Plumbing problems in the breast!

Amy Ready, MPT

MARCH 24, 2018


How many moms out there thought that after delivery, it’s smooth sailing? Breastfeeding may have not been on our list of concerns. It sounds easy, right? Less bottles, no formula, and convenient! The lactation nurse educates on breastfeeding and the pump after delivery, usually before your milk even comes in. Sounds easy at the hospital, no problem!

Well… several years ago as a new mom, I began to have pain with breastfeeding and noticed very little milk coming out. The doctor said it may be a blocked milk duct and recommended to just "keep feeding." I remember it being so painful and just bearing through it. I was a new mom with the stress of a feeding schedule, a pump that didn’t work so well, and a baby not latching on correctly. Not easy at all!

I was never sent to physical therapy and I never knew PT could treat it, even being a physical therapist! It wasn’t until I began working in Women’s Health several years later that I realized more options and treatments were available, which is why I am writing this! I want moms to know there is a quick, easy and effective treatment for blocked milk ducts so you can enjoy your breastfeeding experience.

drawing of breast showing milk ducts

What is a blocked milk duct?

So let’s go through the anatomy first. To put it simply, it’s a plumbing problem! The milk ducts are several small tubes (usually 15-30) that carry milk from the deep networks to the nipple and express milk. If an obstruction forms, the milk duct becomes clogged. Some may experience a painful lump or decreased milk flow. It is usually one breast, but both can be involved.

How did I get this?

The first weeks of breastfeeding are when your body is making more milk than expected and figuring out exactly how much to make. Blocked milk ducts can happen for many different reasons.

  • Are you trying to rapidly wean from breastfeeding, or did you have missed feedings due to a sudden long sleep stretch? Your baby finally starts sleeping through the night, (AMEN!) but then you wake up to a blocked duct due to missed feedings. Ugh, we can’t win!
  • What kind of bra are you wearing and does it fit right? Wearing a poorly fitting bra or an underwire bra can impede milk flow. It wouldn’t be uncommon for a sleep deprived mom may fall asleep with her bra on!
  • Have you changed any medication or recently been sick that may have altered your schedule? Extreme exhaustion and/or dehydration can cause blocked milk ducts. Any exhausted moms out there?
  • Do you change nursing positions? Changing nursing positions from football, cradle, cross cradle, side-lying and other positions can help drain multiple ducts. Gravity can be a big help with positioning. Also, breastfeed equally from both breasts and empty completely. Practicing good latching techniques to prevent sore, cracked nipples and good hygiene is also important.
  • Have you changed eating/drinking habits? Diet can play a role in decreased milk production. "Drinking at least 10 glasses of water a day and eating a well-balanced diet, increasing 500 calories a day while breastfeeding" are just two of the general guidelines.
  • Stressed? If mom is stressed, baby can sense the stress too. As hard as it is, try to take sometime for yourself to decompress. Yoga, quick nap, walking, reading or maybe book that long over due massage!

These can all play a role in preventing and addressing block milk ducts.

I think I have a blocked milk duct. What do I do?

The good news is that your baby is your best tool to treat blocked milk ducts. Remember, breastfeeding with blocked milk ducts will not hurt your baby. If you have a lactation consultant/nurse, this may be your first call for help. They may then refer you to PT. It may come to you as a surprise that you would come to PT for a blocked milk duct, as it is not a typical referral. However, it is very common and easily treated.

If PT is recommended, a typical visit would include an evaluation of the breast tissue and blocked duct. Moist heat is applied to the area, followed by various soft tissue and manual techniques to unclog the duct. Ultrasound has also been highly effective with treating blocked milk ducts. This is a non-diagnostic deep heating device that is applied to the breast tissue with a specific setting. Don’t worry…it doesn’t hurt! At the end of your visit, you nurse! Yes, you can bring your baby to the appointment or the breast pump, whichever you prefer. Usually, 1-4 visits are all that are needed to resolve the issue.

Warning signs!

If you notice red streaking, fever or colored/odor discharge, it is important to notify your MD immediately. This could be a sign of a breast infection, also known as mastitis. In some cases, a breast abscess can complicate mastitis. This needs immediate attention from your physician for antibiotics and/or drainage. PT can be started after the infection has been treated.

Now you know…

Hopefully, this has helped to understand exactly what a blocked milk duct is and how to treat it. It happens and sometimes it’s just unavoidable. If you have these symptoms and the techniques you know are not working, call your lactation consultant, MD or local Women’s Health PT. It can be an easy fix. Now, onto the next item on your mom to-do list!

We accept most major insurances in the Louisville area including Medicare and Passport.