How to Cope With a Clogged Milk Duct

Having a clogged milk duct while breastfeeding can be painful. We turned to medical professionals and lactation experts to learn how to cope.

parent breastfeeding and in pain

zamrznutitonovi/Getty Images

If you’ve ever dealt with a clogged milk duct while breastfeeding, you know how stressful and uncomfortable it can be. Clogged milk ducts are basically tender, sore spots on the breast. When they don’t resolve, they can lead to mastitis, which is an infection in the breast. If you are dealing with a clogged duct, you are likely looking for relief for your discomfort and some effective ideas for treatment.

This specific breastfeeding obstacle can be challenging, but we’ve got you covered. Here, we’ll go over everything you need to know about clogged milk ducts, including causes, symptoms, at-home treatments, and when it might make sense to visit a health care provider.

What Is a Clogged Milk Duct?

 For a long time, sore, tender spots on the breast during breastfeeding were thought to be literally clogged milk, or milk that had gotten stuck or backed up in the milk duct. But research from the Academy of Breastfeeding Medicine (ABM) from 2022 changed all that.

“We once thought clogged milk ducts were like corks and a bottle of wine, but actually what we found in recent studies is that clogged milk ducts are actually not 'plugs' in a milk duct,” explains Andrea Braden, MD, IBCLC, a breastfeeding medicine specialist and CEO & co-founder of Lybbie.

So what exactly are clogged ducts then? Clogs ducts refer to the “swelling and narrowing of multiple milk ducts that are interconnected,” says Dr. Braden. This swelling and narrowing is usually caused by inflammation or a high bacterial load, she explains.

Clogged Milk Ducts vs. Mastitis

A better term for “clogged ducts” would be something like “ductal narrowing,” explains Jacque Ordner BSN, IBCLC, a curriculum coordinator at Aeroflow Breastpumps. This is what happens when the ducts are impacted by factors like inflammation. Many people lump clogged ducts together with mastitis, an infection of the breast, but they are not the same thing.

 “While ductal narrowing is limited to a localized area of the breast, mastitis involves a larger area of the breast and can even cause flu-like symptoms such as fatigue, headache, fever, nausea, and body aches,” Ordner explains.

How Does a Clogged Milk Duct Happen?

The thinking used to be that clogged ducts occurred when milk got “stuck” in your milk duct or was restricted from moving by things like too-tight bras or pressure on the breast. But, like our definitions of clogged milk ducts, our understanding of what causes them has also changed.

There are two main causes of clogged ducts, says Dr. Braden. The first is something called mammary dysbiosis, which is when there is an imbalance in the microbiome of the breast. “You can have a disconnect of the types of bacteria and other microbiome organisms that are supposed to exist there and have overgrowth of certain types compared to other types,” Dr. Braden describes. This can “predispose you to having infections and clog milk ducts, and ultimately mastitis,” she says.

Another common culprit of clogged milk ducts is hyperlactation, says Dr. Braden. “Hyperlactation is when you stimulate your body to produce more milk than your baby is eating,” she says. This often happens if you are pumping a lot, and your baby isn’t taking the excess milk you’re producing.

“It's a bit of a slippery slope, because your body can't get the milk out as quickly as it needs to, which causes it to back up,” Dr. Braden says. “Then, when you have the backup of milk, that can also lead to inflammation of the ducts, or the channels that the milk exits through.”

Symptoms of a Clogged Milk Duct

Symptoms of clogged milk ducts vary from one breastfeeding parent to another. The main symptom that most people have is a sore area on the breast. “Regardless of the cause, the narrowed ducts can result in a tender area of the breast that may have mild redness,” says Megan Oggero, MSN, APRN, IBCLC, board-certified lactation consultant and family nurse practitioner at UTHealth Houston. “Often, this resolves on its own within hours to days, and no additional symptoms appear.”

According to Ordner, other clogged duct symptoms may include:

  • Pain with letdown (the time in your feeding when the milk starts to flow)
  • Reddening over the area, depending on your skin tone
  • Reduced milk output, which may cause your baby to be fussy at the breast

If symptoms get worse instead of better, this can lead to mastitis, a breast infection. “When the inflammation progresses, mastitis occurs, and the parent experiences more severe symptoms, like fever, chills, and body aches,” Oggero describes.

Ways to Treat a Clogged Milk Duct at Home

It used to be that breastfeeding parents were advised to pump or breastfeed as much as possible when they had a clogged duct. They were also told to vigorously massage the area where the clog was felt, to break the clog and release the milk. But as our understanding of clogged ducts has evolved, so have the recommended treatment options.

First, because overproduction of milk can lead to clogged ducts, it’s important not to nurse or pump excessively when you have a clogged duct. In a nutshell, you don’t want to overstimulate your milk production. 

“We don't necessarily recommend decreasing the amount of feeds because you don't want to back up too much, but just feed normally,” Dr. Braden says. “Feed how you normally feed your baby and only feed the amount that your baby is asking for, so that you don't set up a vicious cycle of overproduction.” Don’t try to pump out the clog, either, she says.

In addition to this, you want to do what you can to reduce inflammation in the breast. Here are Ordner’s top tips for managing clogged ducts at home:

  • Apply cold pack/bag of frozen vegetables over the sore area
  • Nurse or pump as usual, taking care to avoid extra milk expression
  • Stay away from deep breast massage and breast massaging tools; this can worsen inflammation
  • Ask your healthcare provider about using anti-inflammatory medications to help reduce inflammation
  • Make sure your bra fits well and isn’t too tight
  • Ensure that your baby has a good, deep latch
  • If you’re pumping, make sure that your flange fits correctly

When to Contact a Health Care Provider

Most clogged ducts can be managed at home and will resolve in a few days. If at-home measures aren’t working and you’ve developed fever, chills, and/or redness that’s starting to spread all over your breast, this is when you should contact a provider, Dr. Braden says. “Infection can set in pretty quickly and you can get quite sick,” she says.

If you have mastitis, you’ll likely have a fever, often above 102°F, Dr. Braden adds. You’ll also experience flu-like symptoms, including body aches. If you are diagnosed with mastitis by your provider, you will likely be prescribed antibiotics to treat the infection.

Of course, be sure to reach to to a medical professional any time you're experiencing pain that doesn't feel normal, or isn't manageable. You know your body best, and if something feels off, it's important to listen to that intuition.

The Bottom Line

If you notice a sore, tender area on your breast and you think you might have a clogged duct, try not to worry. Almost all of us get one at some point or another during our breastfeeding journey. Keep feeding your baby normally, and try treatments like cold packs and anti-inflammatory medications. Most of the time, you should be good to go within a few days and your clog will resolve. If it progresses and you are experiencing flu-like symptoms, don’t hesitate to reach out to a health care provider.

Was this page helpful?
Sources
Parents uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. The Mastitis Spectrum. Academy of Breastfeeding Medicine Clinical Protocol. 2022.

  2. Plugged Ducts, Mastitis, and Thrush. WIC Breastfeeding Support.

  3. Breastfeeding Challenges. American College of Obstetricians and Gynecologists.

  4. Mammary Dysbiosis. Clinical Lactation. 2018.

  5. Management of Hyperlactation. Breastfeeding Medicine. 2020.

Related Articles