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All night feeding sessions, engorgement, breast pumps, leaking, and more. You probably thought you’d heard it all when it comes to the joys of breastfeeding your baby. (Yes, there really are some amazing and sweet moments, too!)

And then you feel a hard, painful lump. What’s this? It may be a clogged milk duct. But don’t freak out just yet — you can actually typically clear the clog at home and get back to your normal routine fast.

Of course, it’s always possible that the lump might be progressing into something more serious, like mastitis. Let’s take a look at what you need to keep an eye out for when it comes to a clogged milk duct and when you should see your doctor.

Clogged or plugged milk ducts happen when a milk duct in your breast gets blocked or otherwise has poor drainage. You might experience one if your breast isn’t completely emptied after a feed, if your baby skips a feed, or if you’re under stress — which a lot of new moms are, if we’re honest.

Symptoms can come on slowly and generally affect just one breast. You may experience:

  • a lump in one area of your breast
  • engorgement around the lump
  • pain or swelling near the lump
  • discomfort that subsides after feeding/pumping
  • pain during letdown
  • milk plug/blister (bleb) at the opening of your nipple
  • movement of the lump over time

It’s also common to see a temporary decrease in your supply when you have a clog. You may even see thickened or fatty milk when you express — it may look like strings or grains.

Related: How to increase milk supply when pumping

Here’s the real bummer: If you do nothing, the clog isn’t likely to fix itself. Instead, it may progress into an infection called mastitis. Take note that fever is not a symptom you’ll experience with a clogged milk duct. If you have pain and other symptoms accompanied by fever, you may have an infection.

Symptoms of mastitis may come on suddenly and include:

  • fever of 101°F (38.3°C) or higher
  • flu-like symptoms (chills and body aches)
  • warmth, swelling, and tenderness of the whole breast
  • breast lump or thickened breast tissue
  • burning sensation and/or discomfort while nursing/pumping
  • redness on the affected skin (may be wedge-shaped)

Mastitis affects up to 1 out of 10 breastfeeding women, so you’re far from alone. If you’ve had it before, you’re more likely to get it again. Untreated mastitis may lead to a collection of pus — an abscess — that requires surgical drainage.

Again, the root cause of plugged milk ducts is usually something that prevents the breast from draining fully. This may be anything from pressure on your breast from a too-tight sports bra or feedings that are too infrequent.

Clogged ducts and mastitis may even be caused by the way you feed your baby. For example, if your baby likes one breast over another, it may lead to clogs in the less frequently used breast. Latching issues and sucking problems are other situations that may promote a backup of milk.

There are also certain risk factors that may make you more likely to develop plugged ducts and mastitis:

  • history of mastitis while nursing
  • cracked skin on the nipples
  • inadequate diet
  • smoking
  • stress and fatigue

Related: What to eat while breastfeeding

What if you’re not breastfeeding?

Much of the information you’ll find about clogged ducts and mastitis revolve around breastfeeding women. But you can occasionally get these conditions — or similar ones — even if you aren’t nursing a baby.

  • Periductal mastitis is mastitis that occurs without lactation. This condition is rare and generally affects women during their reproductive years. Symptoms are similar to lactation mastitis and may be caused by things like smoking, bacterial infection, broken skin on the nipple, and mammary fistulas.
  • Mammary duct ectasia is a condition that primarily affects women between the ages of 45 to 55. A milk duct widens, thickening the duct walls and filling them with fluid that can become thick and sticky. Eventually, this may lead to discharge, pain and tenderness, and periductal mastitis.
  • Mastitis can also affect men in very rare cases. For example, granulomatous mastitis is a chronic form of mastitis that affects both men and women. Its symptoms are similar to those of breast cancer and include a firm mass (abscess) in the breast and swelling.

Stop, drop, and roll. No, really. At the first sign of a clogged duct, you can start working on the issue.

One of the most effective treatments is massage, particularly while you’re feeding or pumping. To massage, start at the outside of the breast and apply pressure with your fingers as you move toward the plug. It may also help to massage while you’re in the shower or bath.

Other tips to clear a clog:

  • Continue breastfeeding. The idea is to continue draining the breast frequently.
  • Start feeds with the affected breast to ensure it gets the most attention. Babies tend to suck the hardest on the first breast they’re offered (because they’re hungrier).
  • Consider soaking your breast in a bowl of warm water and then massaging the clog.
  • Try changing the positions you use to breastfeed. Sometimes moving around allows your baby’s suction during feeding to better reach the clog.

If you develop mastitis, chances are that you’ll need antibiotics to treat the infection.

  • Medications may be given for a 10-day period. Be sure to take all medication as directed to guard against recurrence of the mastitis. Check in with your doctor if symptoms continue after you finish your meds.
  • Over-the-counter pain relievers can also help with discomfort and inflammation of the breast tissue. Your doctor may suggest you take Tylenol (acetaminophen) or Advil/Motrin (ibuprofen).

Redness or the feeling of bruising on the breast may last a week or slightly longer after you’ve cleared the clog or treated mastitis. Still, if you have concerns or feel your clog or infection just isn’t healing, make an appointment to see your doctor. In some cases, you may need another course of antibiotics or additional help, like drainage of an abscess.

If symptoms are ongoing, your doctor may suggest a mammogram, ultrasound, or biopsy to rule out inflammatory breast cancer. This rare form of cancer can sometimes cause similar symptoms to mastitis, like swelling and redness.

Since clogged ducts are generally caused by a backup in milk, you’ll want to make sure you’re feeding your baby or pumping often. Experts recommend 8 to 12 times a day, especially in the early days of breastfeeding.

You may also try:

  • massaging your breast during feeding/pumping sessions to promote drainage
  • skipping tight clothes or bras to give your breasts some room to breathe (loungewear is the best, anyway!)
  • loosening tight baby carrier straps (same idea, but obviously make sure baby is safe)
  • varying breastfeeding positions from time to time to ensure suction is hitting all ducts
  • applying a warm/moist compress before feeding to areas of the breast that tend to clog
  • applying a cool compress to breasts after feeding sessions
  • asking your doctor about lecithin supplements (some women say they help with recurring issues)

Cracked nipples and milk duct openings may provide an easy entryway for bacteria from your skin or baby’s mouth to enter your breast, leading to mastitis. So, be sure to keep your breasts clean and dry, and try using something like lanolin cream to protect cracked nipples.

And while it may seem impossible — especially if you have a newborn — take care of yourself as much as possible.

Ask for help, sneak in some naps, or go to bed early — even if you know you’ll be up feeding a few hours later. In general, do all the self-care things that help you avoid feeling run-down.

Purchase lecithin supplements and lanolin cream online.

Clogged milk ducts can be uncomfortable and annoying to deal with — but keep at it. Usually, you should be able to clear the plug at home without developing infection or needing other intervention.

If the clog persists despite your efforts for longer than 2 days — or you find you’re experiencing frequent issues — consider making an appointment with a lactation consultant (breastfeeding specialist) or your doctor. You may be able to change some things in your feeding routine to help with better drainage of your breasts.

If you do develop mastitis, your doctor can help by prescribing medication and giving you other suggestions to avoid future infections. And since mastitis may recur, be sure to head to the doctor as soon as you suspect you might have an infection so you can treat it promptly.