Clugged Ducts and Mastitis: Symptoms, Causes, and Treatment

Clogged milk ducts and mastitis are common ailments of breastfeeding, but they are treatable and you can get past them to continue to breastfeed.  Breastfeeding isn’t always fun, and it can be really hard work, but the benefits are immense.

I don’t want you to give up breastfeeding, so here are some things you can do to make it easier. 

When I was breastfeeding my children I ran across these issues and it was helpful to talk to a lactation consultant. She walked me through the issues and helped me to continue to feed my baby. Let me say up front that I’m not a medical doctor or registered nurse, or anything close so please consult a professional lactation consultant or visit your doctor for expert advice — you’ll be glad you did.

What’s the Difference Between Clogged Ducts and Mastitis?

Cracked nipples, around the clock feedings that leave you feeling like a zombie, feeling like a human milk machine, are just a few of the side effects of breastfeeding. But there are other issues that may arise, things like clogged or plugged ducts, and mastitis.

I’ll be talking about the key differences between clogged ducts vs mastitis including common side effects, causes so you can avoid them, and what you’re treatment options are if you’re miserable and need some relief.

What are Clogged Ducts?

A clogged, or plugged, milk duct is an area of the breast where milk flow is not able to get through. This can affect either the nipple pores or further back such as the side of the breast. It usually comes on very gradually and only affects one breast.

It can be very painful and you might think you have to stop breastfeeding. You may even WANT to stop because of the pain. But, there is help. 

You might have plugged ducts if you have any of the following symptoms:

• Hard lump or wedge-shaped area of engorgement is present
• Plugged duct site feels tender, hot, swollen, and/or has some redness
• Nursing on the affected breast is painful, especially during a letdown
• The affected breast is more painful before a feeding and less tender afterward
• A low-grade fever of 101 degrees or lower

Occasionally, you may notice tenderness or pain without an obvious lump being present. The location may also shift around.

While it is incredibly painful, avoid the temptation to stop nursing on the affected side. This can make it worse or cause a serious infection.

What is Mastitis?

While engorgement and plugged ducts are painful and quite miserable, they can manifest into mastitis if left untreated.

Mastitis is described as an inflammation of the breast that is caused by a block of milk flow, infection, or even a severe allergy. It may come on abruptly, and typically only affects one breast.

It’s most common in the first 2-3 weeks but can occur at anytime during your breastfeeding journey.

You might have mastitis if you have any of the following symptoms:

• Hard lump or wedge-shaped area of engorgement is present
• Mastitis site feels intense with pain, hot to the touch, swollen, and may have red streaks going outward from the affected area
• Nursing on the affected breast is very painful, especially during a letdown
• The affected breast is significantly more painful before a feeding, and lessens afterwards
• A high-grade fever of 101 degrees or higher
• Chills, aching, and other flu-like symptoms

Key Differences Between Clogged Ducts and Mastitis

Clogged ducts and mastitis are very similar in symptoms, but have different maladies. 

Similarities include:

• The presence of a hard lump in the affected area
• Pain, hot to the touch, swollen, and some redness
• Nursing to be more painful, especially while nursing
• Having some relief after a nursing session

The main differences are that:

• The fever of a plugged duct is low-grade while mastitis is high-grade
• Mastitis also includes the presence of chills, aching, and other flu-like symptoms

Now that we understand what clogged ducts vs mastitis is and some common symptoms, let’s dive a little deeper into each of these.

Clogged Ducts

Clogged ducts occurs when an area of the breast because blocked from milk being able to easily flow through. (Hence the term clogged duct.)

Common Side Effects

With that, comes a variety of side effects that are less than pleasant. These side effects include things like:

• Milk supply and pumping output may drop for a period of time
• You may be able to express strings of milk
• Once the milk is flowing again, you may still feel redness and bruising for another week as your breast continues to heal.

Causes

So what causes a plugged duct and how can you prevent it from happening? Well, there are quite a few things to keep an eye out for.

Engorgement or milk not being fully removed from the breast, that is due to a variety of things including but not limited to:

• Latching problems
• Tongue or lip tie
• Nipple pain
• Sleepy or distracted babe
• Oversupply
• Feedings being rushed
• Limiting baby’s time at the breast
• Use of a nipple shield

Feedings that have been skipped or not occurring often enough, that is due to a variety of things including but not limited to:

• Nipple pain
• Teething
• Using a pacifier too often
• Being too busy
• Working outside the home
• Trying to schedule feedings
• Supplementing with formula
• Baby sleeping longer than usual
• Abruptly weaning from the breast

Pressure on the milk duct, that is due to a variety of things including but not limited to:

• Wearing a tight bra or other clothing
• Prone sleeping

Inflammation, that is due to a variety of things including but not limited to:

• Injury
• Bacterial infection
• Allergies

How To Clear Clogged Milk Ducts

You’ll want to make active decisions to help with the healing process.

