We all know the many benefits of breastfeeding for us and our babies. If we all know how healthy breastfeeding is, why is it that 80% of moms start nursing right after birth, and by 3 months, only half are still nursing? Because breastfeeding challenges are real. They keep you up at night, and they hurt! Issues like breast engorgement, poor latch, tongue tie, sore nipples, low milk supply, problems with infant weight gain, clogged milk ducts, and mastitis are painful. They can be incredibly discouraging, especially if the mother does not have a reliable support system to help her through difficult times.
Today's post is about how to treat clogged milk ducts and prevent mastitis. I'll give you practical midwifery tips that encourage and support you to continue to breastfeed your baby.
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First Days of Breastfeeding
The first few weeks postpartum require a steep learning curve when it comes to learning how to nurse your baby. The first few days after birth, you have colostrum that is more like medicine than like food. It comes out in thick yellow drops. But when your milk comes in, your breast will most likely feel very full, heavy, and engorged! When you nurse, you can hear your baby sucking and swallowing. Your milk just flows out. You might even leak milk. This is a very satisfying feeling.
In the early days of breastfeeding, you have to navigate engorgement, figure out how to get a good latch and care for sore nipples. So, this is the most common time to get a clogged milk duct.
Clogged milk ducts can happen at other times too- We'll get into that later.
Your breast is filled with mammary tissue and glands that produce milk. The milk travels tubes or vessels to the nipple. These tubes are called milk ducts. These milk ducts clog easily. If the milk gets trapped and does not leave the breast, the ducts fill up and swell, causing a hard, red, hot, and painful lump in your breast.
Clogged Milk Duct vs. Mastitis
When the milk gets trapped in the duct, that is called a clogged milk duct. If the milk is not evacuated via nursing, hand expressing or pumping bacteria can grow in the stagnant milk and become a breast infection called mastitis.
Clogged milk ducts proceed mastitis, so all the tips I'm about to share with you will also address and hopefully prevent a mastitis infection. Mastitis feels like a clogged duct does, but way worse. It is like having the flu! Your breasts are hot, red, swollen, and now you have a fever, body aches, chills, and your milk might have pus or blood in it. Did I mention that it hurts?
Photo Credit lansinoh.co.uk/engorgement
Two things are critical to say here:
- Your milk duct is infected, not your milk! Please keep nursing or pumping!
- If you get these symptoms, you need to see your midwife or doctor. This video does not replace midwifery care! Yes, there are natural home remedies to treat mastitis, but your care provider needs to know how sick you are so they can help you. Please don't go through this alone.
The 3 Most Common Causes of a Clogged Milk Duct
1 The most common cause is engorgement. Engorgement happens when your milk supply is getting established. In the early days of nursing, your body makes extra milk to ensure your baby's best chance of survival.
Engorgement also happens when your baby misses a feeding session. Babies need to nurse every 2-3 hours during a 24 hour period with one longer sleeping session of 4-6 hours in that period until they are back to their birth weight. So when your baby sleeps through the night for the first time, as wonderful as it sounds, you might wake up to engorgement and clogged ducts the next morning.
2 The baby has a poor latch. Latching the baby when your breasts are engorged is a challenge in and of itself. Because during the first few days of learning to nurse, your breasts were soft. Now that your milk is coming in, they feel tender, and they are firm and full. This makes it hard for the baby to latch onto and effectively pull the milk out.
A poor latch can also be from not having the baby in a good nursing position. Or from nursing in the same position all the time. And it could also happen if the baby has a lip or tongue tie. See our blog about tongue-tie.
For pumping moms, it might be that they are not using the right size flange. Briefly, if the areola is being sucked into the flange, then it is too big. If the nipple is rubbing on the edges of the flange, it is too small. Either way, it causes nipple pain, and it ineffectively clears the breast leading to clogged ducts and potentially mastitis. See our post about sore nipples.
3- Your breasts are restricted! Avoid wearing tight bras and underwire bras. Getting a good nursing bra or tank top will be supportive and more comfortable for you without restricting milk flow.
You can accidentally restrict the flow of milk if you are holding your breast too tightly as you nurse, or are pressing the pump up against your breast too forcefully.
Another "restriction" might happen if you sleep on your breast or stomach. I've helped several moms who slept on their stomachs because they couldn't for so long because of being pregnant, only to awaken and realize now they can't sleep that way because of their full breasts.
Symptoms of a Clogged Milk Duct
You will notice hard red lumps that feel warm and tender on your breasts, near your armpit and lymph nodes, that do not go away after nursing.
Symptoms of Mastitis
The symptoms of mastitis are the same as a clogged milk duct now add fatigue, fever, body aches, chills, and your milk may have pus or blood in it. The milk is not ruined or bad. However, it may taste salty, and your baby might refuse the breast if that's the case pump or hand express instead.
