Various treatments that may help in resolving a blocked milk duct. Includes information about therapeutic breast massage/hand expressing.
A blocked duct develops when milk is not being optimally removed from the breast. Symptoms include a firm area/lump in the breast, tenderness, and sometimes redness and warmth in the area. Generally, you otherwise feel well, although you may or may not have a low-grade fever.
The first step in treating (and preventing!) blocked ducts is to ensure the breast is drained well at each feeding. See our Breastfeeding Basics page for more information on how to help your baby feed most effectively. Continue feeding your baby on the affected side and use compressions focusing on the area of the blockage.
If your baby misses a feeding at the breast, or is fed away from the breast, pumping or hand-expression is recommended to help prevent a blocked duct from occurring.
Applying heat to the affected area can be both soothing and helpful in resolving a blocked duct.
Try a heating pad or hot water bottle, being careful not to burn your skin.
You can also try soak the breast in warm water and Epsom salts. Mix 4 liters of water (as hot as you can tolerate without burning your skin) with 1 to 2 handfuls of Epsom salts in a sink or basin. You can also add Epsom salts to a hot bath and soak your whole body, if that is easier. Soak the breast for about 10 minutes - massage the breast gently and do some hand expression, if you can. Then rinse the breast with clear water and nurse your baby.
Maya Bolman, RN, IBCLC has described and studied therapeutic breast massage during lactation. Combining gentle breast massage with hand expression can help to clear a blocked duct. See Maya's video to learn her techniques.
Try massaging the blocked area with something that vibrates, like the flat end of an electric toothbrush or a back massager. The vibration may help loosen the blockage.
If your blocked duct has not resolved by 48 hours or so, therapeutic ultrasound may work. Ultrasound may also prevent recurrent blocked ducts that occur in the same part of the breast. Most physiotherapy or sports medicine clinics offer this treatment, but few are familiar with the use of ultrasound for blocked ducts specifically. Try to find a practitioner with experience for more successful results. The "dose" of ultrasound is 2 watts/cm2 continuous for 5 minutes to the affected area, once daily for up to two treatments. If there is no improvement after two treatments, there is no benefit to further treatments.
If you frequently get blocked ducts, try lecithin (from soy or sunflower). Take 1200 mg (usually 1 capsule) 3 to 4 times per day. Lecithin seems to reduce the "stickiness" of the milk, possibly acting as an emulsifier and/or by increasing the percentage of polyunsaturated fatty acids in the milk. This can help prevent future blocked ducts.
Blocked ducts almost always resolve within 24 to 48 hours. If you have a lump in the breast that is not at least decreasing in size within a day or so, see your doctor. If you develop symptoms of mastitis (a red, hot, lump in the breast accompanied by fever and flu-like symptoms), see your doctor. Cephalexin is the antibiotic of choice to treat mastitis. Amoxicillin is often prescribed but is NOT effective. Note than most antibiotics are compatible with breastfeeding and you should continue breastfeeding on the affected side, even in the case of mastitis.
©2017, The Breastfeeding Collective
The information presented here is general and not a substitute for personalized treatment from an International Board Certified Lactation Consultant or other qualified health professional.