Common Concerns While Breastfeeding - What is That Knot in My Breast?

Originally published on June 29, 2011; Revised Dec 30, 2024

Author: Robin Kaplan, M.Ed, IBCLC, FNC

Ever woken up from a deep sleep to find that an area of your chest/breast is tender, a little red, and pretty uncomfortable?  Upon further investigation, there may be a lump where the pain is radiating from?  How did this happen?  Should you be concerned?  In most cases, there is little need for concern.  Most likely, it is a pesky plugged (clogged) duct.  While this condition is often painful and frustrating, it’s usually manageable with some self-care and support.

So, what exactly are plugged (clogged) ducts, why do they happen, and what can you do to resolve them? Let’s break it down!

ABOUT SDBFC

The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent.  Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges.  SDBFC offers a wide range of one-on-one breastfeeding, infant feeding, and nutrition consultations - as well as classes, support groups, online articles, and social media - making it your one-stop-shop for all things infant feeding!

Why Do Plugged Ducts Happen? 

There are several reasons why milk ducts can become plugged:

  • Infrequent or Skipped Feedings: Skipping feedings/pumping sessions or your baby sleeping for a longer stretch than your chest/breasts are used to can cause milk stasis. Milk stasis refers to a condition where milk is not effectively removed from the chest/breast, causing it to accumulate and remain stagnant in the milk ducts. This stagnation can lead to increased pressure, inflammation, and eventually a plugged duct if not addressed promptly.  

  • Pump inefficiency: Using an incorrect flange size or a pump that doesn’t effectively remove your milk can increase your chances of a plugged duct

  • Poor Latch: If your baby is having latching difficulties, milk may not be efficiently removed.

  • Pressure on the Chest/Breast: Underwire bras, tight clothing, or even sleeping in certain positions can sometimes contribute to clogged ducts.

  • Stress, Fatigue, or Illness: Lack of sleep, emotional stress, or getting sick can all impact milk flow and immunity.

How to Resolve Plugged Ducts 

The good news is that most plugged ducts can be resolved with some simple strategies:

  1. Frequent and Effective Nursing or Pumping: Feed your baby often, starting on the affected side, or pump at regular, frequent intervals.

  2. Ensure Proper Pump Fit and Technique: Make sure you're using the correct flange size for your pump and watch reliable YouTube tutorials on optimal pumping techniques to ensure effective milk removal.

  3. Gentle Chest/Breast Massage: Apply gentle compressions while feeding/pumping to help move the blockage. Use your fingertips to apply light, circular motions starting from the outside of the chest/breast and moving toward the nipple. Avoid deep or aggressive massage, as this can worsen inflammation and discomfort.  Therapeutic breast massage can also be very helpful.

  4. Dangle Feeding: Lean over your baby while nursing to let gravity assist in clearing the duct.

  5. Cold Compresses: Apply cold compresses (like frozen peas) to the swollen area for 20 minutes in between feedings to help reduce swelling. 

  6. Self-Care: Rest, stay hydrated, and eat immune-supporting foods to help minimize inflammation. (Check out last month’s blog post about boosting your immune system!)

What If Plugged Ducts Keep Happening? 

If plugged ducts become a recurring issue, it’s time to dig deeper:

  • Meet with a Lactation Consultant: SDBFC’s lactation experts can help identify and resolve the root cause. This can range from addressing tongue/lip ties, troubleshooting your pump situation, or diving into your medical history to determine what’s causing chronic chest/breast inflammation.

  • Choline Supplementation: Incorporating choline can help disperse milk's fat particles more evenly, preventing them from clumping together and forming clogs. Starting recommended dosage is 500mg/day and can be increased, if necessary.

  • Therapeutic Ultrasound: Therapeutic ultrasound helps clear plugged ducts by using high-frequency sound waves to generate gentle heat within the chest/breast tissue, which can effectively break down milk blockages, increase blood flow to the area, and promote milk flow through the ducts.

When to Seek Help 

If the lump doesn’t improve within 24-48 hours, or if you develop flu-like symptoms, fever, or increased redness and swelling, contact your lactation consultant or healthcare provider. These could be signs of mastitis, which may require additional recommendations or medical treatment. Check out our article on Mastitis for additional remedies/treatments.

If you still have questions about remedying plugged (clogged) ducts, we are just a consult away!

Plugged ducts can be a painful (temporary) interruption in your chest/breastfeeding journey, but with early intervention and proper care, they’re usually resolved quickly. Don’t hesitate to reach out to our lactation consultants if you need extra support. Schedule a one-on-one appointment (consider a virtual appointment, if you don’t live in San Diego!) with one of our lactation consultants for personalized care and expert advice tailored to your chest/breastfeeding and pumping journey. 

SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

About the Author

Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center.  Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018.  Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.

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