Clogged Ducts vs Mastitis: What Is It And Should I Panic?

Urghhhh. Such a pain in the…..boob. I remember getting a clogged duct and just experiencing THE worst pain ever. It was so painful I thought I was going to need surgery. I also thought that, alright, this was it, this was my calling that I just could not go on. I kept repeatedly telling myself that breastfeeding was not for me. It was just too, too, painful of a thought to carry on and think about breastfeeding my child for a few more hours what more the two years I intended.

So did I continue my breastfeeding journey? Read my breastfeeding journey here Mamas 🤍

Just like previous articles, I won’t sugar coat motherhood. Because it is meant to be raw, it’s meant to be confusing, it’s meant to be challenging. But that doesn’t mean that it doesn’t come with it’s rewards. Remember boss mamas, you’re making LIQUID GOLD. Whoever said that was easy?! Give yourself a hug for coming this far 💗

What is a clogged duct and do I have it?

Now after reading the above, would you have been able to tell whether what I described was the case of the mastitis or a clogged duct? It’s hard to tell now isn’t it? Because you’re right. Clogged duct and mastitis symptoms are almost very similar to each other.

A clogged or plugged duct, happens when the milk duct in your breast gets blocked. This generally happens when there is a delay in removal of milk, infrequent feedings or situations which may cause poor milk flow seen in cases where baby misses a feed, baby sleeps through a feed or when we moms start stressing out - you can imagine the likelihood of that huh? Commonly, symptoms usually affects one breast and the process happens gradually.

Here are several symptoms to help you identify whether you have a blocked milk duct:

1. A lump in the breast

Finding this lump may be very alarming to a lot of mothers. But if you’re breastfeeding, know that this is a common occurrence that happens a lot among nursing mothers. The size of the lump can be as small as a pea or slightly bigger. As I type this out, I vividly remember massaging the lump that I found in my right breast as I was nursing my baby. It was small but hurt like A LOT.

2. Breast feels tender

At this point, your breast will feel very tender and the skin around the affected area will appear reddish. The slightest brush against your brush might cause searing pain so be very mindful with your movements to minimize the discomfort/pain.

3. Engorgement

Even after a full feeding session, your breasts may still feel full. I remember just feeding and feeding my baby but my breast didn’t feel emptied. It still felt painful and engorged.

4. Swollen

Because your breast are so tender at this point, it’s easier to locate and feel the lump. Naturally, this will cause a swelling that will make the lump feel sore and painful to the slightest touch.

5. Milk blister (bleb) at the opening duct of your nipple

If you spot a tiny white dot on your nipple or areola, then that’s also a telling sign that you have a plugged duct. During this period, your milk will be thicker than usual as the oversupply of milk and the result of poor milk drainage has caused the milk to thicken. Hence, nursing will be more uncomfortable until the lump subsides.

6. Pain during let down

This was my red flag. I didn’t notice any swelling nor did I notice the lump until each feed made me yelp and cry. It was unbearable and that’s when I noticed how heavy my breasts felt. It didn’t feel any emptier after I nursed my baby and it was when I massaged my breast that I felt the lump.

Causes of clogged milk ducts

Again, clogged milk duct mainly occurs due to poor removal of milk or anything that prevents it from doing so. However, there are other contributing factors which could risk the likelihood of you developing clogged ducts or mastitis. Here are some risk factors:

1. Tight-fitting bras or tops

The pressure from these clothing will cause the milk to be backed up and blocked. Not to mention, it is not advisable for new moms to wear underwire bras yet as this will impede your milk flow.

2. Infrequent feedings

It is natural for clogged ducts and mastitis to occur among mothers during the early weeks or months of postpartum as during this period babies are still adjusting life. From less predictable sleep patterns, to teething, to dealing with possible illness, these are some scenarios which may leave you with an oversupply of milk. Your baby may have developed a longer sleeping pattern hence causing you to miss a feed and teething could be very uncomfortable for both you and baby therefore, less boob action. Yet when they’re smaller, they would often fall asleep during feeds leaving us moms with half-empty breasts.

3. Stress and fatigue

Stress has been known to be a buzz kill with milk let down. So the poorer the milk flow, the higher the tendency for milk to be backed up.

4. Dry or cracked skin on the nipples

Just like licking lips, the more you lick them, the drier they become. Similar with baby’s suckling, they leave your nipples exposed with their baby saliva. Hence why it’s recommended to wipe down your breast after every feed.  

5. Inadequate diet

A low nutritional diet would naturally leave you physically weak and cause your energy level to deplete. This will then snowball into stress because let’s face it, who isn’t stressed when they’re tired?

6. Baby's latch

Getting a good latch with your baby is something you must not take lightly. A good latch not only ensures the best feeding experience for your baby (less milk back up) but for you too, mamas. If you notice you’re your baby prefers one breast over the other then be wary of this because it may lead to plugs in the less frequently fed breast.

Treatment and prevention of clogged ducts

1. Wipe down after every feed

I took this tip lightly that was until I learned my lesson (or at least paranoia made me do it after my scary experience) to wipe down baby’s excess saliva or milk residue of my breast. Saliva can cause dryness to the skin so to prevent milk blebs from occurring, wipe down and MAKE NIPPLE BALM/CREAM YOUR BREASTFRIEND!

2. Use heat or cold compress

Applying heat or a cold compress can help relieve some pain/discomfort. When you apply heat, you’re encouraging milk let down for clogged milk ducts or mastitis. However, when you use a cold compress, you’re relieving some pain from engorgement by reducing the swelling. The cold compress can also be used when you’re dealing with clogged ducts or mastitis as the coolness will soothe the burning sensation.

