References:

1. Toronto Public Health - Breastfeeding Protocols for Health Care Providers | Protocol #6: Plugged Ducts
2. MyHealth.Alberta.ca – Blocked milk ducts
3. Best Start - Blocked Ducts

What is a blocked milk duct?

• When a duct in the breast becomes clogged with milk and other material
  • Sometimes an area of the ducts or nipple opening becomes blocked and milk stops flowing well
  • Milk flows through ducts in the breasts
• May also be called a clogged or plugged duct

Causes

• Not enough milk is being removed from the breast
  • Baby is suddenly feeding much less than usual
  • Baby is not latching well or sucking well
  • Baby is not in a good position when feeding
• Breasts are very full because too much milk is being made
• Pressure on the breast
• Stress
• Feeling tired
• History of trauma or surgery on the breast
• Use of a nipple shield when symptoms are present
• Wearing a tight bra or clothing
• Wearing a purse or baby carrier that crosses an area of your chest
• Sleeping on the same side

Symptoms

• Usually affects only one breast and one area of your breast
  • Breast is sore or tender in one area
    • Pain is mild
  • May look red
  • May feel a lump or feel lumpy and the location may change
  • White dot at the end of the nipple (milk bleb)
• Temperature is lower that 38.4°C/101°F
• Feeding parent feels well overall

Treatment

• Most blocked ducts will resolve in 1-2 days on its own
• See your health care provider if lump does not go away after 2 days, you have had a blocked milk duct more than once or have signs of a breast infection
• Continue breastfeeding
• Treat cause if known and is able to be treated
• Seek help with positioning and latching from a breastfeeding expert
• Self-care
  • Rest
  • Eat and drink well
  • Use the people around you for support

Breastfeeding with a blocked milk duct

• Before:
  • Breastfeed early when the baby shows signs of hunger
  • Breastfeed frequently without restriction (at least 8-12 times in 24 hours)
    • Express milk if feedings are missed or cut short
  • Apply moist heat to the area
  • Gently, but firmly, massage the breast just above the sore area, moving towards the nipple
  • Hand express or pump to remove a small amount of milk
  • Take a warm shower
  • If there is a white dot at the end of the nipple, apply moist heat and roll the nipple gently
• During:
  • Breastfeed on the affected side first (babies usually suck stronger on the first breast when they are hungry)
  • Breastfeed on the affected side for longer
  • Massage the area with symptoms towards the nipple
  • Avoid putting pressure on the breast for a long period of time
  • Try breastfeeding your baby in different positions to help remove milk from all areas of the breast
  • Breastfeed with the baby’s chin pointed toward the sore area
  • Ensure baby is sucking and swallowing well
• After:
  • Avoid putting pressure on the breast for a long period of time
  • Avoid tight bras or clothing
  • Watch for signs of mastitis

Further Your Learning:

1. Toronto Public Health - Breastfeeding Protocols for Health Care Providers | Protocol #6: Plugged Ducts

Shareable Resources for Clients:

1. Best Start - Blocked Ducts
2. MyHealth.Alberta.ca – Blocked milk ducts

Referral Sources:

1. Niagara Parents - Infant Feeding Appointments with a Public Health Nurse - 905-684-7555
2. Health811 - Breastfeeding advice and referrals - 1-866-797-0007
3. La Leche League Canada – Mother-to-mother breastfeeding support - 613-238-5919