Plugged Ducts & Mastitis: Prevention & Treatment

Breastfeeding can bring up unexpected challenges, like plugged ducts and mastitis. These conditions can be uncomfortable, frustrating, and even isolating, especially when you just want to enjoy bonding time with your little one.

Plugged ducts, caused by a blockage in the milk flow, and mastitis, a painful inflammation or infection of the breast tissue, are common issues many breastfeeding moms face. The key is understanding what causes these conditions, how to prevent them, and how to respond when they arise.

With the right support and information, these issues can be effectively managed, so you can continue breastfeeding with greater comfort and confidence.

At CLS, we understand how these complications can affect your breastfeeding journey. Our lactation consultation programs offer evidence-based breastfeeding education, personalized guidance, and hands-on support to help you prevent and manage issues like plugged ducts and mastitis.

Whether you’re a first-time mom or seeking help with ongoing concerns, we ensure you feel supported, informed, and empowered in your breastfeeding journey.

A plugged duct, also known as a clogged or blocked milk duct, occurs when the normal flow of breast milk is obstructed during lactation. This blockage prevents milk from moving freely to your nipple, often leading to discomfort and tenderness. The blockage can be in the nipple pores or the ductal system.

Inside your breast, milk travels through a network of small, tube-like structures called mammary ducts, which carry milk from the milk-producing glands to the nipple.

When one of these ducts becomes compressed, due to inflammation, swelling of nearby tissue, or pressure from a tight bra or improper latch, milk can build up behind the blockage, creating a firm, often painful lump.

Symptoms of Plugged Ducts

Plugged ducts can be uncomfortable, but recognizing the symptoms early can help you manage them more effectively. You may notice:

• Pain that worsens before a feeding and feels better afterward as the breast begins to empty.
• Redness, warmth, and tenderness in one area of the breast, often without signs of infection.
• Sharp pain during letdown, when milk begins to flow.
• Firm, lumpy, or tender spot that may feel smaller or softer after feeding or pumping.
• White spot or blister on the nipple tip, called a nipple bleb, milk blister, or nipple blister.
• Thick, stringy, or grainy milk when expressing milk from the affected breast.
• Temporary drop in milk supply or pumping output from the blocked breast.

These symptoms tend to develop gradually and usually affect only one breast. While plugged ducts can be frustrating, they are typically short-lived and respond well to early treatment and support. 

Recurring plugs are not uncommon, but with prompt attention, most clear up within 24 to 48 hours. It’s also normal to feel a tender, bruised sensation in the affected area even after the blockage has resolved.

Causes of Plugged Ducts

Plugged ducts can develop for many reasons, often related to how milk is removed from the breast or external factors that put pressure on the breast. 

Common causes of plugged ducts include:

• Engorgement or incomplete milk removal due to poor latch or ineffective nursing
• Oversupply of milk, making drainage more difficult
• Missed or infrequent feeding or pumping sessions due to nipple discomfort or pain, returning to work, rapid weaning, or rigid feeding schedules
• Tight or restrictive clothing, especially bras that press against the breast
• External pressure on the ducts of your breast from holding the breast too firmly during feeding or a sleeping position that puts pressure on your breast
• Inflammation from breast injury or trauma, bacterial or yeast infections, or allergic reactions
• Stress and fatigue, which can impact milk flow and letdown

If a plugged duct lingers or milk continues to build up without proper drainage, it can progress into mastitis, a more painful condition that may require medical treatment. That’s why early intervention is so important. 

At CLS, we offer guidance and hands-on support to help you address issues early, relieve discomfort, and keep your breastfeeding journey on track.

Mastitis is the inflammation of the breast tissue, which may or may not involve infection. It can develop when blocked ducts remain compressed or when the breasts become overly full, leading to swelling and inflammation. It can also occur when bacteria enter the breast through cracked or damaged nipples.

Mastitis doesn’t occur from just one missed feeding. It is often the result of an ongoing process, such as chronic engorgement or persistent issues with milk removal. 

Over-pumping or trying to fully empty the breasts can actually increase the risk of mastitis. When certain areas of the breast experience repeated pressure, it can disrupt milk flow and create conditions where bacterial imbalance and infection become more likely.

If you develop mastitis, it is important to continue breastfeeding or pumping gently from the affected side.

A common myth is that breastfeeding during mastitis is unsafe for your baby, but this is not true. Mastitis isn’t contagious, and your baby is not at risk from nursing. Responsive, frequent feeding is one of the most effective ways to support healing and prevent complications like abscess formation.

Symptoms of Mastitis

Mastitis can come on suddenly and may feel intense. Common signs and symptoms include:

• Flu-like symptoms, including chills, fatigue, body aches, and headache
• Fever that is typically 101.3°F (38.5°C) or higher
• Redness or visible red streaks, often in a wedge-shaped pattern
• Lingering bruised or swollen feeling even after recovery
• Milk may taste salty due to increased sodium or chloride levels
• Expressed milk may appear clumpy, stringy, gelatinous, or contain mucus, pus, or a small amount of blood
• Decreased milk output from the affected breast

Causes of Mastitis

Many of the same factors that lead to plugged ducts can also increase the risk of developing mastitis. In fact, a plugged duct that isn’t promptly cleared is one of the most common triggers for mastitis.

Additional contributing factors for mastitis can include:

• Bacteria that enter through broken skin, such as sore, cracked, or bleeding nipples
• Untreated plugged ducts that allow milk to stagnate
• Poor breast drainage, whether from ineffective latching or missed feeding
• Previous episodes of mastitis, which may increase your risk for recurrence

At CLS, we help you identify early warning signs and take steps to resolve the issue before it worsens. Breastfeeding through mastitis is often recommended to help clear the infection and keep milk flowing. 

