Overview

Milk ducts: what is their purpose?

Firstly, let’s begin with what are milk ducts. Milk ducts are thin tubes located inside female breast tissue. These ducts deliver milk from your mammary glands (milk-making glands) to your nipples ready for your baby to feed from.

If one of your mammary glands has not been drained properly when you are feeding your baby this can cause one of your milk ducts to become blocked. Blocked milk ducts can result in you feeling a sore lump on your breast.

Why is it important to address the issue of blocked milk ducts? 

If a blocked milk duct is not treated this can result in your breast becoming inflamed, which is known as mastitis. Mastitis occurs when your milk ducts become swollen (engorged) with milk, possibly due to a blocked milk duct. Milk that has not drained from your milk duct starts to stagnate and bacteria start to reproduce and multiply here, causing infection. The prevalence of mastitis is quite variable in breastfeeding individuals, with the condition reported to occur in 2 to 30%.¹

If you have a blocked milk duct and/or mastitis it is important that you continue breastfeeding your baby with the breast that feels tender and has the blocked duct. If you do not continue breastfeeding your baby you may develop a breast abscess which may require an operation to drain it. Therefore it is important to address the issue of a blocked milk duct as soon as possible, before the condition worsens.

(NHS)

Causes of Blocked Milk Ducts

Infrequently breastfeeding or pumping

Excess breast milk in your breast can cause blocked milk ducts. The causes of having too much milk in your breast are listed below:

• Delaying feeds with your baby
• Your baby is missing feeds
• You are weaning your baby off breastfeeding
• Infrequently pumping breast milk from your breast

The excess of breast milk in your breast can irritate your milk ducts causing inflammation. When your milk ducts are inflamed this can result in the milk ducts becoming narrower, resulting in milk not being able to drain properly from the breast, and blocked milk ducts. (NCT)

Putting pressure on your breast

If you are putting too much weight or pressure on your breast this may irritate your breast tissue, resulting in a blocked milk duct. You may be asking: what can cause this irritation? This irritation can be caused by the following:

• Wearing a bra that is too tight or tight clothing over your breast
• A bag strap over your breast, baby carrier or seat belt may put too much pressure on your breast tissue, thus irritating the breast
• Sleeping in a position where you are putting too much weight on your breast may also cause this irritation

(NCT)

Poor latch

If your baby has not latched onto your breast properly this can result in a blocked milk duct. A baby that is tired or tongue-tied may not latch onto your nipple properly. (Mayo Clinic)

You may be asking how can I tell if my baby has a good latch on my nipple whilst feeding? Listed below are some of the signs of a good latch:

• Your baby’s chin is touching your breast
• Your baby has their mouth wide open and full with breast
• Your baby’s nose isn’t squashed up against your breast whilst feeding
• You can see more of the dark skin that surrounds your nipple above the baby’s top lip than their lower lip whilst they are feeding
• It is not painful in your breasts and nipples when your baby is breastfeeding

(NHS)

Feeling stressed and fatigued

As a mother, feeling stressed, fatigued or having a weakened immune system may result in you having a blocked milk duct. (Mayo Clinic)

Symptoms

What are the symptoms of a blocked milk duct? The symptoms of having a blocked milk duct are listed as follows: ²

• A small and tender lump on the breast
• Painful and tender breast
• A small white blister on the surface of your nipple
• Your breast milk may have strings of milk that are hardened/fatty-looking
• Part of your breast becomes red and hard

Prevention

Regular feeding or pumping

Ensuring that you are regularly breastfeeding or pumping can prevent blocked milk ducts.

How often is ‘regular’ you may be asking? Well, it is recommended to breastfeed/pump 8-12 times a day. This should help prevent blocked milk ducts. (CHOP)

Ensuring proper latch technique

Ensure you are positioning your baby correctly whilst feeding so that they can latch onto your nipple properly. When you are breastfeeding your baby you may want to change positions so that all parts of your breast can be drained of breast milk. If you are struggling with getting your baby to latch onto your nipple properly when feeding, you can seek help and guidance from a lactation consultant or another healthcare provider. If you struggle with getting your baby to latch onto your nipple properly, please seek help before quitting breastfeeding, as quitting breastfeeding can cause engorgement, where your breast is too full of milk. Engorgement can increase your risk of developing a blocked milk duct, therefore this is something to be wary of.³

Wearing supportive, non-restrictive clothing

In order to prevent yourself from getting a blocked milk duct ensure that you wear clothing that is not too tight, and avoid wearing ill-fitting bras.

Managing stress and prioritising self-care

Ensure you are making time for yourself. Avoid over-exerting yourself, and becoming exhausted and fatigued. (CHOP)

Treatment options

Home remedies

Warm compresses

Using a warm compress over your breast can help to encourage more milk to flow through the milk duct to the nipple. (NHS)

Massage techniques

You can try gently massaging the area above the lump in your breast, then move towards massaging the lump in your breast towards your nipple, whilst you are breastfeeding your baby. Avoid excessively massaging the affected area as this can exacerbate the problem. (NHS, John Hopkins Medicine)

Frequent nursing or pumping

When breastfeeding or pumping, try to feed your baby frequently from the affected breast to relieve the blockage in your milk duct. (NHS)

Medical interventions

Consult a lactation consultant

A lactation consultant can help you to ensure that the baby is latching on properly to your nipple when you are breastfeeding, as a blocked milk duct may be recurrent if your baby is not latching onto your nipple properly. A lactation consultant can also advise you on how to change positions when breastfeeding so that all of your breast is drained of milk, to prevent a blocked milk duct from occurring.³

Possible use of anti-inflammatory medications

It is safe to use certain anti-inflammatory medications when you are breastfeeding your baby. For example, you can use paracetamol or ibuprofen, however, if you are taking other medications you should consult with your local pharmacist before taking these medications. Please be informed however that you should only take low-dose aspirin whilst you are breastfeeding, and only if your doctor has advised you too as a treatment option. Small amounts of the aspirin you ingest can pass to your baby via your breast milk, however, it is unlikely to cause any side effects. (NCT, NHS)

In severe cases, drainage procedures

If a blocked duct is left untreated via both home remedies and/or medical interventions this can result in mastitis. However, if mastitis is left untreated this can lead to you having a breast abscess, which will require you to have an operation to drain the abscess. (NHS)

When to seek medical attention

You should seek medical attention when:

• The lump on your breast does not go away after a few days
• You start to feel ill with a fever and/or chills (this can indicate that you have an infection, such as mastitis)
• The area around the lump on your breast starts to look red (this can be a symptom of mastitis, and can indicate that you have an infection)

(John Hopkins Medicine, NHS)

Summary

• A blocked milk duct is when one of the mammary glands (that produce milk) in your breast is not drained properly during a breastfeeding session with your baby, which can cause a blocked duct
• A blocked duct can feel like a small lump on your breast
• An untreated blocked duct can lead to mastitis and possibly a breast abscess
• A blocked duct can be treated using home remedies such as using a warm flannel on your breast, continuing to breastfeed from the affected breast frequently, and gently massaging the lump on your breast towards your nipple when you are feeding your baby
• You may seek out a lactation consultant if you have a blocked milk duct, who can advise you on how to spot that your baby has latched onto your breast properly during a feed, to prevent a blocked milk duct.
• It is also important that you do not wear tight clothing over your breasts or ill-fitting bras as this can cause a blocked milk duct
• Ensuring that you are getting enough rest and are prioritising your well-being is also another way of preventing a blocked milk duct
• You should seek medical attention if after home remedies the lump on your breast remains for a few days, you start to feel ill with a fever and/or chills and the area around the lump on your breast is red