The breast is made of a lace-like pattern of connected, very small milk ducts. When there is inflammation or swelling in the breast, the milk ducts become very narrow. The milk ducts are not actually plugged but pushed closed so that milk cannot easily flow out of the nipple. The area that is swollen can feel firm, tender and sometimes warm to the touch. Milk duct narrowing is a more appropriate term for “plugged ducts.

Potential Causes of Milk Duct Narrowing

• Baby sleeping for longer periods of time
• Baby not sucking well
• Skipped feedings or pumping
• Breast too full or an oversupply of milk
• Weaning too quickly
• Outside distractions that prevent or delay breastfeeding
• Using an ineffective breast pump

Pressure outside the breast such as a tight-fitting bra or clothing

Milk Removal to Help Relieve Milk Duct Narrowing Symptoms

If you are directly breastfeeding the baby:

• Breastfeed as frequently as the baby is hungry starting with the affected breast
• Offer both breasts at each feeding
• Latch the baby deeply so there is no pain with breastfeeding. If there is pain with latch, seek help to prevent nipple soreness.
• Change position of baby during feedings to help with drainage of milk ducts.
• After breastfeeding, do not remove more milk by pumping. This causes your body to make more milk than your baby needs and can worsen the breast swelling.
• Do not compress or massage the breast since this can make the swelling worse.

If you are pumping exclusively:

• Pump your milk each time the baby eats from a bottle
• Leave pump suction strength at a comfortable level. Do not turn the suction up too high and cause pain at the nipple.
• Only remove the same amount of milk your baby takes by bottle. Pumping significantly more milk can cause an oversupply of milk, which worsens breast swelling.
• If you have less milk than your baby eats, stop the pump when the milk stops flowing. Feed your milk to the baby in addition to formula to give the full feeding amount.

If you are combining breastfeeding and pumping:

• Breastfeed as frequently as the baby is hungry
• Offer both breasts at each feeding
• Latch the baby deeply so there is no pain with breastfeeding. If there is pain with latch, seek help to prevent nipple soreness.
• Do not compress or massage the breast since this can make the swelling worse
• If you do not feed the baby at the breast for a feeding:
• Pump on a comfortable setting only while milk is coming out
• Only remove the same amount of milk your baby takes by bottle. Pumping significantly more milk can cause oversupply and worsen the swelling

Prevention

• Rest, drink plenty of fluids, and eat healthy.
• If possible, get help with household tasks and caring for the baby so that you can get rest.
• Do not massage or compress the breast as this can lead to more swelling of the affected area.
• Use cool compresses to the breast between feeding or pumping sessions to provide comfort.
• Avoid soaking the nipple and do not put topical products on the breast.
• If you are prescribed any medications, make sure to ask your health care provider if the medication is compatible with direct breastfeeding or pumping. You can take an anti-inflammatory medicine such as Ibuprofen as recommended by your health care provider.

To prevent milk duct narrowing from occurring or from occurring again after the first episode

When to Call the Doctor

When bacteria enter the milk glands where milk duct narrowing is located, the area of the breast may develop worsening redness and soreness. Any individual with milk duct narrowing symptoms who develops fever, chills, or a fast hear rate could be developing mastitis and should seek medical care right away.