Estimated reading time: 8 minutes

The last thing a new breastfeeding mom needs is for her milk-makers to start hurting! Sore breasts can be an alarming experience, and it’s best to get to the bottom of your pain before it gets worse. What is causing the pain? Perhaps either a milk duct is clogged or you developed an infection. In either case, how do you know which one? Let’s discuss clogged milk ducts vs mastitis symptoms, and help you get to the bottom of this pain as soon as possible!

Clogged Milk Duct vs Mastitis Symptoms: A Quick Summary

Okay, mama, here’s the Cliff Notes version of sore breasts symptoms and causes:

Do your breasts feel overly full and sore? Probably engorgement.

Do you have a sore lump in one spot of your breast with no other symptoms? Probably a clogged milk duct.

Do you feel like you have the flu (e.g. fever and achy) and an area of your breast is in pain? Probably mastitis.

The USDA has a great resource about engorgement. Continue reading below to get the details on both clogged milk ducts and mastitis. No matter the cause of your sore breasts, you will want to remember the following tips (3): 

1. Breastfeed frequently
2. Rest lots
3. Apply moist heat
4. Call your doctor if you either have a fever or if symptoms don’t improve in 24 hours 

Clogged Milk Duct vs Mastitis Symptoms: What is a Clogged Milk Duct?

Breast milk travels through a duct system in your breasts (3). Sometimes a duct doesn’t drain all of its milk, so it can get clogged with cells or other milk components (4). As a result, the pressure in the clogged area causes inflammation and soreness (5).

Clogged Milk Duct: Symptoms

Clogged milk duct symptoms are localized, so they do not impact other parts of the body (4). Symptoms include the following (1; 2):

• An area of your breast may feel firm or tender
• Breast may be swollen
• Breast may feel sore or even painful
• Lumpiness in breast

Clogged Milk Duct: Causes

Clogged milk ducts are usually caused by the following (1; 4):

• Incomplete milk removal at each feeding (Clogged milk ducts are most common in women who have an abundant milk supply, because it may be hard to drain all the milk during feedings.)
• Restricting the breasts (e.g. tight bra or baby sling)
• Skipping feedings
• Improper latch
• Poor nutrition
• Stress
• Sleeping with pressure on your breasts
• Untreated engorgement
• Milk blebs in the nipple (A milk bleb, also called a milk blister, is when a pore in your nipple gets blocked by hardened milk or skin.)

Clogged Milk Duct: Treatment

To help release the plug and relieve your pain, try the following: (1; 2; 3; 4)

• Breastfeed frequently on the side with the blocked duct
• Gently massage the blocked area before and during each feeding (massage in front of the lump (toward the nipple) and knead/push the lump toward the nipple
• Take a shower or apply warm moist compresses before and/or between feedings (massage the blocked area after)
• Place your baby in different positions during each feeding (try nursing your baby with his chin or nose pointed toward the clogged area)
• Make sure you’re emptying your breasts at each feeding; express milk afterward, if needed
• Rest as much as possible
• Stay hydrated
• Wear loose clothing or go without a bra for a few days
• Take an anti-inflammatory pain medication approved by your doctor
• Try soaking your breasts by leaning over a basin of warm water
• Use warm water to remove any dried milk on your nipples
• Try holding the flat end of an electric toothbrush or other vibrating massager against the clogged duct

Good news—you will feel immediate relief when the milk duct becomes unclogged! Sometimes a plug is absorbed by the body, while other times it is released in your breast milk while pumping or nursing. It may be brown or green in color and may also be clumpy or stringy (4). Your baby may reject the milk with the plug because of the taste, but it won’t impact her (4).

When to Call the Doctor

If you do not treat a clogged milk duct, then the area can become infected and lead to mastitis (3). If your clogged milk duct is not responding to at-home treatment after 24 hours, call your doctor. Additionally, call your doctor if you notice any of the following (5): 

• You’re feeling sick (fever or vomiting)
• Dry nipple
• Bloody or pus discharge from your nipple

Clogged Milk Duct: Prevention

After experiencing a clogged milk duct once, you probably don’t want to experience it again! Remember these main tips: let those breasts breathe, and empty all that milk! Here are more tips to keep in mind to prevent clogged milk ducts (3):

• Avoid clothing or positions that restrict your breasts
• Check your baby’s latch and breastfeeding position (have a lactation consultant take a look if you’re unsure about good latch and positioning)
• Ensure you’re emptying your breast at each feeding
• If your baby has any feeding changes (sleeping longer at night, is sick or teething, etc.), you may want to express some milk to avoid overfull breasts

Clogged Milk Duct vs Mastitis Symptoms: What is Mastitis?

