A clogged, or blocked, milk duct is common during lactation, characterized by a painful, tender lump or a wedge-shaped area of hardness felt within the breast tissue. This condition arises from milk stasis, which is the result of milk not being effectively removed from a section of the ductal system. When milk accumulates, it causes the surrounding tissue to become inflamed and swollen, narrowing the duct and obstructing milk flow. A blockage is typically localized and, while uncomfortable, is often temporary and resolved with consistent milk removal.
Identifying the Appearance of the Expelled Plug or Bleb
The material expelled when a blocked duct clears is the physical manifestation of the obstruction. Its appearance varies depending on the composition and how long the milk has been stagnant.
When the blockage is near the surface, it may appear as a milk bleb, a tiny white, yellow, or clear spot visible on the nipple pore. A bleb is a superficial blockage, often caused by solidified milk or a thin layer of skin growing over the duct opening. Once dislodged, the underlying milk flows freely, often providing immediate relief.
Deeper blockages, which cause the painful lump, typically release a physical plug of thickened milk. This material is frequently described as small, white “grains” or “strings” of thickened milk fat. The stagnant milk’s fat globules and proteins may solidify, creating a texture that can be lumpy, clumpy, or gelatin-like when expressed.
If the milk has been stuck longer, the plug may appear yellowish or brownish due to concentrated fatty material. This solidified milk is not harmful to the nursing child and indicates the successful clearing of the obstruction. A temporary decrease in milk flow or the appearance of stringy milk during a feeding session are positive signs that the blockage is resolving.
Techniques for Clearing a Blocked Duct
The primary goal of clearing a blocked duct is to encourage milk flow past the obstruction, reducing inflammation and pressure. Applying a warm, moist compress to the affected area just before a feeding or pumping session helps open the milk ducts and promote flow. Taking a warm shower or soaking the breast in warm water can also soften the area before milk removal.
During the feeding or pumping session, gravity and targeted suction can dislodge the plug. The “dangle feeding” position involves leaning over the child or pump flange so the breast hangs down, allowing gravity to assist drainage. Positioning the child so their chin or nose points toward the lump directs the strongest suction force toward the blockage location.
Gentle massage is recommended to help move the thickened milk out of the duct without causing further inflammation. Use a light touch to encourage lymphatic drainage away from the blockage after a feeding, avoiding deep, aggressive pressure which can worsen swelling. For pain management, over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may reduce localized pain and swelling.
Recognizing When a Blockage Progresses to Mastitis
A simple blocked duct is localized inflammation without systemic symptoms, but it can quickly progress to mastitis if not resolved. Mastitis is inflammation of the breast tissue that often involves a bacterial infection, requiring prompt medical intervention. The defining difference between a blockage and mastitis is the presence of flu-like symptoms.
If the blockage progresses, a reliable sign is the sudden onset of systemic illness, including a fever of 101.3°F (38.5°C) or higher. This fever is often accompanied by chills, widespread body aches, and fatigue, creating the feeling of having a severe flu. Local breast symptoms also become more intense, with increased heat, swelling, and redness that may radiate outward.
If these systemic symptoms appear, seeking medical consultation is necessary, as mastitis often requires antibiotic treatment. Continuing to remove milk frequently, even with mastitis, remains important to prevent complications like a breast abscess. Recognizing the difference between a tender lump and the onset of fever and malaise is key for timely and effective care.
Strategies for Preventing Future Blockages
Proactive strategies focus on maintaining consistent and effective milk drainage to prevent the buildup of stagnant milk. Ensuring the breast is thoroughly emptied at each feeding or pumping session is the most direct method of prevention. This involves feeding or pumping on a schedule that matches milk production and avoiding missed sessions or abrupt changes in frequency.
Attention to comfort and clothing is important, as pressure on the ducts can trigger a blockage. Avoid wearing bras that are too tight, especially those with underwires, or clothing that compresses a specific area of the breast for prolonged periods. Minimizing carrying heavy bags with straps that cross the chest also prevents consistent pressure.
For individuals experiencing recurrent blockages, a dietary supplement such as lecithin is sometimes recommended to reduce the stickiness of the milk. Lecithin acts as an emulsifier, breaking down large fat globules into smaller pieces. A typical dosage is around 1,200 milligrams taken three to four times daily, which decreases milk viscosity and allows it to flow more easily through the ducts.