By: Taya Griffin, IBCLC – Taya Griffin is a Toronto Based International Board Certified Lactation Consultant. She prepares mothers for their breastfeeding journey in the prenatal period and provides in- home and hospital postpartum breastfeeding support. She can be reached at www.tayagriffin.com. 

The breastfeeding breast is amazing!  Indications of the first changes it will go through begin as early as weeks into pregnancy. Breasts can feel tender and sore, the areola may darken and the Montgomery tubercles around the areola may become more raised. Many mothers also begin to see a crust-like formation on the nipples. This crusting is a minute amount of colostrum which is seeping out ever so slowly and drying on the tip of the nipple.

Milk production doesn’t truly begin until the placenta is delivered. The progesterone and estrogen levels drop and milk production begins. After the milk has transitioned from colostrum to more mature milk, in and around the seventy two hour mark, one of the most common issues with breastfeeding breasts that I see as a Lactation Consultant (after sore nipples and low milk supply of course!) is blocked ducts. 

When a mother suffers from blocked ducts milk becomes clogged in the straw-like ducts that bring the milk to the nipple.  The breasts may feel tender and this uncomfortable sensation is also accompanied by a hardness that one can palpate. Sometimes the block can be small like a marble but it may be much larger.

When there is a clog or block in the ducts babies may become more fussy. They want all the straws to flow well so they can get their milk quickly! An indication for a blocked duct may be a baby pulling and arching away from the breast in response to slower flow. With a block there is also a protein created called, “Feedback Inhibition of Lactation”. It tells the brain to slow down milk production so that the breast stays healthy.   Long term blocked milk ducts can decrease milk supply over the long run.   Unresolved blocked ducts can also be a risk factor for mastitis which is a breast infection accompanied by fever and chills and overall malaise.

There can be many reasons for blocked ducts. Here are a few with some simple suggestions on how to trouble shoot. If you feel you are suffering from ongoing blocked ducts and that you cannot manage on your own make sure to call an International Board Certified Lactation Consultant (IBCLC) who can help to truly solve your issue.

Problem – Poor Latching: If baby is not latched on well to the breast they cannot draw enough milk out. They may also collapse ducts with their poor latch.

Solution – Fix the latch!  Work to get the breast tissue more deeply into the baby’s mouth. Work with an IBCLC if you find that tweaking the latch on your own isn’t working.

Problem – Poor Feeding Management:  If mother has not been taught good feeding management techniques such as compressions and switching sides milk may remain in the breasts. This may lead to blockage.

Solution – Make sure to use deep compressions and keep the baby drinking well at the breast. If you find the baby isn’t draining the breast well make sure to get good help.

Problem – Too tight clothing or underwire bras: Anything that cuts into the breast and applies local pressure may prevent good flow and cause blockage.

Solution – Loosen those clothes and pick wire free nursing bras for at least the first 6 weeks postpartum!

Some mothers also have stickier milk and despite fixing the latch and working on feeding management blocked ducts are persistent. For these mothers we recommend Lecithin, a food supplement, which can make the milk less sticky.

Finally, for very stubborn blocked ducts that persist, ultrasound can be extremely helpful.   There are many wonderful practitioners offering ultrasound treatments for blocked ducts. Speak to your IBCLC for a list!

Happy block-free breastfeeding!!  And let me know if you have any questions!