Mastitis is a painful breast infection usually caused by bacteria. Since many of its symptoms are flu-like, many moms who have mastitis mistakenly think they just have the flu (1). Mastitis is most common in the first six weeks postpartum, though you can get mastitis at any time you are breastfeeding (1; 4). Some moms get recurrent mastitis. Usually mastitis only impacts one breast at a time, but you can get a double-breasted infection (4; 5).

Mastitis: Symptoms 

If you are a breastfeeding mom, and you develop any flu-like symptoms, call your doctor! You might actually have mastitis, which needs to be treated as soon as possible. Mastitis symptoms include the following (1; 2; 4):

• Flu-like symptoms (e.g. chills, headache, fatigue, body aches)
• Fever over 100.4℉
• Firm, red, tender, hot, swollen, and painful area of your breast
• Rapid pulse

If you have developed a fever or chills, then the infection is probably more severe and your body is trying hard to fight it off (5). So call your doctor! 

Mastitis: Causes

Mastitis is most often caused by a common bacteria, Staphylococcus aureu, getting inside your breast (1; 5). It’s common and normal to have it on your skin, but it can cause an infection if it gets inside your breast. Risk factors that can lead to mastitis include the following (1; 2; 4; 5):

• Cracked or damaged nipples
• Infrequent breastfeeding or a change in breastfeeding routine
• Untreated engorgement or clogged milk ducts
• Abundant milk supply
• Use of a nipple shield
• Stress
• Exhaustion (I know, I know—every mom is exhausted.)
• Lowered immunity
• Restrictive clothing
• A diet high in saturated fat and sodium

Mastitis: Treatment

If you think you have mastitis, call your doctor immediately. Your doctor might prescribe some of the following treatments (2; 3; 4; 5):

• Antibiotics (make sure you take your antibiotics for as long as your doctor says!)
• Rest as much as possible
• Drink lots of fluids
• Continue to breastfeed your baby from both breasts often (If your baby is premature and in the hospital, then you will probably be told to not breastfeed your baby from the breast with mastitis until after mastitis symptoms are gone.)
• If needed, use a pump to express your milk to keep your breasts drained and milk supply up
• Talk with a lactation consultant
• Apply warm, moist compresses to the inflamed area before and during feedings
• Apply cold packs to the inflamed area after nursing/pumping
• Place your baby in different positions during each feeding (try nursing your baby with his chin or nose pointed toward the clogged area)
• Massage or compress the hard area of your breast during and between feedings
• Take an anti-inflammatory pain reliever approved by your doctor

After you start treatment, mastitis symptoms usually only last 2-4 days (5). If you aren’t feeling better after 48 hours or if symptoms get worse within 24 hours, call your doctor again! 

Mastitis: Prevention

Some women are prone to recurring mastitis. The following tips might help prevent you from getting it again(2):

• Wash your hands often, especially after changing your baby’s diaper and before breastfeeding
• Ensure milk is removed regularly from your breasts (pump if your baby misses a feeding at night or is teething and doesn’t want to eat as much, etc.)
• Avoid becoming overworked or overly tired
• At the first signs of a clogged milk duct, apply warm compresses, breastfeed more frequently, and sleep!

At the end of the day, sometimes breastfeeding moms gets clogged milk ducts or mastitis even if they do everything right. Without a doubt, it is not a reflection of who you are as a mom! It’s just something that happens. Keep those breasts empty and free to try to set yourself up for the best chances not to have to deal with it, and if you do, rest up and get healing as soon as possible, mama.

Kopa Birth’s online childbirth classes allow you to prepare for a natural childbirth in the comfort of your own home, 24/7. Enroll today in our free online childbirth class to learn more about preparing for natural childbirth. 

Sources

1. CAPPA: Childbirth & Postpartum Professional Association. (2016). Lactation Educator Manual (Ninth Edition).
2. Injoy Health Education. (2016). Understanding Breastfeeding: Your Guide to a Healthy Start (Seventh Edition). Longmont, CO: InJoy Birth & Parenting Education.
3. La Leche League International. (2021). Breastfeeding Info: Mastitis. Retrieved 2021, from https://www.llli.org/breastfeeding-info/mastitis/
4. Lauwers, J., Swisher, A. (2021). Counseling the Nursing Mother: A Lactation Consultant’s Guide (Seventh Edition). Burlington, MA: Jones & Bartlett Learning.
5. Rosenthal, M.S. (2000). The Breastfeeding Sourcebook (Third Edition). Lincolnwood, IL: Lowell House.

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