POSTPARTUM

The Best Home Remedies For Clogged Milk Ducts (and when to call the doctor)

by: Alejandra Carrasco, M.D. and Christine Maren, D.O.

by: Alejandra Carrasco, M.D. and Christine Maren, D.O.

Physician founders of Hey mami!

It’s a rare mami who doesn’t experience at least one (or more) cases of clogged milk ducts.

Clogged ducts can range from a mildly uncomfortable nuisance that goes away quickly, to an all-out painful, feverish, emotional ordeal which can wind up turning into a breast infection aka: mastitis.

Fortunately, most cases of plugged milk ducts aren’t a big deal and resolve within a couple days. However, since mastitis is a very real complication, it pays to get started with your home treatment ASAP, and know when to seek medical attention.

What causes clogged or plugged milk ducts?

Per the Academy of Breastfeeding Medicine,1 any number of things can cause a clogged duct, including:

  • A change in your baby’s nursing schedule.
  • Irregular feedings.
  • A sudden change in feeding schedule, like baby sleeping through the night or a random nursing strike.
  • Oversupply
  • Illness in mother or baby.
  • Breast(s) not being fully emptied, either due to poor latch or short feedings.
  • Exclusive pumping.
  • A weak pump.
  • Pressure on the breast due to a bra, tank, or clothing that’s too tight.
  • Weaning
  • And, (the big one) a stressed out mami.

Symptoms of Clogged Milk Ducts

  • A red, swollen, and/or painful bump on your breast.
  • A red mark, often shaped like a wedge, which may or may not feel lumpy or bumpy.
  • Pain in a localized area on your breast.
  • Fussy baby or baby refusing one side—this can be due to slower milk flow on the affected breast or an unpleasant taste if infection is present).
  • A small white dot on your nipple known as a “nipple bleb”.
  • Inflammation or heat on the breast.
  • Strings or “grains” or thick, fatty looking milk.
  • Fever, fatigue, and general “icky” feeling—a low-grade fever can accompany a clogged milk duct. This is nothing to be concerned about unless it goes over 101, which could indicate infection (but now always). In that case, be sure to call your doctor or midwife.

7 Home Remedies for Clogged Milk Ducts that Really Work

#1. Heat, massage, nurse, repeat often

Five to ten minutes before you need to nurse (we know, it’s hard to time sometimes with newborns or infants, so just do your best), apply a heating pad, warm neck wrap, or hot water bottle to the affected area.

Next, gently massage the area toward your nipple

Finally, nurse your baby on the affected side first (their suction is stronger when they first start nursing) while continuing to gently massage your breast. If this causes your baby to unlatch, then skip it as it’s more important they drain your breast without getting frustrated.

If nursing is painful, you have a few choices: cold compresses between feedings can really help, and ibuprofen is safe to take while nursing* and a real life-saver for clogged duct pain.

*Keep in mind, ibuprofen will also reduce a fever. So, if you choose to take it for pain, be sure to watch for other symptoms of your condition worsening, such as other flu-like symptoms, red streaks, increased heat around the clog, or fatigue.

If you can’t nurse, you can pump, just keep in mind that nursing is the best-case-scenario for clogged ducts as your baby will be more effective at draining the breast than a pump.

What’s the best way to massage a plugged milk duct and how much pressure should you apply?

It depends who you ask.

Our best advice is to start by gently massaging the area in a circular motion to break up the coagulated milk, then sweep downward in the direction of your nipple. Repeat a few times, then nurse your baby.

If you’re successful, your baby will suck out the clog. If not, no worries, just try again before the next feeding/pumping. You can also do this in between feedings.

A word about pressure…

If, after a few attempts, you don’t feel you’re making progress or the lump is very hard and stubborn, you can increase the pressure. No need to bring yourself to tears, but it is safe to massage firmly if you need to. Just don’t agitate the area too much or you’ll wind up causing yourself more pain.

#2. Slap on an old fashioned potato poultice

We are such fans of a good old fashioned poultice…especially for clogged ducts, pimples, or very minor skin infections.

The easiest way to do this is to cut a few thin slices of potato, slap them on the affected area, cover with a bit of plastic wrap, and put on a comfortable bra.

Leave this on for 20-30 minutes (you can leave it longer but it may dry out your skin), and repeat a few times during the day with fresh potato slices.

Do this at the first sign of a plugged duct to speed healing.

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#3. The herbal poultice

Herbal poultices are wonderful because you can choose specific herbs to help with different symptoms. For example, mullein is traditionally used to help with pain and has antispasmodic properties,2 marshmallow root has antimicrobial properties,3 and chamomile or lavender help soothe inflammation.4,5

To make, choose your combination of herbs and steep in boiling water for 10 minutes. Next, place herbs in a clean cloth and apply directly to the affected area OR dip the cloth in the infused water and apply.

No dried herbs lying around? You can use tea bags directly on the clog, Chamomile with Lavender Tea from Traditional Medicinals for example, would work great!

