Plugged Milk Duct

Plugged Milk Duct

A plugged duct happens when inflammation (or swelling) narrows milk ducts in the breast, reducing the flow of milk. Globs of fat in breast milk can clump together and form a plug that gets stuck in the narrowed duct. This can feel like a small lump, sore knot, or hard area in the breast. You won’t have a fever or feel sick, but sometimes the narrowed duct can get worse and lead to an infection.

A plugged duct may happen:

  • If more milk is produced than your baby needs, your body may respond with inflammation. Swelling from inflammation can put pressure on some of the ducts, which slows or blocks the milk from flowing well.
  • If your breasts are engorged.
  • If your baby skips a feeding or isn’t feeding as often as usual.
  • If your bra or clothing is too tight.
  • If you often have plugged ducts, it may mean your baby or breast pump isn’t removing enough milk, or you're using the same feeding positions too often.

What you can do:

  • Continue to breastfeed or pump at the rate that has been normal for you when you were not experiencing a plugged duct. Pumping or breastfeeding more often can make a plugged duct worse.
  • Use gentle massage for a few minutes before and during feedings to help loosen the plug and promote milk flow. Using your fingers, start behind the plugged area and use gentle circular motions moving toward the nipple. Do not pinch, squeeze, or massage firmly – this can cause more inflammation.
  • Begin feedings on the side where you feel you have a plugged duct first. Your baby’s stronger initial sucking can help loosen the plug and keep milk moving freely.
  • Try different feeding positions. Positioning your baby’s chin or nose toward the plug may help direct suction to that area.
  • Apply ice or cold packs to reduce pain and swelling. Use the cold pack for 10 to 15 minutes at a time, several times a day. Help protect your skin by placing a thin cloth between the ice pack and your breast.
  • Stay well-hydrated with water and rest as much as possible.
  • Wear a well-fitting, supportive bra that doesn’t put pressure on your breasts.
  • Use warm compresses cautiously before feeding, as brief warmth (about 5 to 10 minutes) can encourage milk flow, but avoid heat if your breasts are already inflamed, as this could make swelling worse.
  • Ask your healthcare provider about medicine to help with pain and swelling, like acetaminophen (Tylenol) or ibuprofen (Motrin). A lecithin supplement may help to treat and prevent plugs as well. Ask your doctor about the safest options for you.

If the plug doesn’t resolve or get smaller in size within 24 hours, ask for help from a lactation consultant or healthcare provider. Plugged ducts can sometimes lead to an infection of the breast, called mastitis, which may require medical attention. Learn more about mastitis.

Side-Lying-Hold

Side-Lying Hold

  1. For the right breast, lie on your right side with your baby facing you.
  2. Pull your baby close. Your baby’s mouth should be level with your nipple.
  3. In this position, you can cradle your baby’s back with your left arm and support yourself with your right arm and/or pillows.
  4. Keep loose clothing and bedding away from your baby.
  5. Reverse for the left breast.

This hold is useful when:

  • You had a C-section
  • You want to rest while baby feeds
  • You are breastfeeding in the middle of the night
  • You and your baby are comfortable in this position
cross-cradle-hold-1

Cross-Cradle Hold

  1. For the right breast, use your left arm to hold your baby’s head at your right breast and baby’s body toward your left side. A pillow across your lap can help support your left arm.
  2. Gently place your left hand behind your baby’s ears and neck, with your thumb and index finger behind each ear and your palm between baby’s shoulder blades. Turn your baby’s body toward yours so your tummies are touching.
  3. Hold your breast as if you are squeezing a sandwich. To protect your back, avoid leaning down to your baby. Instead, bring your baby to you.
  4. As your baby’s mouth opens, push gently with your left palm on baby’s head to help them latch on. Make sure you keep your fingers out of the way.
  5. Reverse for the left breast.

This hold is useful when:

  • Your baby is premature
  • Your baby has a weak suck
  • Your baby needs help to stay latched
  • Your baby needs extra head support
  • You and your baby are comfortable in this position
Football-hold

Clutch or “Football” Hold

  1. For the right breast, hold your baby level, facing up, at your right side.
  2. Put your baby’s head near your right nipple and support their back and legs under your right arm.
  3. Hold the base of your baby’s head with your right palm. A pillow underneath your right arm can help support your baby’s weight.
  4. To protect your back, avoid leaning down to your baby. Bring baby to you instead.
  5. Reverse for the left breast.

This hold is useful when:

  • You had a C-section
  • You have large breasts
  • You have flat or inverted nipples
  • You have a strong milk let-down
  • You are breastfeeding twins
  • Your baby likes to feed in an upright position
  • Your baby has reflux
  • You and your baby are comfortable in this position
CRADLE-HOLD​

Cradle Hold

  1. For the right breast, cradle your baby with your right arm. Your baby will be on their left side across your lap, facing you at nipple level.
  2. Your baby’s head will rest on your right forearm with your baby’s back along your inner arm and palm.
  3. Turn your baby’s tummy toward your tummy. Your left hand is free to support your breast, if needed. Pillows can help support your arm and elbow.
  4. To protect your back, avoid leaning down to your baby. Instead, bring your baby to you.
  5. Reverse for the left breast.

This hold is useful when:

  • Your baby needs help latching on
  • You and your baby are comfortable in this position
laid-back

Laid-Back Hold

  1. Lean back on a pillow with your baby’s tummy touching yours and their head at breast level. Some moms find that sitting up nearly straight works well. Others prefer to lean back and lie almost flat.
  2. You can place your baby’s cheek near your breast, or you may want to use one hand to hold your breast near your baby. It’s up to you and what you think feels best.
  3. Your baby will naturally find your nipple, latch, and begin to suckle.

This hold is useful when:

  • Your baby is placed on your chest right after birth
  • You have a strong milk let-down
  • You have large breasts
  • You and your baby are comfortable in this position