While breastfeeding your precious little one can stir up many emotions and feelings, it should never, ever hurt. If you are feeling pain while you pump or nurse, you could be dealing with either clogged milk ducts or mastitis.
Learn more about what causes these two common conditions, how to prevent them, and what you can do to treat them.
What Are Clogged Milk Ducts?
Clogged milk ducts result from an obstruction of milk flowing out from your breast. The milk gets trapped behind the obstruction. This typically happens when not enough milk has been expressed from the breast or because you’ve missed a feeding or pumping session. Other reasons for a clogged milk duct include a too-tight bra, sleeping on your chest, or something pushing against or aggravating your breast, such as a heavy diaper bag.
The symptoms of a clogged milk duct include:
- Pain in a specific part of the breast
- A swollen lump that is tender to the touch
- Slow milk flow from the breast
- A red area on the breast that feels warm
- Pain that subsides after nursing or pumping
What Causes Mastitis?
Mastitis is a painful inflammation of the breast caused by an infection or clogged milk duct. When it happens, it usually occurs in the first three to six months of breastfeeding.1 Symptoms of mastitis include:
- Breast lump or thickening of breast tissue
- Skin on the breast that is red and tender to the touch
- Continuous pain and/or burning
- Pain while breastfeeding
- Fever of 101 degrees Fahrenheit or greater
- Overall feeling of illness, often including chills and flu-like achiness2
How To Avoid Mastitis
The most effective way to avoid mastitis is to avoid clogged milk ducts. The simplest way to do that is to empty your breasts as often and as completely as you can. That means continuing to breastfeed often and according to your baby’s hunger cues. If your baby has an ineffective latch or is not draining your breast, follow up your nursing sessions with pumping to ensure you have adequate breast drainage. If pumping the affected breast is too painful, start with the unaffected breast first. Once your milk lets down, pump the breast with the clog until you’ve expressed as much milk as you can.
Additionally, it can be difficult for your baby to latch properly if your breasts are engorged. If they are, express a small amount of milk by hand before nursing to help ensure proper latching. Changing breastfeeding positions from time to time can also be an effective way to avoid clogged milk ducts.
Finally, be sure you get enough rest, eat a well-balanced diet, don’t smoke and care for cracked or sore nipples, as all of these decrease your risk for developing mastitis.
Other Effective Treatments for Mastitis
If you do develop a clogged milk duct, avoid pinching it. This can actually make the clog and the pain worse. Instead, try one of these ways to treat your clogged duct:
- Massage. Use a warm compress or heating pad on the affected area before nursing or pumping. Follow that with massage, either by hand or by using a vibrating lactation massager.
- Dangle pumping. Lean over as you pump to allow gravity to push out the clog.
- Epsom salt bath. Submerge breasts in a warm tub to which you’ve added Epsom salts. Soak for 10-20 minutes, then follow with massage.
- Change baby’s breastfeeding position. While nursing, position baby’s chin or nose so that it’s directed toward the clogged duct, which will make it easier to loosen and drain.
- Skip the bra. Don’t wear a tight sports bra, a bra with underwire, or other tight-fitting clothing.
- Proper nipple care. Treat sore or cracked nipples with a high-quality lanolin cream.
When To See a Doctor for Treatment of Mastitis
A clogged milk duct usually resolves within 24-48 hours. If it does not or you begin to exhibit symptoms of mastitis, be sure to see your doctor immediately.
Your doctor will want to know your symptoms and how long you’ve been experiencing them, in addition to your pain level, your breastfeeding technique, and whether you’ve had mastitis in the past.
If you do have an infection, your doctor will likely prescribe a course of antibiotics as well as over-the-counter pain relievers like ibuprofen or acetaminophen.
Although mastitis is painful, it’s important to continue nursing and pumping. If you stop, the blockage could become worse and even more painful. Left untreated, mastitis can develop into an abscess in your breast, which could cause complications and may require surgery to drain.
Mastitis will not affect your baby (thank goodness!), though it may make your milk taste a bit saltier than usual.
Most importantly, try not to let it discourage you, mama! Approximately 20% of breastfeeding moms will experience clogged milk ducts and mastitis along their breast milk feeding journey. Using the techniques listed here will help get you and baby back on the right breastfeeding track and loving your bonding time together.
- Wambach, K. & Spencer B. (2021). Breastfeeding and Human Lactation. Burlington, MA. Jones & Bartlett Learning.
- Amir et al., 2014: Amir & Academy of Breastfeeding Medicine [ABM], 2014