Lorna C. Aliperti, APRN, IBCLC
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Home » Lactation Information » Plugged Ducts

Plugged Ducts

Plugged ducts are caused by inadequate removal of milk. They often occur if mom has a really high milk supply or when nursing gets off to a slow start, but there can also be a number of other contributing factors, such as missed feedings, rapid weaning or a pump with an ill-fitting breast shield. Not only do they lower milk supply, but they can also lead to mastitis, since the residual milk is a breeding ground for bacteria. Nipple damage can make this more likely.

Symptoms

  • Sore, hard lumps or a swollen area in the breast which remains after the breast has been pumped or the baby has nursed.
  • Decreased milk supply.
  • Plugged ducts may also be accompanied by a “bleb”, which is a white spot on the nipple—either a spot of dried milk or a milk filled blister, which covers the nipple pore.

Milk which hasn’t been removed becomes more thick and “sticky” so it is difficult to remove by pumping or nursing. It is usually necessary to compress the breast behind the hardened areas to drain the milk.

Treatment

  • Heat—Warmth and wetness help to induce letdown and expand the ducts, allowing easier expression of milk. A heating pad before nursing can be helpful.
  • Pressure—with counter pressure– from behind the hard areas or working back from the areola toward the blocked ducts—whichever works. Hold until the milk flows and keep holding until it stops. Move your hands and repeat. It can also be helpful while your baby is nursing to use a technique explained by Dr. Jack Newman called
  • Breast Compression.
  • If your baby is nursing well, increase drainage of blocked areas by pointing baby’s chin toward the plugged area.
  • Ultrasound therapy combined with lymphatic drainage massage techniques is extremely effective in clearing stubborn plugged ducts. Two Fairfield county physical therapy centers provide this service, which is usually covered by insurance. A prescription is necessary.
  • Ibuprofen (Motrin or Advil)—400-600 mg. for inflammation and pain. Acetaminophen (Tylenol) is helpful for pain if ibuprofen is not tolerated.
  • Bleb treatment—warm olive oil compresses applied to the nipple, then using a washcloth or fingernail to loosen the callous of milk that has formed. Antibacterial/antifungal treatment for skin helps reduce the associated skin inflammation.

Prevention and treatment for recurrent plugged ducts

  • Change nursing positions—always using the same position or always using a nursing pillow can encourage drainage of only one area and neglect others.
  • A bra that continuously compresses some ducts is occasionally a problem.
  • Lecithin—1000 mg. three or four times a day can help prevent plugs.
  • Correcting oversupply problems which make it difficult to effectively drain the breast is important.

Henry M. Rascoff, MD, Riverside Pediatrics

There are extremely few specialists to whom I refer patients that I hear 100 percent glowing remarks about. You are at the very top of that short list, and the one and only lactation consultant whose name crosses my lips when a private referral is needed. Thank you so much for the superb care you provide.

Henry M. Rascoff, MD, Riverside Pediatrics

Jonathan Sollinger, M.D., Willows Pediatric

I have frequently referred patients to Lorna and been very pleased with the results. She responds quickly, the moms like her, and she is flexible and knowledgeable in her treatment of both mother and baby.

Jonathan Sollinger, M.D., Willows Pediatric

Abbey Fox

I can’t thank you enough for everything–your encouragement, patience and enthusiasm–without you this would have been over LONG ago. Harrison thanks you as well!

Abbey Fox

Elizabeth Gallo

Lorna is professional, knowledgeable and caring. She saw me and my baby through some of the toughest weeks of breastfeeding. I felt comfortable calling her whenever I needed help and she was always there. Without her expertise and support I highly doubt we would be nursing as happily as we are today. She was an indispensable asset to me.

Elizabeth Gallo

Eliza Miller

Lorna’s help was invaluable in breastfeeding my twins. She helped me through the early days of dealing with tiny, sleepy babies, sore nipples, engorgement, and oversupply, and I found myself calling on her again in later months as I had recurring plugged ducts and milk blebs. Her advice was always practical, easy to follow and yielded immediate postiive results. Today I’m still nursing my fourteen-month-olds–thank you Lorna!

Eliza Miller

Cathy Grammon

The service and products were great. Lorna was especially helpful during that first difficult week. She gave me the moral support I needed to keep going.

Cathy Grammon

Amy Mora

Lorna, you are wonderful. You saved my child from having to go on formula. I was able to continue breastfeeding. (I had yeast and it was horrible!)

Amy Mora

Marlene Ferguson

Lorna was a godsend. Michael was losing weight and no one at the hospital was able to help him to latch on. She got him started breastfeeding and then showed me how to do it myself. He’s now gaining an ounce a day.

Marlene Ferguson

Susan Kunin

Lorna, I sincerely thank you. You made what was a difficult beginning, one of the most wonderful things I have ever done. You are caring, knowledgeable and always there for moral support. I have recommended you to many new moms, and they all have similar success stories. I truly appreciate everything you have done for us.

Susan Kunin

Kathryn Laird

I really appreciate your help, Lorna. Things started turning around after your visit. Although I had already reduced my milk intake, eliminating all remaining dairy had an enormous impact on Avery’s issues, and really solved our colic problems pretty much right off the bat. One thing that was very telling is that about a month later, I had about 24 hours where I decided I’d try milk again, and we had sour cream, cheese and whatnot…We had a miserable 24 hours and I actually threw away three bottles that I had pumped because it was just so bad. I immediately went back on soy milk. Thanks again.

Kathryn Laird