Advertisement

Blocked ducts during breastfeeding

Mum sitting on sofa breastfeeding baby
Photo credit: Katie Rain for BabyCenter

What does a milk duct do?

Your ducts are tiny tubes that carry milk from the milk-making glands deep in your breast to your nipple.

The glands in your breasts are divided into segments, like an orange (NHS 2016a). Muscle cells squeeze milk along the ducts, creating a flow of milk to your nipple each time your baby feeds.

Advertisement | page continues below
Blocked ducts caused by breastfeeding problems are most likely to occur in the early weeks, when you're getting used to feeding your baby.

What causes my breast ducts to become blocked?

Although we talk about blocked ducts, it rarely means that there is anything blocking the flow of milk to your baby.

Having a blocked duct usually means that the milk is not moving well in a part of your breast. Then the milk backs up, causing lumpiness and discomfort (NICE 2017). This may happen when:

  • Your baby does not feed from your breast fully. This may be because she's not latched on well, perhaps because your breasts are engorged or she has tongue-tie.
  • Your baby does not feed from your breasts often enough. This may be because you're feeding to a routine, or have dropped a feed.
  • Your milk flow is obstructed. Your milk can become backed up (whether you're feeding or not) if there's sustained pressure on your breasts. This can happen if you're wearing tight clothing, your baby carrier squashes your breasts, or you're holding your breast too near your nipple.
  • You've had a knock or blow to your breast.
    (Bonyata 2018a, NICE 2017)

How will I know if I have a blocked duct?

There are a few symptoms to look out for. You may develop a tender, lumpy patch in your breast. The skin over the tender area may be red.

You may notice a small white blister, about 1mm across, at the end of your nipple. This is called a bleb, and may be caused by a collection of fatty materials from your milk (Bonyata 2018a, b, NICE 2017).

You can remove blebs by rubbing them gently with a clean, warm, damp flannel after you've had a bath or shower. You can also loosen them with a clean fingernail (Bonyata 2018b, NICE 2017). Your baby may even remove the bleb herself while feeding. As long as you deal with these spots, and check for them from time to time, they should be nothing more than a nuisance.

Deeper in your breast, you may develop a harmless milk-filled cyst, called a galactocele. The cyst will appear as a smooth, round swelling. Cysts happen when fatty residues have built up in part of your milk duct. If you press the swelling you get a milky discharge from your nipple (NICE 2017, Pearson-Glaze 2018).

Advertisement | page continues below
A cyst isn't usually painful or tender but may sometimes be uncomfortable. If you're concerned, see your GP, who can refer you for an ultrasound scan of the cyst. The cyst will go when you stop breastfeeding (Pearson-Glaze 2018).

Blocked ducts can also cause an inflammation called mastitis (NHS 2016b, NICE 2017). Mastitis happens when milk backs up and is forced out of the duct into the surrounding tissues (Entwistle 2017, Inch 2014, Pickett 2016). Traces of milk may enter your bloodstream and your immune system responds, making you feel feverish and as if you have flu (Inch 2014, Pickett 2016).

See your doctor if the hard area in your breast becomes hot, red and wedge-shaped or you start to feel feverish. If left untreated, mastitis can become infected and develop into an abscess (Bonyata 2018a, NHS 2016b, NICE 2017).

Will having blocked ducts affect my baby?

Your baby will still get the milk she needs, though the milk flow in your affected breast may be lower than usual. This is normal, and will soon right itself if you feed your baby often, and boost your flow by expressing between feeds (Bonyata 2018a). There's no need to carry on expressing once your symptoms have eased.

If you develop mastitis, your baby may be slightly less keen to feed from your affected breast at first, because mastitis can give your milk a salty taste. She'll soon adjust, though, and the more you feed her, the sooner mastitis will clear (Bonyata 2018a).

What can I do about my blocked ducts?

Keep breastfeeding your baby from your affected breast. This may be uncomfortable, but if you can stick with it, it will help you to get better faster (Bonyata 2018a, NICE 2017). Each time your baby feeds, it helps to move the stuck milk through your breast (Bonyata 2018a, NHS 2016a).

Try to feed your baby every couple of hours (Bonyata 2018a, NHS 2016a, NICE 2017). You may need to wake your baby for a feed, or express in between feeds to keep your milk flowing (Bonyata 2018a, NHS 2016a).

