Clogged milk duct happens when breast milk is backed up in the tubes that carry milk to your nipples. If you have a clog, it may feel like a tender, hard lump. You may have redness and a hot sensation or swelling around the lump. Home treatments for clogs include breastfeeding and/or pumping often, trying different breastfeeding positions, and using heat and gentle massage. A clogged milk duct will usually get better in a day or two, but if it doesn’t, let your provider know.

IN THIS ARTICLE

• What’s a clogged milk duct? 
• What does a clogged duct feel like? 
• What causes a clogged duct? 
• How to unclog a milk duct 
• Clogged milk duct picture 
• Will a clogged milk duct eventually dry up? 

What’s a clogged milk duct?

Milk ducts are small, straw-like tubes that carry milk from your mammary glands to your nipples. When your body makes breast milk faster than it’s getting expressed, it can get backed up in the duct. When this happens, the tissue around the duct may become swollen and inflamed and press on the duct, causing a blockage. This is called a clogged or plugged duct. According to one study, 4.5 percent of women have clogged ducts in their first year of breastfeeding.

There’s a network of these ducts, with some merging together. The number of main ducts ranges from 4 to 18 at the base of the nipple. The size of the ducts ranges from 1.0 to 4.4 mm in diameter, and the diameter can increase to allow for the flow of milk when nursing.

When your baby breastfeeds, the hormones prolactin and oxytocin increase. This causes the muscles in the breasts to contract, moving the milk through the milk ducts to your nipples. This is known as letdown.

When the milk lets down but isn’t emptied at the nipple, the duct can become clogged or plugged. Clogged ducts can appear anywhere that you have milk ducts, including on the nipple (causing a milk bleb), breast, or near the armpit.

Clogged ducts can usually be successfully treated at home. If a clog doesn’t go away, though, it can evolve into mastitis, a painful and potentially serious breast infection. If you have a clogged duct that doesn’t go away in a couple of days, or you develop mastitis symptoms – like a fever, flu-like symptoms, and an area on the breast that’s hot and tender – contact your healthcare provider right away. You’ll need antibiotics to treat mastitis.

Keep in mind, too, that a lump may not be breastfeeding-related. Always contact your provider about any lump on your breast that isn’t getting better.

What does a clogged duct feel like?

A clogged duct feels like a small, hard lump about the size of a pea or larger. It may be sore to the touch. You may feel a knot in the tissue, or tenderness in your breast. You may also feel an aching as if you were punched.

Other signs of a clogged duct include:

• Localized redness
• A hot sensation or swelling around the lump that may feel better after nursing
• Pain during letdown
• A milk blister (bleb) in an opening on the nipple (if the nipple is plugged)
• Decrease in milk supply (Sometimes milk flow on the affected side may be slower than usual, and your baby may become fussy when nursing on that breast.)
• Milk that’s grainy, stringy, or thicker than usual (You would see this if you pumped.)
• Nipple discharge

Note that it’s possible to have a clogged duct and not have any symptoms. The duct may just open on its own, without causing any problems.

The lump may also move over time – closer to the surface so you can better feel it or further into the duct, where you can’t. And once the duct is unclogged, the area may still be red or feel tender for a week or so, but any hard lumps will be gone and it won’t hurt as much to nurse.

What causes a clogged duct?

Some moms seem more prone to clogged ducts than others, for no discernable reason.

But clogged ducts generally happen if your breasts aren’t getting completely emptied of milk on a regular basis. The breast milk builds up in the tissue, causing swelling and inflammation.

Here are some common causes of a clogged duct:

• Your baby is having trouble feeding – because of a poor latch or tongue tie, for example.
• You’re having trouble nursing because of cracked nipples or another breastfeeding problem.
• Engorgement, which means that you have more milk than your baby is consuming, leading to breasts that are overfilled with milk.
• Nursing more often on one side than the other. This can cause milk to build up on the less frequently emptied breast.
• The flange on your breast pump is the wrong size. (The flange is the funnel-shaped part of the pump that fits over your breast.) If it’s too small, it can rub the nipple against the side of the flange, causing inflammation and hindering the flow of milk. If it’s too large, it can cause trauma around the areola (the dark, circular area around the nipple).
• You’ve abruptly weaned your baby. When possible, try to wean your baby gradually.
• You’ve been unable to nurse your baby or pump as often as usual – because you’ve returned to work or your baby is sleeping for longer stretches, for example.
• A duct becomes compressed or damaged, due to pressure on it. This may be from carrying a heavy bag (when the strap presses on your breast), from a nursing bra that doesn’t fit well (or has an underwire that pushes on your breast), or from sleeping on your stomach, for example.
• You’re under stress. Stress lowers your body’s production of oxytocin, the hormone that causes your breasts to release milk.
• You’ve had surgery, such as a breast biopsy. The area that was operated on may interfere with milk drainage and cause a blocked duct.
• Dry milk may plug the openings in your nipples after feedings. If you notice this, wash with warm water after breastfeeding.

If you’re nursing and have a painful lump in your breast, you might have a plugged duct. Get tips on how to find relief from moms who have been there.

