Plugged ducts can be painful depending on the size and the location of the plug. Telltale signs include a red, tender area or a small lump in your breast. Plugs form when milk traveling through narrow tubes (milk ducts) becomes trapped. Milk ducts carry milk from the milk-producing cells to the nipple openings. When you delay or miss feedings or your baby breastfeeds poorly, milk can collect in the ducts and form a thick plug or a small lump. Most plugs can be easily removed with gentle massage and continued breastfeeding. If a plug persists, however, milk can collect behind the plug and put pressure on the surrounding breast tissue causing inflammation and increasing the risk of infection (mastitis).
Tips for removing a plug:
- Place a warm compress on the plugged area before each breastfeeding.
- Breastfeed more often during the day, using a variety of breastfeeding positions.
- Begin each feeding on the breast with the plug.
- Using the flat part of your fingers, gently massage the plugged area while your baby breastfeeds. This will soften the plug and make it easier for your baby to remove it while breastfeeding. Don’t worry—milk plugs are safe to drink!
- If necessary, hand express or pump after each feeding to remove the plug and relieve the fullness.
If you are unable to remove the plug or you develop signs of a breast infection—severe pain, red streaks on the breast, flu-like symptoms, fever of 101°F or greater—contact your health care provider right away. Your doctor may prescribe an antibiotic. Be sure to take all the pills in the prescription, even if you feel better after two or three days.
Sometimes a plug forms in a nipple opening. These white dots, or blebs, can be extremely painful and may need to be opened by you health care provider with a sterile needle.
To prevent plugged ducts:
- Position your baby correctly on your breast (view our positioning slideshow here).
- Use 2–3 different breastfeeding positions each day. This will ensure that your baby removes milk from all parts of the breast.
- Avoid bras that are too tight or bind, making it difficult to remove milk from all parts of the breast.
- If you must delay or skip a feeding, hand express or pump to relieve fullness.
- Get adequate rest; exhaustion and stress can increase the risk of plugged ducts.
Mothers with a history of recurrent plugged ducts might want to consider reducing saturated fat and sodium (salt) in their diet. Fluid retention caused by too much sodium can make women more susceptible to any type of infection, including mastitis.
You can also try taking lecithin, a food additive that may prevent plugged ducts by increasing the amount of polyunsaturated fatty acids in breast milk, which in turn makes the milk less sticky. Although there is limited evidence showing lecithin’s effectiveness, it is considered safe. Consult your health care provider or lactation consultant about appropriate dosing.