Advertisement | page continues below
You could try "dangle feeding" your baby. This is when you feed leaning over your baby, so that gravity helps to dislodge your milk blockage (Bonyata 2018a).

Whatever breastfeeding position you use, make sure that your baby gets a big mouthful of breast at each feed (Bonyata 2018a, Inch 2014, NHS 2016a), so she can take plenty of milk.

A breastfeeding specialist will be able to help your baby to latch on properly. Your midwife, doctor or health visitor should be able to put you in touch with a specialist.

You could also go along to a baby café. These are drop-in centres for breastfeeding mums. Search online for your nearest baby café, or ask your health visitor about your local breastfeeding support options.
VIDEO

How can I ease the pain of blocked ducts?

If let-down is really painful in your affected breast, switch to it after your baby has started feeding from your other breast. Let-down happens in both breasts at the same time (Bonyata 2018a).

If it's still too painful, or your baby isn't moving enough milk from your affected breast, try expressing (Bonyata 2018a, Inch 2014, NHS 2016a). Use the pump as often as you need to relieve your discomfort.

Advertisement | page continues below
There are other, helpful steps you can try to ease your symptoms:

  • Put a warm compress or flannel on your breast, or have a warm bath or shower to help the milk to flow. Fill a basin or bowl with hot water and lean over it, soaking your breasts in the comforting warmth while massaging the blocked area towards your nipple (Berens 2016, Bonyata 2018a, NHS 2016a).
  • When you're having a hot shower, use a wide-toothed comb on your breast to disperse the plug. Lather the comb thoroughly with soap suds until it's very slippery. Then massage over the affected area towards your nipple (Bonyata 2018a).
  • Gently massage the lumpy area with the flat of your hand during feeds, pressing in the direction of your nipple (Bonyata 2018a, NHS 2016a).
  • Between feeds you could use cold compresses to soothe pain and swelling (Bonyata 2018a).
  • Vary your feeding positions, for example, feeding your baby under your arm with her body to the side of you, instead of across your body. It may also help your baby to latch on better. Try to get a midwife or breastfeeding counsellor to help you with positioning (Inch 2014, NICE 2017).
  • Take paracetamol or ibuprofen for the shortest time at the recommended dose (Bonyata 2018a, NHS 2016a).
  • Avoid tight clothes or a tight, or under-wired bra, so your milk can flow freely from all parts of your breast (Bonyata 2018a, NHS 2016a).
  • Get plenty of rest, if you can (Bonyata 2018a, NHS 2016a).
  • Drink plenty and eat healthily, to make sure you're well-hydrated and your immune system is as strong as it can be (Bonyata 2018a, NHS 2016a).

Get tips from other mums who express breastmilkOpens a new window in our friendly and supportive community.
Track your pregnancy on our free #1 pregnancy & baby app
phone with BabyCentre app

BabyCentre's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organisations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies.


Berens PD. 2016. Breast pain, engorgement, nipple pain, and mastitis. Clin Obstet Gynecol 58(4):902-14

Bonyata K. 2018a. Plugged ducts and mastitis. Kellymom. kellymom.comOpens a new window [Accessed September 2018]

Bonyata K. 2018b. What is a milk blister? Kellymom. kellymom.comOpens a new window [Accessed September 2018]

Entwhistle F. 2017. Infant feeding and relationship building. In: McDonald S, Johnson G. eds. Mayes’ midwifery. 15th ed. London: Elsevier, 757-88

Inch S. 2014. Infant feeding. In: Marshall JE, Raynor MD. eds. Myles textbook for midwives. 16th ed. Edinburgh: Churchill Livingstone, 703-36

NHS. 2016a. Breast pain and breastfeeding. NHS Choices, Health A-Z, Pregnancy and baby. www.nhs.ukOpens a new window [Accessed October 2018]

NHS. 2016b. Mastitis: causes. NHS Choices, Health A-Z. www.nhs.ukOpens a new window [Accessed October 2018]

NICE. 2017. Breastfeeding problems. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. cks.nice.org.ukOpens a new window [Accessed October 2018]

Pearson-Glaze P. 2018. Breast lumps: What is a galactocele? Breastfeeding Support. [Accessed September 2018]

Pickett E. 2016. You’ve got it in you: a positive guide to breastfeeding. Kibworth Beauchamp: Matador

Chess Thomas

Chess Thomas is a freelance health writer and former research editor at BabyCentre.

Advertisement