But remember, do not leave the heat compress/pads too long on the affected area as you don’t want to aggravate your skin even further. Prolonged application may cause injury so have your partner or family member nearby to supervise the process in any case you doze off during the feeding session.

This was what I used:

3. Take a hot shower

Taking a warm, hot shower is not only calming but the warm water will help stimulate and encourage better milk let down. So as soon as you finish your shower, while you’re still warm, cradle your baby and start nursing. Massage the area gently so that you continue to create warmth around the lump.

4. Massage

I didn’t have a lactation massager so I tried manual massaging and although it was painful, it did the job. At one point I was too scared to massage and was just emotionally and mentally drained that my older sister took over and helped massage my breast while I nurse. She was there to support me and assist me.

Motherhood is not a one-person job. Sometimes it takes a village. But you need to know the right people to let in to help you. Only keep people who support you close to you.

Tip: Massage gently above the blocked duct and then hand express behind your nipple to assist milk flow. Some has recommended using an electric toothbrush against the clogged milk duct as this will mimic vibrations similar to a lactation massager. Learned this tip from my sister too.

5. Feed frequently

It’s easier said then done but keep the feedings going. The goal for frequent feeds is to encourage consistent milk drainage. Babies tend to suck the hardest on the first breast offered therefore, begin your feeds with the affected breast for your hungry baby.

6. Check for proper latch

Even though you and baby hit it off with a good latch, sometimes along the way, your baby can slack due to drowsiness, teething or sometimes your breastfeeding position could also effect the process.  This can cause discomfort and restrict your baby’s suction. Ensuring proper latching can result in optimal milk drainage and prevent further engorgement.

7. Switch up your positions

Experimenting with different positions also enables you and baby to get better suction of the clogged duct. Amazingly, after all the treatments I did, this tip worked the most. Readjusting and positioning my baby’s chin and nose to nurse directly to the position of my clogged duct helped but what helped immensely was when I kneeled on all fours to feed my daughter.

This position may seem silly but don’t knock it until you’ve tried it. I almost stopped midway as I was getting into position because it just felt so weird dangling my breast over my daughter as she laid down waiting for her feed, but THIS WAS THE TRICK THAT UNCLOGGED MY BREASTS!

8. Free the nipple!

Wearing less constrictive clothing and wearing the right bra makes a world of a difference in your breastfeeding journey. Not only is it more comfortable but going bra-less sometimes also helps to reduce the discomfort of that engorgement brings. While they may be pretty, say goodbye to your underwire bras until you wean your baby as underwire bras are a huge contributing factor to engorgement.

9. Increase your fluid and eat right

Drinking more water and eating a more nutrient-dense diet also helps to prevent clogged ducts. During postpartum it is vital for moms to continue a healthy lifestyle to heal mentally, physically and emotionally.

10. Invest in a good breast pump

I can’t stress this one enough, mamas. I didn’t do proper research on breast pumps and used a hand-me-down breast pump that my older sister used only twice. Being a new mom, I figured no harm right as it has a all the functions that a breast pump caters. I learned it the hard way. I believe that my clogged duct was due to my breast pump as it wasn’t not doing the proper drainage that a breast pump should do. The massage mode was not as long as it should be and the suction was rough on my nipple. Hence my milk bleb.

What is mastitis and do I have it?

The moment you when you notice your symptoms are more intense, then most likely you’re dealing with is mastitis. This happens when your plugged duct is not treated immediately and you develop a bacterial infection. However, it is important to note that although mastitis can occur at any point of time while breastfeeding, it is most common to occur during the early six weeks postpartum.

As highlighted before, mastitis also usually affects one side of the breast.

Here are some symptoms to help you identify and differentiate mastitis from clogged ducts:

1. Breast appears hot and red

At this point, your skin would be radiating heat and the redness of your skin around the affected area would be very prominent causing you deep discomfort due to the inflammation of the untreated clogged milk duct.

2. Tender and painful

Due to the inflammation, the pain is more unbearable if you develop mastitis.

3. Burning sensation

You will feel a burning sensation as the swollen lump as caused your inflamed breasts to radiate heat.

4. A swollen lump

This is the same lump from the clogged milk duct that was left untreated causing it to become a bacterial infection.

5. Fever and chills

Just like any fever, the whole works including body aches, dizziness, the flu are also telling signs that you have mastitis. If there is no change in your breast in two days or you begin to notice signs and symptoms of infection, notify your obstetrician. Antibiotics may be indicated.

Treatment for mastitis

Follow the above guideline if you begin to experience your mastitis symptoms starting to worsen.

My experience

I remember being desperately frustrated for my baby to empty my breast naturally because pumping to me, personally, felt more painful and I just couldn’t endure further pain. But at that moment I was desperate for everything and ANYTHING. I went to the hospital and saw a lactation nurse. She observed how I fed and I couldn’t hide my tears as I nursed in pain. She said baby’s latch was good so it could be due to poor removal of milk. I told her that baby tends to fall asleep during feeding sessions and she says that another common factor where engorgement occurs. When baby sleeps and we don’t properly empty our breast for the next feeding session, our milk duct will get blocked due to oversupply.

So I did it all. The tips and tricks but the one that worked for me most was nursing my daughter while on all fours. The heat and cold compress/pad also helped with relieving pain and swelling but it was only temporary as my milk was so thick, it was hard to get the best flow for baby to drain the blockage.

My lactation nurse also reminded me that it’s okay to continue nursing with the affected breast (even if you’re on antibiotics for mastitis) as the infection is not transmittable. Continuing to empty your breast is the only way to rid of the infection, reduce the swelling and unclog your milk ducts.

Do not feel shameful of your breastfeeding journey. No matter how you struggled, the sacrifice, the determination, the commitment is what makes you a GREAT mother. No matter how long your breastfeeding journey lasted ❤

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