What it is
You have a tender lump, or a red hot patch on your breast, or you feel like you have the flu and you are breastfeeding. This page covers clogged ducts and mastitis.
A clogged or plugged duct is a spot where milk flow has narrowed and the tissue around it is swollen. It feels like a sore marble or a wedge. Mastitis is when that inflammation spreads. The breast gets red, hot, and painful, and you get a fever, chills, and body aches.
About one in ten breastfeeding mothers gets mastitis, most often in the first six weeks.
What's typical
A clogged duct often clears in a day or two with frequent feeding and cold. Mastitis comes on fast, sometimes in hours. With rest, cold, and feeding, many cases turn around in 24 to 48 hours. If they do not, providers often prescribe an antibiotic. Keep feeding or pumping on that side. The milk is safe for the baby and stopping makes it worse.
A lump that stays after the fever is gone, or that feels soft and squishy in the middle, can be an abscess. That needs an ultrasound and often draining.
What's known
The Academy of Breastfeeding Medicine rewrote its guidance in 2022. The old advice was heat, deep massage, and pumping to empty. The new advice is the opposite: ice, gentle lymphatic strokes, feed on the baby's cue, and do not add extra pumping. Lecithin is widely used by mothers who get repeat clogs. The evidence is thin, and the ABM lists it as something that may help some. Ask your provider or lactation consultant.
What helps
- Cold packs on the sore area between feeds, 10 to 15 minutes at a time.
- Feed on the baby's schedule, starting on the sore side if it is bearable. No marathon pumping.
- Light strokes from the lump toward the armpit, the pressure you would use on an eyelid.
- Rest, fluids, and someone else on baby duty. Mastitis is your body asking you to lie down.
- Ask your provider about an anti-inflammatory that is compatible with breastfeeding.
When to call someone
- Now (go in): a fever over 103, confusion, a racing heart, fast breathing, or feeling faint. Those are signs of sepsis.
- Todaya fever of 100.4 or more with a red, hot breast, or flu-like aches that came on fast.
- Todayno improvement after 24 hours of rest and cold, red streaks, pus or blood from the nipple, or a cracked nipple that looks infected.
- This weeka lump that is still there after the fever is gone.
- At your next visitclogs that keep coming back. Ask about flange fit, latch, and lecithin.
Who helps
Tools: Feeding Prep · Birthworker Directory
Related
- Engorgement when milk comes inPostpartum: Your Body
- Keeping ducts clear: prevention habitsFeeding Your Baby
- Nipple pain, cracks, and healingPostpartum: Your Body
- Thrush and other nipple infectionsPostpartum: Your Body
- Oversupply and forceful letdownFeeding Your Baby
- Flange sizingFeeding Your Baby
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Sources
- Academy of Breastfeeding Medicine — Clinical protocol on the mastitis spectrum (2022 revision)
- Centers for Disease Control and Prevention — Breastfeeding FAQ: mastitis
- La Leche League International — Mastitis
- NHS — Mastitis
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