What are Clogged Ducts?

You may have heard the term clogged or plugged milk duct to describe a tender, sore area in the breast during lactation. However, research shows that milk doesn’t actually get “stuck” in a single duct. Instead, swelling and inflammation in the surrounding breast tissue can compress the ducts, slowing or restricting the flow of milk. This process is called ductal narrowing.

Ductal narrowing often develops from infrequent feeding or pumping, poor milk transfer, or oversupply. These factors can lead to breast fullness and engorgement, which increase pressure inside the breast and make it harder for milk to flow freely.

The good news is that most cases can be managed at home with gentle, effective strategies to reduce inflammation and protect your supply. Recognizing early signs and responding promptly helps prevent symptoms from worsening.

Symptoms of A Clogged Milk Duct

  • Symptoms usually develop gradually
  • Breast tenderness or a bruise-like, pulled-muscle feeling
  • A tender lump or firm area of the breast
  • Decreased flow from the affected breast

What is Mastitis?

Mastitis refers to inflammation of the milk ducts and surrounding tissue that can occur when ductal narrowing and poor milk flow (called milk stasis) worsen inflammation. While mastitis was once thought to always indicate bacterial infection, more recent research shows that many cases are inflammatory rather than infectious.

Mastitis can cause symptoms similar to a plugged duct, such as breast tenderness, firmness, or a lump, but it may also include flu-like symptoms, including fever, chills, or body aches. The good news is that most cases can be managed safely at home, and antibiotics are usually only needed if symptoms persist or there are clear signs of infection.

Symptoms of Mastitis

  • Symptoms may come on quickly or develop after a blocked milk duct
  • A tender, hard lump or area of your breast
  • Swelling, warmth, or redness over part of the breast
  • Breast pain or burning sensation during feedings
  • Decreased flow from the affected breast
  • Flu-like symptoms such as fever, chills, or body aches

How to Prevent Clogged Ducts and Mastitis

Understanding and addressing risk factors is key:

  • Feed Responsively: Frequent, effective milk removal prevents milk stasis and inflammation.
  • Avoid Oversupply. Pumping “just in case” or to empty the breast after feedings can overstimulate production.
  • Don’t Skip Feedings. If you must miss a feeding, use your breast pump to ensure regular milk removal.
  • Limit Nipple Shield Use, if Possible: Shields can reduce milk transfer. If you use one, work with a lactation consultant for support and a gradual plan to wean.
  • Wear a Comfortable Bra: Avoid underwire or tight styles that press on breast tissue.
  • Pump in Moderation: If exclusively pumping, aim to meet your baby’s needs without overstimulating production.
  • Treat Sore or Cracked Nipples: Use mild soap on your nipples once per day while bathing and wash your hands frequently to reduce the risk of infection.

Treatment for Clogged Ducts and Mastitis

Whether you’re experiencing early ductal narrowing or mastitis, the approach is the same: reduce inflammation, relieve pressure, and support milk flow. Most symptoms will improve within 24–48 hours with gentle, consistent care. Recognizing the early signs and treating promptly can help prevent progression and protect your milk supply.

Feed Responsively

  • Breastfeed on demand, offering both breasts at each feeding.
  • If flow is slower, your baby may need to feed more often, but avoid repeated attempts to encourage your baby to “empty” the breast, which can worsen inflammation and oversupply.
  • If exclusively pumping, aim to meet your baby’s needs without overstimulating production.

Reduce Inflammation

  • Cold Therapy: Apply an ice pack or a bag of frozen peas for 10–15 minutes several times a day. Avoid heat, which can increase swelling.
  • Anti-inflammatory Medication: If recommended by your healthcare provider, take an NSAID such as ibuprofen to reduce pain and swelling.
  • Lecithin: Oral sunflower or soy lecithin (5–10 g/day) may help reduce inflammation and improve flow.
  • Probiotics: Certain strains (Limosilactobacillus fermentum or Ligilactobacillus salivarius) may help in the prevention and treatment of mastitis.

Support Milk Flow

  • Reverse Pressure Softening (RPS): Before feeding, place two fingertips from each hand at the base of your nipple, press gently inward, and hold in place for 30–60 seconds. This temporarily displaces swelling and may help your baby latch more easily.
  • Breast Movement: Gently move your breast ("breast gymnastics") to relieve fluid congestion.
  • Gentle Lymphatic Drainage: Use light, “petting” motions toward your collarbone and armpit to help move fluid away from swollen tissue. Avoid deep tissue massage, which can worsen inflammation.

Keep Pressure Off

  • Wear soft, nonrestrictive clothing and a supportive nursing bra.
  • Avoid sleeping on your stomach or leaning on your breasts.
  • Experiment with different breastfeeding positions to reduce pressure on affected areas.

Address Contributing Factors

  • Nipple Blebs: These small white or yellow spots are caused by inflamed duct cells. Avoid picking at them or trying to open them. A topical hydrocortisone ointment may aid in healing. While blebs can be painful, it is safe to continue breastfeeding.
  • Oversupply: Producing more breast milk than your baby needs can worsen inflammation. Work with a lactation consultant to safely adjust supply.

Preventing Recurrence

  • Feed your baby on demand. Don’t skip feedings, as regular milk removal helps prevent engorgement and clogged ducts.
  • Ensure a deep, comfortable latch. A good latch prevents nipple damage and makes feeding more effective.
  • Avoid excessive pumping, as it can lead to oversupply and worsen inflammation and congestion.
  • Choose comfortable, nonrestrictive clothing. Avoid tight clothing or underwire bras that put pressure on your breasts.
  • Stay hydrated and rest whenever possible. Your body heals best when it’s supported with fluids, nourishing food, and time to recover.

When to Contact Your Healthcare Provider

Most cases of clogged ducts or early mastitis improve within 24–48 hours with home care. Contact your healthcare provider if your symptoms do not improve within this time frame or if you notice any of the following warning signs:

  • Spreading redness or swelling that expands beyond the initial area
  • Increasing pain or discomfort that doesn’t improve with gentle care
  • Persistent fever, chills, or flu-like symptoms
  • Hard lumps that don’t soften or signs of a breast abscess (such as pus or severe localized swelling)

Prompt evaluation is important to ensure proper treatment and prevent complications. You don’t need to wait until things get severe — reaching out early can help you heal faster and protect your milk supply.

Disclaimer: Our classes and accompanying materials are intended for general education purposes and should not replace medical advice. For personalized recommendations, please consult your healthcare provider and/or lactation consultant.