Mastitis or a plugged milk duct?

This post was written by Brook Hartman, BS, RN, IBCLC, birth planner/lactation consultant, Parkview LaGrange Family Birthing Center.

Plugged (or blocked) ducts and mastitis are two very common issues for breastfeeding mothers. Though they can be painful and are issues to take seriously, they are by no means a reason to discontinue breastfeeding or to feel discouraged.

Plugged milk ducts

Plugged ducts are exactly what they sound like; a conglomeration of milk particles that plug (or block or clog) the duct when that portion of the breast doesn’t get emptied completely. They can feel like a small, pea-sized lump, and be somewhat painful. If you find yourself with this issue here are the steps to follow:

  • Apply a warm compress to the area before feeding.
  • Massage the lump toward the nipple during feeding.
  • When feeding, position your baby’s chin toward the blockage; this is where the greatest emptying occurs.
  • Be patient. It might take 2-3 feedings to move the lump out of the breast.
  • If you find the lump is persistent and does not move out of the breast, contact your primary healthcare provider.

Mastitis is caused by an inflammation of tissue, generally due to cracked or sore nipples.  Because there is a break in the skin, it is an area where bacteria can enter and cause infection.  Babies can continue to breastfeed even when the mother has mastitis, as the infection involves the tissue around the milk ducts and not the actual milk ducts.

Mastitis needs to be treated quickly so that it does not spread or lead to other issues. The condition can also occur during periods of high stress, such as when returning to work, during the holiday season or any other time of abnormal stress. 

Symptoms of mastitis can include:

  • High fever that starts suddenly
  • Hot, reddened area on the breast
  • Red streaks up the breast
  • Pain and a lump in the breast tissue
  • Hard, wedge-shaped area
  • Flu-like symptoms
  • Extreme tiredness

Treating the mastitis is very similar to the treatment for the plugged milk duct. You will want to apply the warm compress, massage the area downward toward the nipple, and keep your breasts empty by nursing frequently. Again, there is no need to stop breastfeeding due to mastitis. You will actually want to continue to feed on that side as much or more than normal to keep the milk flowing freely through the ducts to avoid a blockage.

If your breast does not empty after a feeding, you may want to hand express that area or use an electric pump. After feedings, apply ice to the affected area for 10-15 minutes for the first day or two to help reduce the swelling in the tissue. During this time, it is important to rest and drink plenty of fluids. If you feel like you may have mastitis, contact your physician as they might want to prescribe an antibiotic. It is important for your healing and for prevention of future infections to finish the entire course of antibiotics, even if you feel better after a couple days.

After a bout of mastitis, it’s important to consider working with your lactation consultant to troubleshoot any breastfeeding problems. Cracked, sore nipples are generally a sign of poor latch and correcting the latch will help reduce problems in the future. If you are experiencing dry, cracked, bleeding nipples, be sure to let the nipples dry completely after each feeding before putting clothing over the skin. You may also apply expressed breast milk, a topical product such as nipple balm or coconut oil to the nipples to help the healing process. If you notice red, hot streaks on both breasts at the same time, call your healthcare provider right away.


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