Mastitis must be treated! If you've gone over 24 hours of home treatment and are still feeling feverish without any improvement, please contact your midwife or doctor.
Do some of these things, or do all of these things, but no matter what you do, don't stop nursing!How to Treat Clogged Milk Ducts and Prevent Mastitis My mentor used to say, "Heat, rest, and empty the breast!" Now that is some sound advice. If you feel yourself getting a milk clogged duct, take care of it right away! Because if you don't, you will be forced to lay down if you get the full-on flu-like mastitis infection
- 1- Wet Heat Examples of wet heat are showers, compresses, and baths. Moist heat works better than dry heat at moving the clogged milk. Alternating hot and cold is another effective way to loosen the clog. The heat expands the breast tissues, and the cold contracts the muscles. This expansion and contraction of the tissues creates movement, improves circulation, and prevents infection.
- Hot showers-Angle the hot water directly on the lump while you're in the shower massage your breast.
- Baths- Baths are great because you can lay on your side and get your whole breast in the water. If you are taking a postpartum herb bath, your newborn baby can get in too and nurse while you massage and rest.
- Hot compresses can be simple with warm water on a washcloth. I used to tell my clients to pull out their crockpot, fill it with fresh water, clean washcloths, and add :
Ginger Root- The warmth and stimulation of ginger can help encourage the movement of lymph and milk.
Postpartum Herb Bath- The antiseptic qualities of the herbs help prevent infection from setting in. Plus, the drawing or pulling action of plantain helps dislodge the clog.
Other types of compresses worth mentioning are:
- Castor Oil Compresses can pull or draw the clog out. Just be mindful not to get any of it on your nipple and clean it off really thoroughly before nursing.
- Grated Raw White Potato Compresses are cool and relieve the hot inflammation. Potatoes are astringent and good at pulling and drawing things out. It's a little messy, but it feels and works really well. Potatoes make great compresses for bee stings and bug bites too!
2- Breast Massage You can massage yourself while in the shower, bath, or with a compress to enhance its effectiveness. Or use coconut oil when you are dry. You have to gently but firmly massage the clog so you can empty your breast. You want to make circular motions from the outside edge of your breast toward the nipple. Follow the path the milk travels. I have a short breastfeeding massage and stretching video for you. The link is in the description.
3- Change Nursing Positions We learn how to nurse in stages. We master one position before we learn the next one. However, if you only nurse in one position, you are not emptying the breast effectively. The baby has such a strong sucking ability, but if he only nurses in one position, he is only pulling milk from one angle. You have to get creative and nurse in every possible position that angles the babies chin toward the clog.
Utilizing gravity is very helpful! Try to dangle nurse. If you ever had to sit in the back seat and lean over the car seat and nurse your baby while your partner drives, then you already know what dangle nursing is. A more comfortable way to dangle nurse is to lay the baby down on the floor or bed and get on your hands and knees over the baby and nurse that way.
I have one quick tip for exclusively pumping moms that I want to give. After your pumping session, hand express both breasts because you might still have some residual milk in the ducts that can get clogged.
4- Rest and Nourish! Rest like you have the flu! Drink at least a gallon of water and lots of immune-boosting herbal teas, eat chicken noodle soup or bone broth with plenty of fresh garlic, eat fermented foods like yogurt, kefir or pickles, crawl in bed, get skin to skin and nurse your baby!
Supplements and Herbs
- Sunflower lecithin helps thin out your breastmilk so it can flow better. It is also an excellent supplement for brain health for you and your baby. So if you are prone to clogged ducts or mastitis, then consider adding this to your daily routine. Just take one capsule with your meals.
- Probiotics promote healthy gut flora and support our micro-biome. When our gut is healthy, so is the rest of our bodies. Research has shown that the strains of Lactobacillus fermentum and Salivarius are more effective treatments for mastitis than traditional antibiotics. Plus, they maintain and improve gut health, whereas antibiotics destroy gut flora taking six months or more to repair.
- Vitamin C Supports a healthy immune system.
- Antimicrobial Herbs such as Garlic, Echinacea, Elderberry, Thyme, and Oregon Grape Root are great infection fighters and immune boosters that are safe for breastfeeding moms. If you have our Elderberry Complex Tincture or our Children's Immune Boost tincture, then you have a remedy for your clogged milk duct and your whole family's immune health!
One last thing I should say, your breasts should feel better after these treatments. However, you might feel sore or bruised because you stimulated and massaged your tender tissues. You have to notice the signs your body is giving you to determine if this tenderness is a part of your recovery process or a continuation of your infection.
Well, beautiful, I hope this video helps you get relief and prevents this from happening again. Know that you are doing all the right things! Challenges in breastfeeding are normal and to be expected as a part of the process. You got this! I know you can do it!