Blocked milk duct

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Blocked milk duct
Other names: Clogged milk duct, plugged milk duct
Milk ducts (arrow 6)
SpecialtyFamily medicine
SymptomsSmall tender lump, affected one breast[1][2]
ComplicationsMastitis[3]
CausesBreast engorgement, insufficiently breastfeeding, injury of the breast[4]
Differential diagnosisBreast engorgement, breast abscess, Pagetʼs disease of the breast[5]
TreatmentFrequent feeding, applying warmth and cold[2][5]
FrequencyCommon during breastfeeding[4]

A blocked milk duct is when one or more ducts carrying milk to the nipple is not draining.[2] Symptoms include a small tender lump, with potentially redness of the overlying skin.[1][2] Generally only one breast is affected and fever is not present.[1][5] A milk bleb may also occur at the nipple.[6] Complications may include mastitis.[3]

It may occur as a result of breast engorgement, insufficiently frequency of breastfeeding, poor attachment by the baby, or pressure on the breast such as from a seatbelt or poorly fitted bra.[2][4] The underlying mechanism may involve thick milk blocking a milk duct, resulting in a build up of pressure.[1][4] It may be associated with a milk bleb at the nipple.[5]

Treatment is generally by frequent feeding and application of alternating warmth and cold.[2][5] While massage of the lump towards the nipple when feeding has been recommended,[2][5] this practice may cause injury and has been discouraged by others.[7] Once the thick milk is removed, and the duct drains, symptoms generally rapidly resolve.[1] A blocked milk duct is common during breastfeeding.[4]

Signs and symptoms

A blocked milk duct has the following common symptoms:[8][9]

  • Low fever and breast infection
  • Pain in a particular side of the breast
  • Swollen or tender lump in the breast
  • Slower milk flow
  • a small white blister on the nipple called a milk bleb
  • swelling or redness of the breast
  • areas of the breast that are hot or warm to touch
  • the infant may feel fussy when feeding from the affected breast

Causes

Blocked milk ducts are a common breastfeeding problem and can be caused due to a number of reasons:[8][10]

  • When the infant does not latch properly
  • Wearing a tight bra or tight clothing can restrict the breasts and put pressure on them leading to a blocked milk duct
  • A bad or weak pump could lead to a drainage issue
  • When the breast milk is not removed regularly, the milk can back up and create a blockage
  • A nipple bleb can also block the milk duct
  • When the body produces milk in over abundance, it can engorge the breast and hence lead to a blockage
  • Other reasons include fatigue, over exercise, dehydration and weaning.

Treatment

Breastfeeding

The most effective treatment against blocked milk ducts is to empty the affected breasts by frequent breastfeeding or pumping.[11] Numerous other treatment approaches have been suggested, however, there is insufficient clinical research to determine the effectiveness.

Efforts that have been studied but with unclear evidence include:

  • A gentle massage of the affected breast[12] Sometimes after gentle massage over the lump, a string of the thickened milk comes out through the nipple, followed by a stream of milk, and rapid relief of the blocked duct.[1]
  • Ensuring a correct positioning and latching of the baby[12]
  • Wearing loose clothing items that do not bind the breasts[13]
  • Applying warm compresses[12]
  • Drinking a specialized herbal tea[13]
  • Acupuncture[12]
  • Gua-Sha[12]
  • Proteolytic enzymes[12]

A blocked milk duct can result from a nipple bleb. Both of these can lead to mastitis.[14]

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 "Management of breast conditions and other breastfeeding difficulties". National Center for Biotechnology Information US National Library of Medicine. Archived from the original on 18 January 2017. Retrieved 4 August 2017.Public Domain This article incorporates text from this source, which is in the public domain.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 "Breast pain and breastfeeding". nhs.uk. 7 December 2020. Archived from the original on 17 January 2024. Retrieved 25 January 2024.
  3. 3.0 3.1 "Lactation and nipple problems | DermNet". dermnetnz.org. Archived from the original on 2 October 2023. Retrieved 25 January 2024.
  4. 4.0 4.1 4.2 4.3 4.4 "Plugged Ducts, Mastitis, and Thrush | WIC Breastfeeding Support". wicbreastfeeding.fns.usda.gov. Archived from the original on 2 January 2024. Retrieved 25 January 2024.
  5. 5.0 5.1 5.2 5.3 5.4 5.5 Jacobs, A; Abou-Dakn, M; Becker, K; Both, D; Gatermann, S; Gresens, R; Groß, M; Jochum, F; Kühnert, M; Rouw, E; Scheele, M; Strauss, A; Strempel, AK; Vetter, K; Wöckel, A (December 2013). "S3-Guidelines for the Treatment of Inflammatory Breast Disease during the Lactation Period: AWMF Guidelines, Registry No. 015/071 (short version) AWMF Leitlinien-Register Nr. 015/071 (Kurzfassung)". Geburtshilfe und Frauenheilkunde. 73 (12): 1202–1208. doi:10.1055/s-0033-1360115. PMID 24771901.
  6. "Plugged Milk Ducts and Nipple Blebs" (PDF). Archived (PDF) from the original on 13 June 2023. Retrieved 27 January 2024.
  7. Kaptanian, Melissa (9 November 2022). Management of Benign Breast Disease, An Issue of Surgical Clinics, E-Book: Management of Benign Breast Disease, An Issue of Surgical Clinics, E-Book. Elsevier Health Sciences. p. 977. ISBN 978-0-323-98734-9. Archived from the original on 28 January 2024. Retrieved 27 January 2024.
  8. 8.0 8.1 "Clogged Milk Ducts: Symptoms, Causes and Treatments". www.thebump.com. Archived from the original on 2019-09-21. Retrieved 2019-09-21.
  9. "Reasons for blocked ducts". Medela. Archived from the original on 2019-09-21. Retrieved 2019-09-21.
  10. "Clogged milk duct: Symptoms, home remedies, and prevention". Medical News Today. 3 September 2018. Archived from the original on 2019-09-21. Retrieved 2019-09-21.
  11. Roberts, Kathryn L.; Reiter, Maureen; Schuster, Diane (September 1998). "Effects of Cabbage Leaf Extract on Breast Engorgement". Journal of Human Lactation. 14 (3): 231–236. doi:10.1177/089033449801400312. ISSN 0890-3344. PMID 10205435. S2CID 13110956.
  12. 12.0 12.1 12.2 12.3 12.4 12.5 Zakarija-Grkovic, Irena; Stewart, Fiona (18 September 2020). "Treatments for breast engorgement during lactation". The Cochrane Database of Systematic Reviews. 2020 (9): CD006946. doi:10.1002/14651858.CD006946.pub4. ISSN 1469-493X. PMC 8094412. PMID 32944940.
  13. 13.0 13.1 "Tackling engorgement and mastitis: an all-in-one guide". www.meandqi.com. Archived from the original on 2019-03-26. Retrieved 2019-03-26.
  14. Walker, Marsha (2011). Breastfeeding management for the clinician : using the evidence. Sudbury, Mass: Jones and Bartlett Publishers. p. s 534–5. ISBN 9780763766511.

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