Blocked milk ducts are a pain, in every sense of the word. They can cause significant soreness and discomfort for women during breastfeeding or simply moving around throughout the day. Furthermore, if not resolved blocked milk ducts can lead to mastitis, a potentially dangerous infection. Today, I want to talk about what causes blocked milk ducts and what both you and your physical therapist can do to help reduce associated symptoms and concerns.
Milk ducts, also called lactiferous ducts, are tubes through which breast milk travels from the tissue where it is produced to your nipple, allowing the milk to express from your breast. When the breast is filled with milk that is not emptied by breastfeeding or pumping, the weight of the tissue can press on the milk duct and block the normal flow. Additional causes may include an overabundant milk supply or pressure on the breasts such as a tight bra, as well as poor latching. When the normal flow of milk is blocked for any of the above reasons, a plug can form, resulting in a blocked duct. These blockages can cause significant pain during breastfeeding and wearing tight clothing, but typically resolve on their own in 24-48 hours.
During the early stages of a blocked duct, the breast may feel hardened in the area of the plug and are painful to the touch. Like mentioned earlier, if this doesn’t resolve quickly you may be at risk for developing mastitis. Women are highest risk for developing mastitis in the first 4 weeks of pregnancy, with research showing that 60% of cases occur in this time frame. In the United States, mastitis has a prevalence of 9.5% with that rate rising to 23% in developed countries worldwide.1
Knowing the signs of these conditions is important. While blocked ducts are common and you can attempt many home remedies independently, mastitis needs immediate e medical attention. While a blocked duct feels like a hardened, painful lump in the breast, mastitis will cause the breast to appear red, hot and inflamed. Systemic effects may also be felt such as flu like symptoms, body aches, chills, fatigue and fever. If you start feeling any of these symptoms, call your physician right away.
Fortunately, if caught early, there is plenty that both you and your physical therapist can do to make you more comfortable and help reduce the blockage. Here are some helpful options for managing a blockage at home:
- Don’t stop breastfeeding. Although it can be tempting to avoid nursing on a sore breast, it can increase the likelihood of a blocked duct. Keeping the milk moving is essential.
- Try to completely empty your breast milk each time you feed your baby. Use breast compression while your baby is feeding. If there is milk left afterwards, you can pump to further empty.
- Apply moist heat before nursing for about 15 minutes to help loosen the plug. You can bend over while using moist heat to assist in drainage.
- Start each nursing session on the side of the blocked duct.
- Use self massage on the affected breast, starting on the outside of the breast and moving towards the nipple to help express milk.
- Cabbage! Studies have shown that cabbage leaves can relieve pain from swelling in the breast. First boil the cabbage, then let it cool and separate the leaves. Apply it to the affected area for about 20 minutes, 3-4x/day.
If these techniques are not enough, your physical therapist may have a few other tricks up her (or his) sleeves. Physical therapists can treat a blockage by using heat, massage and ultrasound. Ultrasound is a physical therapy modality that is painless and can help break up a blockage, reducing pain within 1-2 sessions.
You are not alone. These symptoms are common. While not every physical therapy clinic will have the training to treat you for a blocked duct, call around to clinics or clinicians in your area who specialize in women’s or pelvic health. Or, ya know, you could also come see us at Sullivan!
Please feel free to leave questions and comments below or email firstname.lastname@example.org for more information.
-Rebecca Maidansky, PT, DPT