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Engorgement and Plugged Ducts

October 22, 2025 Women
EngorgementEngorgement

Sometimes your breasts may feel full, hard, or painful. This can happen when your milk first comes in, or if milk is not being removed often enough. This is called engorgement. It can also happen later if your baby sleeps longer, skips a feeding, or is not latching well.

woman-breastfeeding_infant_nursing_baby_pain_discomfort

Here are some ways to feel better:​

Tip #1

Breastfeed often

In the first month, try to feed your baby about every 2 hours (10–12 times each day). If you are too uncomfortable to breastfeed or your baby cannot latch on because your breasts are too full, try hand-expressing or using a breast pump to remove some of the milk. Your WIC team can help you with best options.

Tip #2

Warm Comfort Before

Taking a warm shower or placing a warm washcloth on your breasts before nursing may help get your milk flowing.

Tip #3

Cold Comfort After

A cool gel/ice pack can help reduce swelling after feeding. Refrigerated, raw, clean cabbage leaves may also help because of their coolness and how they fit nicely all around your breast.

Tip #4

Reverse-Pressure Softening

Press gently with your fingers around your nipple to move swelling away. (see photo) This may also help your baby latch on better.

Plugged Duct Plugged Duct

A plugged duct happens when milk gets stuck in part of the breast. This may feel like a small, painful lump, usually about the size of a grape.

Mom_Sad_Baby

Here’s what you can do:

Tip #1

Warm Comfort Before Feeding

Use a warm pack (like a warm towel, hot water bottle, or microwave-safe heat pack) before feedings or pumping.

Tip #2

Massage

Gently push on the lump with your fingers toward the nipple. You can do this while your baby is feeding at the breast or while you are pumping. Vibrations from the back side of an electric toothbrush or a massager may also be helpful.

Tip #3

Try Different Positions

Feed your baby in different positions, like dangling the breast over your baby while nursing so gravity can help (see photo).

Tip #4

Wear a Good-Fitting Bra

Make sure your bra fits well and is not too tight. Tight spots can block milk flow. Your WIC counselor may be able to help you with options.

Tip #5

Don’t Ignore Your Pain

Plugged ducts can come and go. Keep a close check on areas of pain in your breasts. If the pain doesn’t go away or keeps coming back, contact your healthcare provider or WIC staff for help.

REFERENCES:

Author: Dr. Maya Bunik, MD, MPH

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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