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Lactation Woes: Plugged Ducts and Mastitis


Try as we may, plugged ducts and Mastitis seem like a rite of passage for every nursing mother at some point. These conditions are never welcome and far from fun. If you know the pain and discomfort of having a plugged duct, then you understand the importance of addressing the issue right away to prevent it from progressing into something worse. Those plugs can quickly turn into Mastitis, a breast infection, and have a dramatic effect on your milk supply.

Never experienced a plugged duct? Count yourself blessed. Experiencing plugged ducts or mastitis over and over again? Absolutely frustrating! So what do you need to know to help combat these lactation woes?

Know what causes them

Plugged ducts and mastitis are often the result of not emptying your breasts completely or frequently enough. When milk is not removed from the breast, it flows back to the ducts and accumulates often leading to engorgement, when your breasts become overfull. Engorgement can lead to plugged ducts and ultimately mastitis.

Plugged ducts can also occur if there is consistent pressure on specific areas of your breast. Do you wear a bra with an underwire? Sleep in positions that put pressure on the breast? Carry and hold your baby in the same position each and every day? These are the types of pressure that can restrict the flow of milk in your breast and lead to a plug.

Plugged ducts differ from Mastitis. Mastitis is often the result of a bacterial infection. This infection can occur for many reasons:

  • You recently changed or interrupted your regular pumping schedule, causing milk to remain in your ducts and your breasts to become engorged.
  • You experienced a life change such as returning to work, going on a vacation, or dealing with a family crisis. You have little energy and feel stretched thin.
  • You’ve recently had a cracked nipple, making a pathway for bacteria to enter the breast.
  • You had a plugged duct that you didn’t notice or treat – or the plugged duct didn’t respond to treatment (Lauwers & Swisher, 2016).

Know the signs and symptoms

Plugged ducts are typically described as a single, painful lump on the breast. They will rarely have additional symptoms such as swelling or fever.

Mastitis, on the other hand, is best described as a swollen area of the breast that is red, hot and tender to the touch. Mastitis is usually accompanied by Flu-like symptoms and fever (Lauwers & Swisher, 2016).

Know your treatment options

When you suspect that you are experiencing a plugged duct, it’s important to remove it quickly to prevent it from progressing into Mastitis.

You can work out a plug by trying some of the following options:

  • Massage – If you massage and knead the skin in the direction of the plug toward the nipple, it may dislodge and work itself out of the breast.
  • Frequent, regular feedings – Do your best not to miss a feeding or pumping session. When nursing, try to position the baby so that their chin is pointed toward the plugged duct. If you notice that baby is not fully emptying the breast, take extra time to pump or express the remaining milk after your feeding.
  • Moist heat – Jump in the shower and gently massage the skin in the direction of the plug towards the nipple. You may find that this helps to remove the plug.
  • Talk with your physician about the use of Lecithin.

If you’ve tried to resolve the plug and nothing is working, please contact your physician for further guidance and treatment options.

Uh oh – the worst has happened, you have a fever and feel terrible! Is it the flu? No, your breast is inflamed, hot and tender to the touch – you probably have Mastitis. What do can you do to relieve discomfort?

  • Contact your physician, or a breastfeeding medicine specialist, immediately! Only these medical professionals have the expertise needed to provide you with a diagnosis. Because Mastitis is typically caused by an infection, antibiotics will likely be needed to treat it. Those who delay consulting with their doctor or antibiotic treatment are at risk of their milk supply decreasing and ultimately, weaning. If antibiotics are prescribed, make sure to take them all, even if you start to feel better sooner. Your physician may also recommend the use of an anti-inflammatory medication to help with the swelling. Remember, you’re sick – take care to rest so that your body is able to fight off the infection.
  • When consulting with your medical provider, be sure to check with them on whether the following options are right for you:
    • Breastfeeding as often as possible – It is often suggested that moms with mastitis allow the baby to feed from the affected breast first. Since they’re hungry, the stronger sucking will help remove milk from the breast better. Remember to position baby so that their chin is pointed towards the inflamed area. Using massage during your nursing session to help fully drain the breast is also frequently recommended.
    • Using compresses – Warm compresses may be useful in relieving discomfort when applied to the affected area before and during your nursing session. Cold compresses applied to the affected area after your nursing session may also bring relief (Lauwers & Swisher, 2016).

If you’ve sought treatment in a timely manner, you should find relief from your symptoms and find that your supply, though it may have decreased some, can gradually bounce back following recovery.


Lauwers, J. and Swisher, A. (2016). Counseling the Nursing Mother: A Lactation Consultant’s Guide, Sixth Ed. Burlington, MA: Jones & Bartlett Learning.