How to unclog a milk duct

Keep breastfeeding. Not only is it perfectly safe to nurse your baby while you have a clogged duct, it will help remedy the clog. And the antibacterial properties of breast milk will keep your baby safe from bacteria, even if you develop an infection.

To draw out the clog, nurse and/or pump regularly. It may be painful to nurse or pump on the affected side, but frequent breastfeeding is crucial to completely empty the breast, which will make you more comfortable and reduce inflammation.

Here are some other strategies that can help:

• Get rest. This may seem difficult or impossible with a baby to care for, especially if you have other children, but it’s the most important thing you can do next to regularly breastfeeding or pumping. If possible, ask someone to help you for a few hours a day so you can take naps. If you haven’t yet, you may want to introduce a bottle so someone else can help with feedings.
• Start with the sore breast. Nurse on the side with the clogged duct first, because your baby sucks strongest at the beginning and that may help dislodge the plug. If your baby doesn’t want to nurse enough to empty the breast on that side, use a breast pump or hand express the milk after your baby’s feeding. (A lactation consultant can show you how to hand express milk.)
• Massage. Gently massage the sore area while nursing or pumping. Start at the outside of the breast and work your way toward the nipple. Try massaging your breast while you’re in a warm shower or bath. Massaging your breast while nursing can also help the milk flow.
• Vary your nursing position. For example, if you use the cradle hold, try the football hold or nurse lying down. This will help ensure that all of the ducts are drained. Many women swear by this trick: Position your baby at your breast with their chin pointed toward the sore spot, and then have them latch on and begin nursing. This helps concentrate suction on the clogged area.
• Avoid wearing tight bras or tight clothing. Don’t put pressure on your breast.
• Eat well and drink water. Focus on nutritious foods to boost your immune system, and drink plenty of fluids to stay hydrated.
• Consider medication. Taking ibuprofen may help relieve pain and inflammation. Ask your healthcare provider or lactation consultant before taking medicines or herbs while you’re breastfeeding, though, even if it’s an over-the-counter drug.
• Hot and cold. Some moms rely on cold packs while others prefer a heating pad to ease pain and discomfort. See which provides you with the best relief. You might want to try a warm compress before feeding (dip a washcloth in hot water and wring it out, then place on the clogged duct) and a cool compress after nursing.
• Soak the clog in warm water with Epsom salts. The salts can help draw out the plug. You can do this in a wash basin or bowl (over a sink). Use about 2 teaspoons of Epsom salts per cup (8 ounces) of water.
• Try a silicone breast pump. The suction of a silicone pump – used in combination with an Epsom salt soak – can help relieve clogs. Place Epsom salts and warm water in the pump, and stir to dissolve. Leaning over a sink, apply the pump as directed. The combination of suction, warm solution, and gravity can help pull the plug out.
• Apply an electric toothbrush. Some moms use the vibrations of an electric toothbrush to help clear the blockage. Hold the flat end against the blockage and turn on the brush.
• Try lecithin. There’s no scientific support for this, but it’s often suggested that lecithin (a fatty substance found in plants and animals) can help prevent and eliminate clogged milk ducts by making the milk less sticky and so less prone to blockage. Lecithin is available as a supplement. If you’d like to try it, ask your provider for a brand recommendation and guidelines for how often to take it.
• Make adjustments to your diet. Limiting the saturated fat in your diet may help reduce inflammation in the duct. Increasing your water intake is also recommended.
• Try therapeutic ultrasound. For a stubborn blockage, you may want to try ultrasound to loosen the clog. Talk with your provider to get a referral to a physiotherapy or sports medicine clinic, where they can do the treatment.

Breastfeeding can hurt! Learn which items can bring relief to cracked nipples, leaking breasts, and other nursing challenges.

Clogged milk duct picture

You may be able to see (as well as feel) the hard lump where the duct is plugged. It may look reddened and inflamed.

Note: The following picture shows a naked breast with a clogged duct and may be NSFW.

Will a clogged milk duct eventually dry up?

Most clogged ducts will clear on their own in a day or two, with or without treatment. A clogged duct can temporarily affect your milk supply a bit, but it won’t cause you to stop producing milk.

But if a clogged duct doesn’t go away, it may develop into mastitis or cause a milk-filled cyst to form. (These are called galactoceles, and while they’re usually painless, they can also become infected and require drainage.) So it’s a good idea to help clear the clog with some of the measures mentioned above.

If your breast still hurts after frequent nursing and other self-treatments for 24 hours, call your healthcare provider. Also call right away if you develop a fever at any time, because this could be a sign that you have an infection.

Signs that your clogged duct has progressed into mastitis:

• Fever
• Flu-like symptoms, including fatigue and achiness
• A large area that’s tender and painful (rather than a small, localized area around the plug)
• Skin that’s red and hot to the touch

And again, talk with your provider if you have a breast lump that’s not going away, even without other symptoms.

Read more about

• Signs of mastitis – and what it looks like
• How to bottle-feed your newborn
• How to breastfeed your newborn
• Good positions for breastfeeding
• How to treat a milk bleb (milk blister)