Breastmilk flows through a series of "pipes" called milk ducts inside your breasts and then out through pores in your nipples. Clogged ducts are just a blockage in these "pipes" which can cause hard lumps or nodules to form in a localized area of your breast.
These can be painful and give you an achy sensation
Usually do not cause a fever
Most times unilateral, or only on one side
Can lead to mastitis if no intervention, so contact IBCLC to be sure you have the correct treatment plan
Typically can be resolved by
Breastfeeding or pumping frequently, especially on affected breast
Massage breast during feeding/pumping toward the nipple
Cold compresses are generally preferred although some people find that warm showers decrease discomfort
Sunflower lecithin - a supplement that helps make milk less "sticky" and can help prevent reoccurrence
You can also use warm water with epsom salt in a haakaa with suction to gently pull the clog out
Click here for a step-by-step guide on how to do this
Mastitis
Mastitis is an infection in the breast tissue. It causes flu like symptoms (fever >101, chills, aches), along with localized pain, swelling and redness in the breast.
May notice decreased milk supply or a fussy baby on the breast
Contact your OBGYN if you suspect mastitis, as it MUST be treated with antibiotics.
Other ways to help treat mastitis at home include:
Expressing milk or breastfeeding about every two hours on the affected side
It is safe to give your infant breastmilk when you have mastitis- you cannot pass a breast infection to your infant via the breastmilk
Use NSAIDs for pain/fever management
Use warm, moist compresses on the affected breast, warm showers and breast massage
Wash hands often
Rest and drink plenty of fluids
Wear a supportive, but not tight/restrictive bra
New onset severe nipple pain while breastfeeding after previously breastfeeding without discomfort
Typically described as itching, burning, shooting, stabbing pain that extends back to the chest wall
Breasts can look shiny, inflamed, irritated, or even get small blisters
Baby may also have symptoms such as thick, white spots or patches on their tongue, inner cheeks and upper palate, or a red, spotted, "angry" looking diaper rash.
Contact IBCLC if you suspect a fungal infection because they can prescribe a treatment for you and baby.
In the meantime, air dry the nipples as much as possible. Yeast thrives in a warm, moist environment.
If you're using breast pads because of leakage, make sure you change them immediately once they become wet
Wear 100% cotton bras and underwear that "breathe" and can be washed frequently
Nipple Vasospasm
Caused by constriction in the arterioles of the breast which limits blood flow to the nipple causing intermittent, but severe pain and discoloration of the nipples
This can feel like a deep shooting or stinging pain and typically occurs after baby comes off the breast
Will notice a discoloration of the tip of the nipple - starts as white (blanching), then progresses to a deep purple/blue, then back to normal.
To combat this, make sure that you have a warm towel or heat pack ready so that you can apply that to your breast immediately after baby un-latches from the breast
You don't want the cold air to touch your nipples and make the constriction of blood worse
Avoid cold temperatures in general
Have warm towels ready for after showers
Sometimes may need a prescription medication to help dilate the blood vessels
Always contact IBCLC if you suspect this, because it can feel similar to a fungal infection
Milk Bleb/Blister
These can occur on the nipple itself or on the areola, and are typically caused by plugged ducts.
It happens when skin forms over the pores of the nipple which doesn't allow for milk to flow out as it normally should.
You'll want to treat it similarly to a plugged duct by applying warm, moist compresses to the affected nipple, warm saline soaks, and extra pumping to help pull the milk through the thin layer of skin.
Also try exfoliation with a dry or rough washcloth, a loofah or other material that can help rub that thin layer of skin off so the milk can flow.
If these strategies don't work, the last resort is popping or lancing the bleb with a sterile needle. This can be done at home or with the help of an IBCLC or other trained professional.
Click here for a nice article on how to treat these at home
Sometimes your breasts will produce more milk than your baby needs.
Mom's symptoms may include:
Frequent clogged milk ducts or mastitis, pumping >2 oz per hour in addition to breastfeeding, excessive leakage of milk, painful fullness of breasts even after breastfeeding.
Baby's symptoms may include:
Gagging or choking frequently during feedings, requiring them to unlatch
Spray of milk coming from breasts whenever baby pulls off
Frequent spit up, or reflux-like symptoms
Gassy, fussy, restless at the breast, or having explosive green, frothy stools (although we don't recommend basing too much on baby's poop!)
You can try to manage this supply issue by fully emptying the breasts once a day using a double pump, then restricting breastfeeding at one breast for a set number of feedings or a set amount of hours (aka- "block feeding").
Empty breasts = signal to the body to make more milk. Full breasts = NO signal to make more milk
For example: fully empty breasts by pumping both breasts once in the morning. Then offer ONLY left breast for 2 feedings in a row (or 4 hours), then switch and ONLY offer right breast for the following 2 feedings in a row.
You can increase the time/feeding interval as needed based on severity of oversupply, but do not exceed 12 hour blocks.
Try not to pump the other breast unless it's extremely painful
If you need to pump, express just enough to reduce the pain (typically 15-30 ml.
Milk stasis in the breast can lead to plugged ducts or mastitis, so always contact IBCLC with questions or concerns about supply.
Nipple Pain
There are a number of reasons for nipple pain so it's always helpful to speak with an IBCLC if you're experiencing symptoms.
It is important to note that nipple tenderness without any trauma to the nipple (cracks, blisters, bleeding) is normal in the first week of breastfeeding.
Nipples will toughen up naturally over time.
If you're having nipple soreness, there's a few things you can do at home to try and help
Try to change baby's position or switch your hold during a feeding
Saline nipple soaks - dissolve 1 tsp of table salt in 8 oz of warm water in a bowl, then "dip the nip" for a few minutes in the salt water.
