Once you have finally made it past those first harrowing weeks of breastfeeding where your nipples are shred to pieces, your boobs are constantly engorged, you leak—or spray, ahem—milk like the Trevi Fountain, you may think it is finally smooth sailing (or smooth sucking!). That is until you feel slightly uncomfortable in one certain area of your breast. You press on that area to see what gives (or if it gives…), and you notice a lump in your breast. As us ladies know, lumps in breasts are never a good thing. Thankfully for breastfeeding moms, this type of lump is not quite as serious as other breast lumps. However, it can turn into something seriously painful. You, in all likelihood, have a clogged milk duct. Read on for tips on how to unclog a milk duct.
What is a clogged milk duct?
Your breast is filled with small tubes, or milk ducts, that carry milk from the alveoli, grape-like clusters of cells within your breast, to your nipple through a complex and beautiful pathway. Most women have different numbers of ducts in either breast. Ever wonder why your one breast produces more milk than the other? There has been lots of literature and studies on the breast over the years, but the latest research suggests that there are anywhere between 4-18 ducts in each breast.
A clogged milk duct is a blockage in one of these ducts, either in your nipple pore or further down in the ductal network. This blockage causes an obstruction in the free flow of your breast milk. Clogged ducts can present in a few different ways.
- A milk bleb, or nipple blister, in the form of a white or yellow dot on your areola. This form of clogged duct is due to a blockage in your nipple pore.
- A hard lump the size of a pea (or sometimes larger) that feels swollen and/or tender. It may also appear red and feel warm to the touch.
Clogged milk ducts can be caused by a variety of reasons:
- Wrong sized breast pump flange
- Shallow latch
- Tongue or lip tie
- Tight clothing or other compression of the breast (sleeping on your stomach, heavy bag-lady bag pressing against it)
How to treat a milk bleb (or nipple blister)
A milk bleb occurs when a tiny bit of skin crusts over your nipple pore which in turn blocks the flow of breastmilk. It looks like a small pimple or whitehead on your areola. Glamorous, eh? Your breasts will still produce milk, but the milk behind the bleb becomes trapped. This can cause quite a bit of pain and tenderness directly at the spot of the bleb and right behind it. There are many different tried and true home remedies to treat a milk bleb.
1. Hot compress prior to nursing or pumping
Exactly what it sounds like. Take a wet hot compress (don’t burn yourself!) and apply it to your nipple for 2-3 minutes in order to open up the pore. After you remove the compress, immediately nurse your baby or hook up to the breast pump in order to release the plug.
2. Football hold
Try changing nursing positions. If you typically nurse in the cradle position, change baby to the football hold in order to change the direction of baby’s latch. This will change the suction and flow of milk, and may release the bleb.
3. Epsom salt soak
This method works by drying out the milk bleb tissue. Mix up a small bowl or shot glass (or use your Hakaa of Epsom salt or just plain salt water (1-2 teaspoons of salt to 1 cup water) and soak your breast for 5 minutes. You can accomplish this by either lifting the shot glass horizontally while pressing against your breast, or by placing the bowl on a table and lowering your breast into the bowl. Once you are done, gently wipe the area with a soft washcloth. The saline soak should release the clog. If not, move on to #3.
4. Olive oil on a cotton ball
This method works in contrast to the above, and can be used in conjunction with an Epsom salt soak. Soak a cotton ball in 2 teaspoons of olive oil. Take the cotton ball and place it against your breast. Put a breast pad behind the cotton ball and let it soak against your nipple for 15 minutes (or however long you like). Gently wipe the area with a soft washcloth. The olive oil should have moistened the skin enough to allow you to wipe the milk bleb away.
5. Sterile needle
Now listen, before you start operating on yourself hear us out. It is best to have your medical provider do this for you. Your nipple is a very important component of this whole breastfeeding thing. You absolutely do not want to introduce bacteria into your nipple by poking and prodding it with a needle. At the same time, we know how hard it is to take off work for your baby’s well child checks. Penciling in an appointment for yourself to pop a painful pimple on your nipple may not be possible. If you plan to undertake this yourself, check out this article by Kelly Bonyata, BS, IBCLC of kellymom on the proper way to release a milk bleb with a sterile needle.
Whatever approach you take, make sure to apply nipple cream, coconut oil, expressed breast milk or an antibiotic ointment after you clear the milk bleb in order to help your skin heal. You may also find it more comfortable to free the nipple and allow your boobs to bounce by going braless and shirtless. #girlpowa You can also take a anti-inflammatory or pain reliever such as ibuprofen (Advil/Motrin) or acetaminophen (Tylenol). Both are safe for breastfeeding mothers according to LactMed.
How to treat a clogged milk duct
If you notice a small painful lump on your breast, you may have a clogged milk duct. Clogged milk ducts occur further back in your ductal system than milk blebs. Clogged milk ducts gradually occur in one breast with pain localized to a specific spot on your breast. The clogged milk duct may be tender and warm to the touch. You may also have a low grade fever. Left untreated, a clogged milk duct can turn into mastitis, an even more painful breast infection.
There are several different methods you can employ at home to resolve your clogged milk duct.
1. Nurse, nurse, nurse!
Even though it is painful, try to nurse through the pain and have your baby nurse as much as possible on the breast with the clogged milk duct. Point your baby’s chin toward the clogged milk duct while nursing. You can also try switching positions. If you typically nurse in the cradle position, try switching to the football hold. If you exclusively pump, pump as much as you can. The thought here is that you want to completely empty your breast of milk as often as possible. Your glandular tissue will continue to produce milk even if you have a clogged milk duct. By continuing to empty your breast of milk, the clogged milk duct should resolve itself without further treatment.
