You and your new baby have been trying really hard to get the hang of this whole breastfeeding thing. Maybe you’ve been working to correct their latch or you’re a pumping mama still figuring out the best schedule for you.

You wake up in the morning to one breast that has a hard lump and is tender to the touch. What is going on?

Chances are you have a blocked duct, which can lead to mastitis.

Blocked Ducts

Blocked milk ducts, also called plugged or clogged ducts, happen when a part of the milk duct system in the breast becomes obstructed and milk isn’t able to flow properly. The block can happen farther back in the breast, or on the tip of the nipple where the duct opening is located.

When the block occurs at the tip of the nipple, that is called a bleb, or milk blister. You can check out our full blog to learn more about blebs here.

Signs of a Blocked Duct

There are a few telltale signs that you may have a blocked duct.

Here’s what you should look out for:

• A swollen or engorged breast
• A hard lump or wedge-shaped area in the breast
• A red area that is hot or tender to the touch
• Localized pain or tenderness
• Occasionally, a low fever may be present

Most of the time, pain and tenderness are worse before a feed or pumping session. After you feel more relief and your breast doesn’t seem as swollen or have as large of a lump.

Mastitis

If a blocked duct goes untreated, it can develop into a condition called mastitis. It can also be caused by an infection or allergy which might cause it to come on abruptly.

It’s estimated that 1 in 10 breastfeeding women in the U.S. will experience mastitis at some point. The most frequent timeframe that parents get mastitis is within the first 2-3 weeks of breastfeeding, although it’s common up to 6 months. Mastitis can occur at any time for as long as you are nursing.

Signs of Mastitis

Many of the symptoms of a blocked duct are also signs of mastitis, just more severe.

The signs of mastitis are everything above, plus:

• Red streaks coming from the lumpy or swollen area
• Flu-like symptoms such as fatigue, aches, and chills
• Fever of 101.3°F or higher

You might also notice the consistency of your milk has changed to be more stringy or gelatin-like. There may also be pus or blood present.

Common Treatment Options

Blocked Ducts

Treatment for a blocked duct is usually pretty simple and straightforward.

A blocked duct can be treated by doing the following:

• Rest as much as possible
• Apply moist heat to the affected area
• Gently massage the breast to loosen the clog
• Nurse or pump to fully empty your breast at least every 2-3 hours

Ensure that if you are nursing directly from the breast, your baby is getting a good latch and proper positioning so they can effectively empty the breast.

You can also try “dangle feeding” where you lean over your baby to nurse. Gravity can help the flow of milk and cause the blockage to release.

Mastitis

If it’s been more than 24 hours and none of the above methods have been successful, you should speak to a lactation consultant. They might need to refer you to a healthcare provider to prescribe antibiotics, especially if you have a fever or your symptoms have worsened.

You should continue to take the measures used to treat a blocked duct, as well as:

• Take an antibiotic prescribed by your doctor
• Consider bed rest until the inflammation subsides
• Warm showers or baths to encourage the block to loosen

Preventing Blocked Ducts

In some cases, mastitis, unfortunately, can’t be prevented such as an injury to the breast or a history of breast surgeries.

However, there are steps you can take to prevent blocked ducts from happening in the first place.

• Stick to a regular nursing or pumping schedule
• Make sure breasts are fully empty after feeding or pumping
• Correct any latch issues your baby may have
• Switch positions to ensure all milk ducts are being emptied
• Wear loose-fitting clothes and bras that are the correct size
• Practice good self-care by getting adequate sleep, fluids, and nutrition

If you have mastitis, follow the care plan of your healthcare provider and fully finish the course of antibiotics. This will help to prevent recurring cases of mastitis.

Final Thoughts

Seeking help from a medical professional is imperative when mastitis is suspected to avoid the infection spreading. Don’t hesitate to reach out to someone if the above methods are not working. You may need something as simple as switching antibiotics or resolving an incorrect latch to clear up the blockage or infection.

And remember - prevention is the best treatment. Talk to a lactation consultant about how you can reduce your chances of getting a blocked duct and mastitis.

Do you have any of your own tips and tricks that helped you survive mastitis? Share them in the Official Milky Mama Lactation Support Group to help another mama out!