Wyoming WIC

Plugged Ducts or Milk Duct Narrowing

PLUGGED DUCTS OR MILK DUCT NARROWING

Sometimes, inflammation or swelling in the breast can narrow the milk ducts which might slow or block the flow of milk. This can feel like a small lump, sore knot, or hard area in the breast. You won’t have a fever or feel sick, but sometimes the narrowed duct can get worse and lead to an infection.

Inflammation and swelling in the breast can happen when:

  • More milk is produced than your baby needs
  • Your breasts are engorged
  • Your baby skips a feeding or isn’t feeding as often as usual
  • Your baby or breast pump isn't removing your milk well
  • There is an imbalance of normal bacteria in the breast

WHAT YOU CAN DO:

  • Breastfeed your baby when he or she shows signs of hunger. If you are pumping, only remove enough milk to meet your baby’s needs. Pumping or breastfeeding more often can cause your body to make more milk than your baby needs and can worsen the duct swelling or inflammation.
  • Make sure your baby has a deep and comfortable latch. A WIC lactation expert can help you with your latch and positioning.
  • Use gentle massage for a few minutes before and during feedings to help promote milk flow. Using your fingers, start behind the sore or hard area in your breast and using gentle circular motions move towards your shoulder and collarbone. Do not pinch, squeeze, or massage firmly – this can cause more inflammation.
  • Start feedings on the breast without pain or swelling first.
  • Apply ice or cold packs to reduce pain and swelling. Use the cold pack for 10 to 15 minutes at a time, several times a day. Help protect your skin by placing a thin cloth between the ice pack and your breast.
  • Stay well-hydrated with water and rest as much as possible.
  • Wear a well-fitting, supportive bra that doesn’t put pressure on your breasts.
  • Consider hand-expressing a little bit of breast milk from your breast if it starts to feel too full. WIC staff can show you how to do this.
  • Ask your healthcare provider about medicine to help with pain and swelling, like acetaminophen (Tylenol) or ibuprofen (Motrin). They might recommend certain supplements, as well. Ask your doctor about the safest options for you.
Early treatment of milk duct narrowing can help you feel better and help prevent a breast infection, called mastitis, which may require medical attention. If the lump, sore knot, or hard area of your breast doesn’t resolve or get smaller in size within 24 hours or if you develop a fever or start feeling unwell, ask for help from a lactation consultant or healthcare provider.

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SIDE-LYING HOLD

Side-Lying Hold

  1. For the right breast, lie on your right side with your baby facing you.
  2. Pull your baby close. Your baby’s mouth should be level with your nipple.
  3. In this position, you can cradle your baby’s back with your left arm and support yourself with your right arm and/or pillows.
  4. Keep loose clothing and bedding away from your baby.
  5. Reverse for the left breast.

This hold is useful when:

  • You had a C-section
  • You want to rest while baby feeds
  • You are breastfeeding in the middle of the night
  • You and your baby are comfortable in this position
CROSS-CRADLE HOLD

Cross-Cradle Hold

  1. For the right breast, use your left arm to hold your baby’s head at your right breast and baby’s body toward your left side. A pillow across your lap can help support your left arm.
  2. Gently place your left hand behind your baby’s ears and neck, with your thumb and index finger behind each ear and your palm between baby’s shoulder blades. Turn your baby’s body toward yours so your tummies are touching.
  3. Hold your breast as if you are squeezing a sandwich. To protect your back, avoid leaning down to your baby. Instead, bring your baby to you.
  4. As your baby’s mouth opens, push gently with your left palm on baby’s head to help them latch on. Make sure you keep your fingers out of the way.
  5. Reverse for the left breast.

This hold is useful when:

  • Your baby is premature
  • Your baby has a weak suck
  • Your baby needs help to stay latched
  • Your baby needs extra head support
  • You and your baby are comfortable in this position
CLUTCH OR “FOOTBALL” HOLD

Clutch or “Football” Hold

  1. For the right breast, hold your baby level, facing up, at your right side.
  2. Put your baby’s head near your right nipple and support their back and legs under your right arm.
  3. Hold the base of your baby’s head with your right palm. A pillow underneath your right arm can help support your baby’s weight.
  4. To protect your back, avoid leaning down to your baby. Bring baby to you instead.
  5. Reverse for the left breast.

This hold is useful when:

  • You had a C-section
  • You have large breasts
  • You have flat or inverted nipples
  • You have a strong milk let-down
  • You are breastfeeding twins
  • Your baby likes to feed in an upright position
  • Your baby has reflux
  • You and your baby are comfortable in this position
CRADLE HOLD

Cradle Hold

  1. For the right breast, cradle your baby with your right arm. Your baby will be on their left side across your lap, facing you at nipple level.
  2. Your baby’s head will rest on your right forearm with your baby’s back along your inner arm and palm.
  3. Turn your baby’s tummy toward your tummy. Your left hand is free to support your breast, if needed. Pillows can help support your arm and elbow.
  4. To protect your back, avoid leaning down to your baby. Instead, bring your baby to you.
  5. Reverse for the left breast.

This hold is useful when:

  • Your baby needs help latching on
  • You and your baby are comfortable in this position
Laid-Back Hold

Laid-Back Hold

  1. Lean back on a pillow with your baby’s tummy touching yours and their head at breast level. Some moms find that sitting up nearly straight works well. Others prefer to lean back and lie almost flat.
  2. You can place your baby’s cheek near your breast, or you may want to use one hand to hold your breast near your baby. It’s up to you and what you think feels best.
  3. Your baby will naturally find your nipple, latch, and begin to suckle.

This hold is useful when:

  • Your baby is placed on your chest right after birth
  • You have a strong milk let-down
  • You have large breasts
  • You and your baby are comfortable in this position