and more clogs to the extent that I get them daily. At all times I have a clog somewhere. I can usually get rid of them in 1-2 days, but it is constant, painful and exhausting. I know I don’t sleep enough and I am extremely stressed because of working full time, a baby that doesn’t sleep, and the fact that I have no help. These are things that I can’t change right now. I am taking lecithin, have rented a hospital grade pump, and have been doing hot compresses before pumping and cold after, but so far nothing has decreased the number of clogs. I really want to keep giving her breast milk especially since she already has gotten her first cold after just 2 weeks in daycare. I appreciate any and all advice! HELP!

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  9. Hi, i am facing same issue , every week either i am suffering from mastitis or blister , i am taking homeopathic medicine but still its really annoying , please help me to reduce mastitis , i tried everything , drain milk, massage feed every single thing i tried, sometimes i think that my body is pron to have infection thats why, my baby is 9 month old , and co recommend me to let my body decide when to stop producing milk instead of taking medicine to stop milk.

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    1. So, here’s the thing. Homeopathic medicine is not going to help your mastitis. You need to get in to see an actual doctor and get actual antibiotics, which are perfectly safe to take while nursing. Also, do go see an IBCLC. That wil, help also.

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  10. Here’s some things that haven’t been mentioned yet that could help you guys:
    -do not sleep on your tummy or any position that puts pressure on your breasts, apparently while you’re sleeping your body produces a lot of milk so you do not want to be blocking anything
    -breast pads! Where these and change them every few hours or sooner if they get soaked.
    -hot wash bras, breast pads and singlets and dry them in the sun, this helps kill any bacteria waiting to cause mastitis.
    These are just a few things I found usual for preventing mastitis from re occurring.
    Good luck everyone, you’re doing great xx

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