Managing Blocked Milk Ducts and Treating Mastitis

Here's how to prevent and treat plugged ducts, mastitis, and nipple blebs, so you can comfortably and confidently continue your breastfeeding journey.

Along with all the amazing benefits that breastfeeding provides, it can also come with some challenges. Three common concerns for nursing and pumping moms are sore, painful conditions on the breast called plugged (or blocked) milk ducts, milk blisters (or blebs), and mastitis. It’s important to understand the difference between these three conditions, and to know how to prevent a blocked milk duct, a nipple bleb, or mastitis from occurring. Understanding what causes these conditions and how to treat them can help your breastfeeding journey be as easy, and painless, as possible.

About Clogged Milk Ducts

If any milk duct in the breast is not drained well, the area becomes ‘clogged’ up (or blocked) and milk is prevented from flowing. This will feel like a firm, sore lump in the breast, and may be reddened and warm to the touch. Blocked milk ducts are common in breastfeeding moms, and can be caused by anything from missing feedings to wearing a bra that is too tight.

To prevent blocked ducts, it’s important for you to nurse your baby often and not miss feedings, or replace feedings by pumping.

Tips for Unclogging a Milk Duct

If you do end up with a blocked milk duct, here are some tips to relieve it:

  • Prior to nursing or pumping, use a warm, moist compress on the plugged area for several minutes, then massage the area to break up the blockage. 
  • Begin your nursing or pumping (if single pumping) on the affected side until the blockage is broken up.
  • Firmly massage the affected area toward the nipple during nursing or pumping, and alternate with compression around the edges of the blockage to break it up.
  • Try a warm soak in the bath or shower along with massaging the plugged duct while soaking.

If the issue persists, check with a healthcare provider for additional treatment options.

About Nipple Blebs

Also known as milk blisters, this is a congealed milk bubble that has blocked one of your milk ducts and prevents it from draining. This occurs when a very small section of skin grows over a milk duct opening, or a nipple pore, and then breast milk becomes trapped behind it. Nipple blebs can usually be identified as a tiny dot on top of the nipple that resembles a plug. This spot is usually very painful, may cause discomfort while breastfeeding, and even inflammation or irritation of the surrounding skin. 

It is important to note that nipple blebs are different than a blister that may occur due to friction - often because of an improper latch or using the wrong size breast shield - as these happen because of damage due to friction, rather than a blockage. 

If you suspect you have a nipple bleb, the best way to treat it is by removing it. The thickened milk that is the bleb will not be harmful to your baby and nursing may even help soften the bleb. You can also try applying moist heat to the affected area - such as by taking a warm bath or soaking the bleb with a warm compress to help soften it. Hand expression using your fingers near the nipple, grasping the tip of the plug, and then gently "working" it out can also sometimes help remove the bleb. When doing this, you may see a strand of hardened milk come out of the duct. If the nipple bleb doesn't resolve within a day or two of trying to remove it yourself, speak with your healthcare provider or a lactation consultant. 

Finally, remember to empty your breasts frequently by nursing, pumping, or both. Also be sure to avoid clothing, such as sports bras or bras with underwire, that may put extended pressure on your breasts!

About Mastitis

Mastitis is another name for a breast infection. It will usually appear as a painful, hard, wedge-shaped red area on the breast, accompanied by fever and flu-like symptoms. Mastitis isn’t as common as a blocked milk duct, but up to a fifth of breastfeeding moms may experience it at some point.

Mastitis is most common in the first few weeks postpartum, and often follows engorgement, but it can happen at any time. Being overtired, smoking, and having cracked nipples can put you at higher risk for mastitis. When skin is broken, germs from the environment, your skin, or your baby’s mouth can penetrate the breast, leading to the bacterial infection in your breast tissue.

If you have symptoms of mastitis, seek medical treatment immediately. Symptoms to pay careful attention to include:

  • Intense, localized pain in a specific area of the breast.
  • Fever over 101 degrees Fahrenheit.
  • Flu-like symptoms.
  • The presence of a reddened (often wedge-shaped) area on the breast.

In addition to mastitis treatment from a healthcare professional, experts recommend that you “heat, rest, and empty breast”:

  • Use a warm compress before nursing or pumping.
  • Get extra rest and sleep to help the healing process.
  • Continue pumping or breastfeeding. Emptying the breast reduces inflammation, and stopping milk expression could lead to complications like a breast abscess.

Breastfeeding isn’t always easy, but nothing that incredible ever is. As a mom, you will choose to make sacrifices every day for the better of your child and family. And while you can’t predict every challenge you will face, being prepared with what to expect and how to react is the first step in getting through any tough situation. Remember, if you are ever in need of personalized breastfeeding advice, you can reach out to our on-staff Lactation Consultant or sign up for a 24/7 LC membership on your MyMedela app for around-the-clock lactation support. We’re here to help!