Be aware that baby may be fussier when nursing on your affected breast since the flow of milk will be slower due to the clogged milk duct. Remember that you have several milk ducts in your breast, so breast milk is still coming out of your breast with the clogged milk duct. It is just not coming out at full blast since the clogged milk duct is likely putting pressure on the surrounding ducts. If nursing or pumping alone does not work, you can move on to the next steps.
2. Hot compress (or hot shower) on the clogged milk duct prior to nursing or pumping
Similar to treating a milk bleb, apply a hot compress (again, don’t burn ya’ self) for about 10-15 minutes before nursing or pumping. You can also try using a heating pad. This will encourage the clogged milk duct to soften and hopefully break apart the next time you breastfeed or pump. You can also take a hot shower and allow water to run over the clogged milk duct in order to encourage it to release. If you have a removable shower head, take the shower head and position it directly over the clogged milk duct. Move the shower head from the clogged milk duct toward your nipple repeatedly, allowing the water to massage your breast.
3. Breast compressions and massage
Firmly massage the area between your nipple and the clogged milk duct. The lump you feel is backed up milk. The actual clog that you need to break up is between the lump and your nipple (closer to the lump). You can also try breast compressions by placing your hand in the shape of a C on the side of your breast by your armpit with the clogged milk duct. Compress your breast and move your hand toward your nipple. Repeat this several times. Other examples of therapeutic breast massage are available here. You may express milk as you compress your breast. You can also massage your breast in a hot shower for a 1-2 punch.
4. Wide tooth comb across the clogged milk duct
Another thing to try in the shower is using a wide tooth comb to gently, yet firmly, rake over the clogged milk duct. Make sure to apply soap on the comb or your skin to help lubricate the area. Start with the comb at the top or side of your breast depending on where the lump is located, and then move the comb toward your nipple in order to help break apart the clogged milk duct.
5. Dangle feeding
Place your baby on the bed or floor–whichever surface is safer–and lower your breast to baby’s mouth. You may need to help baby latch properly. If possible, point baby’s chin toward the clogged milk duct. Once you have a good latch and position, and are as comfortable as possible (if it’s possible!), let baby nurse for as long as you can. By nursing in this dangle feeding position, the force of gravity coupled with your baby’s sucking should help relieve the clogged milk duct.
If you exclusively pump, you can dangle pump by attaching your pump, and getting in this same all fours position. The suction of the pump and the pull of gravity will have the same impact.
6. Electric toothbrush or lactation massager on the clogged milk duct
Take an electric toothbrush, lactation massager, or any type of vibrator and roll it into the clogged milk duct and the area between the clogged duct and your nipple. Remember that the clogged milk duct is the back up of milk caused by the clog, not the clog itself. The clog is between your nipple and clogged milk duct, but closer to the lump. Gently work on the area in an effort to vibrate the clogged milk duct free. You can also try this tactic while nursing or pumping. If your vibrator is waterproof, try taking it into a hot shower and vibrate the clog while allowing hot water to run over the area.
7. Ask your husband (I know, I know…)
We have listed this last for a reason. Remind your significant other that this is business, not play. Have him suck on your breast with vigor. Or at least as hard as he can and you can stand. His stronger suction may help break up the clogged milk duct. You can try coupling this with #2 or #5.
How to treat repeated clogged milk duct
Some moms may only experience one milk bleb or clogged milk duct, and then never have the pleasure of experiencing one again. However, other moms find that they are facing repeated clogged milk ducts. They can be annoying as they are painful. If they continue to reoccur, you can try a few things.
If you read food labels, you may have noticed sunflower lecithin or soy lecithin listed in lots of the foods you eat. Lecithin a common food additive that generally acts as an emulsifier, lubricant or flavor protector. Oddly enough, it can also help resolve and prevent clogged milk ducts. The reasons how sunflower lecithin works is not entirely understood, but Dr. Jack Newman posits that it may decrease the stickiness of milk by increasing the percentage of polyunsaturated fatty acids in milk.
You can find sunflower lecithin on Amazon, GNC, Walmart, CVS, Walgreens, or a natural food store. The recommended dosage of sunflower lecithin is 1200 mg four times a day, or 2 capsules four times a day. There are no known contraindications to sunflower lecithin for lactating mothers. In rare cases it may upset your baby’s tummy. If that happens, you can try reducing the number of capsules you take to see if that relieves your little one’s stomach discomfort.
2. Ultrasound therapy for clogged milk ducts
Most clogged milk ducts should resolve within 48 hours. If your plugged milk duct is not gone within 48 hours or if you are repeatedly experiencing recurrent blocked ducts in the same part of the breast, ultrasound therapy has been shown to be an effective treatment. Speak with your lactation consultant or OBGYN to see if they can perform or refer you to a place to have this done. Most chiropractic offices, physical therapy centers, or sports medicine clinics have this available on site. According to the International Breastfeeding Centre, the recommended dose of ultrasound is 2 watts/cm² continuous for five minutes to the affected area, once daily for up to two treatments.
Remember that if you experience a fever and flu-like symptoms in addition to your clogged milk duct, call your OBGYN or PCP immediately. In all likelihood, your clogged milk duct has turned into mastitis and you need antibiotics stat. This is a common occurrence, so your physician may call in a prescription without having you come into the office. The important thing is that you do not leave this untreated. It could turn into an abscess, which is a whole different level of pain. As always, call your medical provider if you have any questions or concerns.
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