How to treat blocked ducts

If you’ve ever had a hard, painful lump in your breast while breastfeeding, then this post is for you! The good news is; it’s not breast cancer – it’s just a blocked duct. Blocked ducts are one of those annoying little things that lactating breasts are prone to. This post will give you all the advice you need on how to get rid of them before they turn into something a lot nastier.

What causes blocked ducts?

A blocked duct is usually caused by one of three things:

1. A plug of thickened milk that forms inside one of the ducts. This most often happens because the breast isn’t drained well enough or often enough. So if you go an unusually long stretch between feeds, you may end up with a blocked duct. Women with oversupply often suffer from recurring blocked ducts for the same reason.
2. A bleb. This is a little piece of skin that grows over the opening of a nipple pore, preventing the duct from draining. If you look at the nipple you will see a white spot, almost like a pimple, that no milk comes out of when you squeeze the breast. Usually a plug of thickened milk also forms behind the bleb.
3. Pressure from outside the breast. Ducts can also be blocked by something pressing on them from outside. Poorly fitting bras are a common culprit for this, especially bras that are too small and underwire bras. Breast shells (plastic “cups” that you wear in your bra) can also cause blocked ducts, which is why I don’t recommend them.

All these scenarios have one thing in common: the milk is not draining from one or more of the ducts in the breast. Since the milk glands that drain into that duct are still producing milk, that whole duct and its glands start to swell up like a water balloon. This causes a lump that you can feel when you touch the breast.

Symptoms of a blocked duct

How do you know you have a blocked duct? You’ll have the following symptoms:

• A palpable, usually painful lump in the breast. The lump can be small (the size of a coin) or very large (up to half the breast), depending on where in the breast the blockage is. You can also have multiple lumps in one or both breasts; this is much less common, and usually seen in women with overproduction.
• The lump is usually very painful to touch. It may also be hot and red.
• You may notice a white, pimple-like spot on the nipple – if so, you have a bleb.
• If you develop fever, chills, body aches or other flu-like symptoms, you may be progressing to mastitis.

Treatment for a blocked duct

I’m afraid that the news here is not good: the only way to treat a blocked duct is to drain it – and that can hurt quite a lot. However, if you don’t drain it, it can develop into an abscess, which needs to be drained surgically – and that hurts a heck of a lot more! Here are some tips to help break up that blockage and get things flowing again:

• Breastfeed as much as possible, and feed on the affected breast first, to make sure baby is draining it as well as possible. A baby with a strong suck is still the most effective way to drain a breast! You can try some alternative feeding positions to help the breast drain:
  • Feed baby with his chin pointing to the lump. You may need to get creative here!
  • Lie baby on his back and stand over him on all fours. This “dangle” position means that gravity can help to pull the lump down and out.
    

    “Dangle nursing” to help clear a blocked duct

• Massage the lump to help break up the blockage: simply rub the lump with your thumb in circular movements, using as much pressure as you can stand. You can massage before the feed and also while baby is suckling. Massaging the lump during a feed is especially effective.
• Massage in hot water. This is my number one most effective tip! The hot water does wonders for the pain. Get in a hot-as-you-can-stand bath or shower and do a combination of massaging and hand expressing until that lump is soft and shrunken down. You may actually see the strands of congealed milk coming out in the water – it looks pretty gross, almost like worms, but rest assured that it’s just milk. If you can’t or don’t want to get into a bath, you can also try dangling the breast in a basin of hot water, but that can get rather messy. A hot beanbag on the breast also helps, although it’s not as effective as hot water.
• If you have a vibrator or electric toothbrush (or anything that vibrates, really), you can use it to help break up the blockage. Just switch it on and place it against the duct. The vibration helps to “shake loose” the blockage.
• If you cannot get the duct to unblock with these strategies, consider visiting a physiotherapist. They can do ultrasound treatment to break up the blockage. It is completely painless – just like having a sonar – and very, very effective.

If you notice a bleb on your nipple, you may need to open it up before the duct will drain. To help you remove or pierce the skin that has formed over the nipple, you can try the following:

• After soaking in the bath for 5 minutes, gently wipe over the nipple with a washcloth. Gently – you don’t want to damage the skin on the rest of the nipple!
• Soak a piece of cotton wool in olive oil and put it inside your bra (for the sake of your clothing, put a breast pad and a piece of plastic between the cotton wool and your bra!) Keep it in there for about half an hour – it will help to soften the skin. After that, you can try to feed or express. If the skin hasn’t opened yet, try rubbing gently with a washcloth.
• If the gently methods don’t work, you may need to pierce the skin with a sterile needle. If you want to do this, I recommend you buy a sterile needle at a pharmacy (the kind you use for injections is fine, and they’re very cheap). Just gently pierce the skin and, if possible, remove the little flap of skin with a tweezer. Be sure to put on some antibacterial ointment afterwards to prevent infection (Bactroban ointment is fine)

Prevention

Of course, once you’ve cleared the blocked duct, you don’t want it to happen again! So make sure you implement the following preventative measures:

• Make sure you breastfeed often so that the breasts are drained well.
• Make sure your bras fit well and don’t cut across the breast anywhere. Avoid bras with underwires; rather go for breastfeeding bras or sports bras.
• If you suffer from recurring blocked ducts, you may find it helps to take a daily lecithin supplement, available at your local pharmacy. Lecithin prevents the fat in the milk from clumping together, which helps to prevent blockages.

Important!

Whatever you do, don’t just leave the blocked duct and hope it will clear up on its own. A blocked duct can develop into a breast abscess if you don’t treat it, and an abscess is something that needs to be surgically drained. I know massaging that lump out is super painful, but it has to be done. Be strong!

Have you ever battled with a blocked duct? What treatment methods worked the best for you? Let me know your tips and tricks in the comments below!