Warning: it is very important that you do not decrease or stop nursing on the affected breast. This increases the risk of more serious health complications and can even cause an abscess.

General treatment options include:

• Get plenty of rest
• Drink lots of fluids
• Nutritious foods to strengthen the immune system

When breastfeeding:

Nurse as frequently as possible and be sure to empty the breast (without neglecting the other breast during treatment)

• Nurse on the affected side first, if possible
• Utilize heat and gentle massage before each nursing session by warm compress, hot shower, or other methods.
• Loosen any tight bras or clothing so milk flow isn’t restricted
• Lean over the baby for dangle feedings to help milk flow
• Check to ensure proper positioning and latch
• Pump or hand express after nursing to aid in the process and speed up the healing
• Use cold compresses between feedings for pain and inflammation

Medication options:

Pain reliever or anti-inflammatory may be helpful – be sure to review with a lactation consultant or your doctor

Mastitis

Now that you have all the information on a plugged duct, what about mastitis? Do you run to the doctor right away? Demand antibiotics?

Well, not exactly… not yet, anyway.

Common side effects

Some common side effects for mastitis, include:

• Milk appearing clumpy or stringy during feedings
• Baby may refuse feedings as the milk will become saltier due to increased sodium content
• Milk may contain mucus, pus, or blood

Causes of Mastitis

What about mastitis? What causes mastitis to form? Much like a plugged duct, it can be caused by restricted milk flow.

Restricted milk flow includes things listed above, such as:

• Engorgement or milk not being fully removed from the breast
• Skipped feedings or infrequent nursing sessions
• Pressure on the milk duct
• Inflammation

Note: see the causes of a plugged duct for the full list of causes due to restricted milk flow.

Mastitis is also caused by infection, caused by:

• Sore, cracked, or bleeding nipples that lead to an infection
• Long hospital stays that increase exposure to infectious organisms
• Past history of mastitis

Mastitis Treatment

So what do you do when you think you have mastitis?

General treatment options include:

• Lots of bed rest and a nurse-in with baby
• Increase amount of fluids and nutrition
• Getting help around the house, if possible
• Follow the above treatment options listed for plugged ducts during breastfeeding as well.

The same practices should be followed when you have mastitis too.

Medication options include:

• Pain reliever or anti-inflammatory if desired
• Anti-biotic, if needed as recommended by your doctor (see below)

When should you worry?

In some cases, you may need to visit your doctor and request an antibiotic to be administered to you. If you’d like to avoid antibiotics, check out some of these other treatment options for mastitis.

Make an appointment with your doctor immediately if you:

• Mastitis appears to be present in both of your breasts
• Baby is less than 2 weeks old or you’ve had a recent hospital visit
• There is broken skin on the nipple area
• Blood or pus is present in your milk
• Red streaking is present on the breast
• Temperature spikes very suddenly
• Symptoms are sudden and severe

Follow-up with your doctor if:

• Symptoms do not begin to resolve after 2-3 days
• You have had 3 or more occurrences in the same area
• Nipples become sore after antibiotic treatment

Quick Tip about Clogged Ducts and Mastitis

Clogged ducts and mastitis can be a confusing thing to understand at first. The most obvious difference is that mastitis is much more severe with more pain and includes a high-fever along with flu-like symptoms.

Causes of clogged ducts primarily include restricted milk flow from skipped feedings, inflammation, pressure on the breast, or severe engorgement. Mastitis is also caused by anything that increases the risk for an infection, such as a long hospital stay.

When treating plugged ducts or mastitis, make sure to keep nursing! The more you can try and push milk through and break the plug, the better. Warm and cold compresses along with medications can help with relief.

If your baby has any ties, latching problems, or incorrect positioning, make sure to fix these issues to avoid future complications.

If needed, consult your doctor about being prescribed an antibiotic. This is not always necessary but can be very helpful if there is an obvious sign of infection.

Looking for More Information About Breastfeeding?

If you’re trying to keep your milk supply high, try drinking mother’s milk tea. 

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