What to do if you have a 'blocked duct'?

What is meant by 'blocked duct'?

Breasts that make milk are lumpy. These lumps disappear after breastfeeds. A lump that persists after breastfeeds is often called a 'blocked duct'. A blocked duct

• Is not red or hot, and doesn't cause a fever

• Is not actually a duct which has blocked or plugged up from the inside

• Is not caused by bacteria or biofilm in the ducts. You can read why it's not caused by bacteria or biofilm here.

A blocked duct is a place in your breast where the inflammatory process, which is part of the breast’s natural adaptation to your baby’s needs, has become overactive. You can find out what causes your breast to become inflamed when you're lactating here.

• This happens when there is enough backpressure of milk in enough glands in that area of the breast to trigger an inflammatory cascade.

• The inflammation causes capillary dilation and low-grade stromal swelling in that part of the breast, which presses upon the milk ducts and triggers more backpressure of milk in the glands, which triggers more inflammation, in a cycle.

What helps with a blocked duct?

1. Never try to massage or rub away a breast lump. Deeper massage bruises the sensitive, highly vascular tissues of a milk-making breast and worsens the lump. Light massaging up towards the armpit doesn't help drain away fluid, and might make inflammation worse for some women. You can find out about this here.

2. Offer the affected side for a breastfeed as often as possible, without ever pressuring the baby. Letdown or milk ejection results in dilation of the milk ducts. The ripple dilation of ducts across the tissue of your breast means that there is a pressure pushing back, the ducts open up, and milk flows out.

3. Frequent short breastfeeds are more effective than long less frequent breastfeeds for resolving a breast inflammation. This is because milk ejections occur more often with frequent short feeds than longer, less frequent feeds. Mostly we just let the baby regulate this by offering the affected side frequently – the baby will soon tell you when she doesn’t want to take it.

4. You don’t need to hand expressing milk when you have a blocked duct, unless for some reason your baby isn’t taking the breast very often.

Recommended resources

Why your letdowns help prevent or heal inflammation when you're lactating

Frequent flexible breastfeeds are different to breastfeeding on demand