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Painful Breastfeeding: Plugged ducts and Mastitis

painful breastfeeding

Painful breastfeeding can be one of the most frustrating and distressing things to experience as a new mom. Learning more about what could be causing your pain and some strategies to treat it will help you recognize your symptoms early and get the right support. Plugged milk ducts and mastitis are two common issues that you may encounter during your breastfeeding journey. While these struggles can happen at any time, mastitis occurs to about 1 in 4 breastfeeding mothers during the first 6 months postpartum.  

What is a plugged duct?

A plugged duct occurs when milk isn’t being removed sufficiently from your breast. Skipping feeding or pumping sessions, a shallow latch or an ill-fitting pump flange may cause a plug to form within the milk duct. Anything that prevents the free flow of milk or puts pressure points on certain areas of the breast like tight fitting clothes or an underwire bra can contribute to developing a plug. It is quite painful, and you may notice some swelling or lumpiness in a localized area in the breast. Plugged ducts generally do not come with other symptoms and are usually unilateral, meaning they occur in one breast, unlike engorgement which most often occurs in both breasts at once.

How can I treat a plugged duct?

The goal for treating a plugged duct is to break it up and have it work its way down the milk duct. Some important ways to do this are: frequent feeding (or pumping), a warm compress just prior to feeding and very gentle massage of the breast. The plug will then either be absorbed by your body or come out in your milk. You may notice it is thick, stringy and can be green or brownish. It may temporarily change the taste of your milk, which your baby may not like, but you can rest assured there is no danger to your baby. A lactation consultant can help you with feeding strategies to assist in treating plugged ducts. 

What is mastitis?

Mastitis is severe inflammation of the breast, caused by untreated plugged ducts, engorgement, or bacterial infection. It is often described by moms as a throbbing, localized pain. Symptoms include redness, heat, tender to the touch, often accompanied by fever and flu-like symptoms. Like plugged ducts, mastitis too usually occurs on one breast only. Mastitis most often appears in the first 2 months postpartum, with the newborn period presenting a perfect opportunity for illness as a new mom. Due to lack of sleep and lowered immunity from your recent pregnancy, as well as damaged and cracked nipples, the risk of infection is high. 

How can I treat my mastitis?

Recommendations for the treatment of mastitis have changed over time, so it is important to meet with a lactation consultant for support. Remember that mastitis is inflammation; ice packs, rest and pain medications like ibuprofen are helpful. Oral antibiotics may also be needed to treat infection. Your breastmilk will contain the antibodies for your baby, so not only is it safe to continue breastfeeding, but frequent feedings are also highly encouraged. Keeping the milk flowing is essential to prevent mastitis and latching your baby at the breast removes milk better than a pump or hand expression.


Pain with breastfeeding is a big red flag that something isn’t right. Remember to listen to your body and reach out for support! If mastitis is left untreated, it can lead to a breast abscess, possibly needing IV antibiotic therapy and surgery. Any unresolved breast pain or breast changes should be evaluated by a professional to rule out any other underlying conditions or disease. 

You don’t need the added stress of feeling unwell while caring for a new baby, so talk to a lactation consultant today to get the most out of your breastfeeding experience!


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