#4. Castor oil boobie packs

Many doctors, healers, grandmothers and mamis swear by castor oil for quelling inflammation and reducing pain…and there is some scientific backing for this.

Studies have found the ricinoleic acid present in castor oil acts as a natural anti-inflammatory and analgesic,6,7 which explains why it can work so well for plugged milk ducts.

Here’s how to make a castor oil boobie pack:

  • Apply a generous layer of pure castor oil to muslin or an old, thin rag or cloth
  • Place directly on the clog
  • Cover with plastic wrap
  • Cover the plastic wrap with a clean cloth
  • Apply a heating pad

Chill out for 20-30 minutes. Remove, clean off, and nurse or pump right afterwards.

Since this is a more “involved” process (and castor oil can be messy), it’s a good idea to do this while baby’s napping or at night before bed.

#5. A facial cleansing brush

Ultrasound therapy, done in a medical clinic, is a very effective way to dissolve clogged milk ducts.8

However, you can do a home version using an electric facial cleansing brush, like the Clarisonic.

To use, apply the back side of the brush (not the brush itself) to the clog, turn it on, and massage in a circular motion. You can even do this in the shower for greater benefit. Repeat 2-3 times a day.

#6. Soak your girls in epsom salts

Not only does this feel amazing on sore breasts, but we think it’s more effective than the shower for stubborn clogs.

The set-up can be a little awkward, but you’ll want to fill a deep bowl, or clean sink, with warm water, and add a generous amount of epsom salts. Swish around to dissolve.

The larger your breast, the bigger the bowl or sink you’ll need. The point is to get the clog fully submerged.

Better yet, make this an excuse for a long bath.

Soak for at least 10 minutes, massage, and nurse or pump.

#7. Rest, destress, and surrender

Nine times out of ten stress is a key player in the onset of clogged ducts and mastitis.

We know, we know: how are you supposed to get enough rest and destress when you have a new baby? Especially if that baby isn’t nursing well, is a newborn, colicky, high-needs, or not a good sleeper?

You need to call in help, mami. Doctor’s orders.

Take a sick day (or days), ask your husband or partner to stay home too, and/or call in a friend or family member. This is especially important if you have a fever or feel very run down.

Sure, you can tough it out. But frankly, it’s really hard to care for a baby while you’re trying to care for yourself…let alone do a castor oil pack, soak your boob, apply potatoes, etc.

Rest is the best medicine and if you don’t surrender early on you could wind up feeling really sick later. So just do it.

Is it mastitis or a clogged duct?

If you have a fever and pain while nursing, it can be hard to tell if you have mastitis or a clogged duct. So here’s the deal:

With clogged ducts, your temperature will generally not go over 100.4 and you won’t feel totally terrible.

With mastitis, you’ll likely have fever (higher than 100.4)…and you’ll feel like you got hit by a truck!

Mastitis is defined as an inflammation of the breast 9 which is often, but not always, accompanied by infection.10 Thus, you need to call your doctor or midwife right away as it could lead to an abcess or other complications.

What to do if you’re not making progress

Most clogged ducts clear up within a day or two, but some can take up to a week.

The general rule of thumb is, so long as you’re getting better and your fever isn’t over 101, it’s okay to continue with home treatment. When in doubt, check with your doctor.

You can also ask your healthcare provider for a referral to a physical therapist or chiropractor who does ultrasound therapy. This practice is more common in Europe and Canada, but there are providers who offer it in most major cities.

We recommend this in our practice as it can save you from developing mastitis which could require antibiotics.

How to prevent recurrent clogged ducts

In addition to nursing frequently, developing proper technique, having baby checked for tongue or lip tie, drinking plenty of water, managing stress, and eating a healthy diet you can also take sunflower or soy lecithin to prevent clogged ducts. Both are safe for breastfeeding mothers with no known contraindications and Generally Recognized as Safe (GRAS) by the FDA.

However, if you wish to avoid genetically-modified ingredients (like most soybeans), sunflower lecithin is what we recommend to our patients. We typically recommend between 1200-2400 mg per day, but check with your doctor or midwife about the right dosage for your unique situation.

How to survive postpartum

Hey Mami is dedicated to helping women achieve a healthier and happier mamihood. Be sure to ready our postpartum definitive guide and stay tuned for more articles to help you survive the challenges of the postpartum period.

References:

  1. https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/4-mastitis-protocol-english.pdf
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3350428/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4418059/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2982259/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878871/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1781768/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015816/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437340/
  9. https://www.aafp.org/afp/2008/0915/p727.html
  10. https://www.acog.org/Patients/FAQs/Benign-Breast-Problems-and-Conditions?IsMobileSet=false

Our Bio

We are doctors Alejandra Carrasco M.D. and Christine Maren D.O. We’re board-certified through the American Board of Family Medicine, and certified in functional medicine through the Institute for Functional Medicine. We’re on a mission to support women as they navigate mamihood—from preconception through pregnancy, postpartum, and beyond. As mamis of 3 (each!), we got you.

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