They are one of breastfeeding’s biggest challenges but how do you know you have a blocked milk duct? And what’s the best way to treat it?
This is probably not something you’d thought about before you started breastfeeding. The glands that make milk in your breasts are divided into segments a bit like an orange. Your ducts are the narrow tubes that carry milk to your nipple from each segment (NHS Choices, 2016a).
If you feel a small, tender lump in your breast, you might have a blocked milk duct. They happen when any one of the segments does not drain properly during a feed (NHS Choices, 2016a).
Sometimes, a blocked milk duct can happen if your breast tissue is irritated for other reasons (NHS Choices, 2016a). Reasons include a bra that’s too tight or an awkward sleeping position where you’re putting weight onto your breast (NHS Choices, 2016a; Exclusive pumping, 2016).
Signs and symptoms of a blocked milk duct
When you have a blocked milk duct, the area around your breast will feel hard and painful. It might also be red, warm to the touch and tender (NHS Choices, 2016a). Whatever the cause may be, try to relieve it as soon as possible or it will lead to mastitis if not cleared (NHS Choices, 2016a). When your baby feeds on the side of the blocked duct, they might fuss because they are receiving your milk more slowly than normal (International Breastfeeding Centre, 2017).
Blocked milk duct treatment
The best way to treat a blocked milk duct is to:
Empty the affected breast as often and as completely as possible by feeding.
Gently stroke the breast towards the nipple during the feed to help the let-down.
Apply a cold cloth or cool gel pack.
You could try a lactation massager as some women say the vibrations help break up the blockage (Exclusive pumping, 2016).
Express or pump your milk after a feed.
Use a heating pad or hot water bottle.
Rest as much as possible.
Use paracetamol or anti-inflammatory tablets.
If the lump has not cleared after 48 hours, get a therapeutic ultrasound from a physiotherapist on the affected breast.
See your GP if none of the above work.
(International Breastfeeding Centre 2017; Healthy WA, 2018)
How to prevent blocked milk or breast ducts
Blocked milk ducts can be prevented by doing the following:
Avoid wearing tight clothes or bras so that your milk can flow freely from every part of your breast.
Position the baby so their chin is pointing to the blocked duct.
Avoid long gaps between breastfeeds or expressing.
(NHS Choices, 2016a; International Breastfeeding Centre 2017; Healthy WA, 2018)
Milk blisters or blebs
Sometimes, a blocked duct is associated with a bleb or blister on the end of the nipple. Milk blisters or blebs look like a flat patch of white on the nipple and are often quite painful. Usually they appear at a later stage of breastfeeding but if your baby has a poor latch, they can appear in the first few days (International Breastfeeding Centre, 2017).
Milk blisters can be painful but opening them up can ease them (Healthy WA, 2018; International Breastfeeding Centre, 2017). Try using a sterilised sewing needle to pierce the side or top of blister and squeeze. This will unblock the duct and allow the milk to flow again (Healthy WA, 2018; International Breastfeeding Centre, 2017). Make sure you apply all-purpose nipple ointment after puncturing the blister following each feed; do this for a week to prevent infection (International Breastfeeding Centre, 2017).
Whatever caused your blocked milk duct, it needs relieving as soon as possible or it can lead to mastitis. Mastitis is a common condition that makes your breast tissue painful and inflamed. It’s most common in mums who are breastfeeding during the three months after their baby is born (NHS Choices, 2016b). Symptoms of mastitis include:
A red, swollen area on one breast (usually not both) that can feel hot and painful when you touch it.
A breast lump or a hard area.
Flu-like symptoms like aches, a fever, chills or tiredness.
A burning pain in your breast.
Nipple discharge, either white or with streaks of blood.
(The Breastmilk Its Amazing, 2009; NHS Choices, 2016b; La Leche League, 2016)
For more information on continuing to breastfeed with and treating mastitis, take a look at this article: Mastitis
NCT supports all parents, however they feed their baby. If you have questions, concerns or need support, you can speak to a breastfeeding counsellor by calling our helpline on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk. Breastfeeding counsellors have had extensive training, will listen without judging or criticising and will offer relevant information and suggestions. You can also find more useful articles here.
National Breastfeeding Line (government funded): 0300 100 021.
Best Beginnings - Bump to Breastfeeding DVD Chapter 7 'Overcoming Challenges'.
Healthtalkonline.org: Managing Breastfeeding – dealing with difficult times.