Proactive prevention is one of the best ways to avoid plugged ducts or mastitis. By building a few mindful habits into your daily routine, you can help keep your breastfeeding experience more comfortable, consistent, and enjoyable.

Avoid Long Gaps Between Sessions

Allowing too much time to pass between feeding or pumping sessions can lead to breast engorgement, which increases the risk of milk stasis and plugged ducts. Try to empty your breasts consistently.

If you’re separated from your baby for work or other reasons, consider pumping or hand expressing milk to maintain your supply and avoid buildup.

Ensure a Good Latch

A shallow or ineffective latch can prevent your baby from fully draining the breast, causing milk to back up and potentially form a blockage. If nursing feels painful or your baby seems frustrated, it could be a sign that the latch needs adjusting.

Our certified lactation consultants offer hands-on guidance to help you improve latch techniques and identify early signs of feeding inefficiency.

Vary Breastfeeding Positions

Switching up positions helps ensure all areas of the breast are drained regularly. Different angles help milk flow from different ducts, reducing the chances of blockage. Try the cradle hold, football hold, side-lying, or even laid-back nursing.

Ensure Effective Pumping Techniques

If pumping, be sure that your breast softens after pumping sessions. Poor pump flange fit or suction can lead to breast not draining properly.

Wear Supportive, Non-Restrictive Bras

Tight bras or clothing that compress the breasts can obstruct milk flow and cause blockages. Choose soft, supportive nursing bras that allow for natural breast movement without pressure.

If you're experiencing signs of a plugged duct or mild mastitis, you can manage them effectively at home with a few simple strategies. Early intervention is key to easing discomfort and preventing complications.

For Plugged Ducts

To help relieve a plugged duct at home, consider these strategies:

• Decrease Inflammation with the Use of Ice Packs: Wrap an ice pack or bag of frozen peas or corn in a soft cloth. Apply to comfort every hour for about 10 to 15 minutes until you start to feel better. Then, you can use it less frequently.
• Apply A Warm, Moist Compress Before Feeding (If Needed for Comfort): Warmth helps loosen the blockage and encourages milk to flow more freely. Try a warm washcloth or take a warm shower before feeding.
• Gentle Breast Massage: Use your fingertips to gently massage the lump in a circular motion, moving toward the nipple. Massaging during and after feeding can enhance drainage. Avoid deep massage. This can cause further damage to an already irritated breast.
• Continue to Nurse on the Affected Side: Don’t skip feeding on the sore side, but also don't overfeed on that side. Check to see that your baby is well-positioned and has a good latch.
• Take Care of Yourself: Consider yourself sick and rest when your baby rests.  Eating whole foods and drinking plenty of fluids will help you heal and regain your strength.
• For Frequent Blocked Ducts: Consider taking one capsule (1200 mg) of Sunflower Lecithin 3 to 4 times per day. After a week or two without blockage, reduce the dosage by one capsule. Then, you can wean down to 1-2 capsules per day if needed to prevent plugged ducts.

For Non-Severe Mastitis

If your symptoms resemble mild mastitis, these approaches may be helpful in managing the condition at home:

• Continue to Nurse: Hand express or pump gently if your baby is not feeding on the affected side.  If unable to nurse or pump on the affected side, use ice to reduce inflammation until you are able to breastfeed or pump.
• Rest & Hydration: Your body needs energy to heal. Try to rest as much as possible, drink plenty of water, and eat nourishing foods to support recovery.
• Pain Relief (With Approval): Over-the-counter medications like ibuprofen or acetaminophen can reduce pain and inflammation. Be sure to check with your healthcare provider before taking any medications while breastfeeding.
• Apply Cold Compresses: Wrap an ice pack or bag of frozen peas or corn in a soft cloth. Apply to comfort every hour for about 10 to 15 minutes until you start to feel better. Then, you can use it less frequently. Lymphatic drainage can be helpful to move extra fluid in your breast back into your lymphatic system.  This technique is gentle, like petting a cat.

Occasional plugged ducts are common and often resolve with home care. However, if they happen frequently or don’t improve despite your best efforts, it may indicate an underlying issue that requires a professional evaluation.

Mastitis can develop rapidly and sometimes needs medical treatment. If you notice persistent or worsening symptoms such as a fever of 101.3°F (38.5°C) or higher, fever, chills, or severe breast pain, it’s important to contact your healthcare provider promptly.

You may require prescription antibiotics or additional evaluation to prevent further complications. Early treatment helps prevent complications and supports a faster recovery.

If the pain during nursing becomes so intense that you dread feeding sessions, it may be a sign of an infection or other conditions that require medical evaluation.

Managing these breastfeeding challenges may need a coordinated approach between our lactation consultants and healthcare providers. This ensures you receive comprehensive care, keeping both you and your baby healthy, comfortable, and well-nourished.

Challenges like plugged ducts and mastitis are common for breastfeeding moms, but with early attention and proactive care, you can often prevent them from becoming more serious. Taking the right steps and seeking personalized support makes all the difference in maintaining your comfort and confidence.

At CLS, we provide comprehensive education on breast care, strategies for maintaining a healthy milk supply, and personalized coaching on effective latch techniques. By addressing these key areas, we help prevent common challenges like plugged ducts and mastitis before they arise, empowering you to breastfeed with greater comfort, confidence, and success.

To start your journey with our certified consultants, call us at 888-818-5653 or request an appointment online.