Insanely Painful Breasts After Birth

clogged milk ducts

You are laying in bed, contemplating the latest eat-sleep-poop cycle your baby has presented, when you decide you're finally comfortable enough to get some sleep. You roll over onto your belly, and as you do, your chest explodes with pain, you see stars behind your eyelids, and it feels like you've just been stabbed in the boob.  With a red-hot poker.

You turn on the bedroom light, sure you're going to see a murder scene in your bed, or at least the legos left there by your 3 year old that usually cause that unexpected pain, instead you find all of your insides are exactly where they are supposed to be, but one of your breasts is very tender to the touch, and has a bright red spot.

You have a clogged duct.

Now that you have given birth, clogs aren't just for hairballs in your drains.  Milk can build up in the milk ducts, and causing a blockage in your breast tissue.  And since you can't ever really drain breasts completely, there can be a lot of pressure behind the clog, leading to a lot of inflammation and pain.  You'll want to get rid of this as soon as you can, because a blocked duct can lead to mastitis*.

Ways to help break up a clogged milk duct

  1. If you are trying to feed at the breast, keep nursing.  A baby's mouth is often the best suction available, but a pump is good too if you choose to exclusively pump.  (If you're not breast feeding, you'll want to skip to #4.)
  2. Nurse with the baby's chin pointed at the clog.  I've heard that its the greatest suction that happens when the chin points there, but I think also the motion of the baby's tongue on the tissue may have something to do with it.
  3. Dangle Nursing.  This is exactly what it sounds like-- put the baby in a safe location on his/her back, and dangle your breast over them to let them eat.  This has two benefits: it uses gravity to remove the clog, and also allows easier maneuvering of the breast so the baby can nurse most effectively.
  4. Warm compresses & massage.  We say these together because you want to use the warm compress to loosen the surrounding tissue, then massage from above the clog, through it, down toward the nipple.  Much like massage to hand express.  This is very effectively done in the shower, and keeping warm compresses on as much as possible during the day.
  5. Ultrasonic toothbrushes.  You know those fancy ones that vibrate bacteria away?  The hard end (not the brush end) right on the very tender area can help break up the clog before you express the milk.
  6. Make sure you are getting enough water. Its easy to dehydrate when you are hydrating for two, and if your milk is a bit dehydrated, that can cause clogged ducts.

Unfortunately, none of these things are comfortable, but they can help relieve the pressure until the problem resolves itself.  Some people are more prone to clogged ducts than others, but there are things you can do to set yourself up for not getting them again.

Preventing Plugged Milk Ducts

  1. Drink enough fluids.  I know I just said it above, but it stands to reason here that you want to make sure you are hydrated.  Breastmilk is a bodily fluid, and will be at its best when you are well hydrated.
  2. Let your ladies loose. When your body is balancing out its milk production (first 4-6 weeks) you want to stay away from bras that are too tight, compress the tissue much, or are uncomfortable.  Also, breast size permitting, try to stay away from underwires until your supply regulates.  (Underwires= extra pressure on the tissue). 
  3. Drain your breasts well at each feeding/pumping session. You can't ever really fully drain a breast, because its a demand and supply system.  But if you can express enough so you FEEL less full, you will help your breasts flowing freely.  That's because milk that sits for a long time has a much higher chance of causing a clog.  (Please don't go pumping after nursing in the first few weeks simply to prevent a clog.  That just perpetuates engorgement and oversupply.  But make sure your baby eats well from both sides, and that you notice a difference in the firmness of the breast tissue.)

*If you are experiencing or get any of the following symptoms (in addition to the clogged duct, right before you notice it, or right after) please call your medical care provider (your OB/midwife will see you, so will your general practitioner, as well as most urgent care locations) to get your potential mastitis diagnosed and to get antibiotics.

Victoria McCollum

Victoria McCollum is a birth and postpartum doula and owner of Doulas of Fredericksburg, in Fredericksburg, Virgina. She resides there with her husband and three precocious sons.