A mother lies in bed with her baby.
Moms who suffer inflammation while breastfeeding should consult a doctor who can help identify the likely source of the problem. (For Spectrum Health Beat)

I follow several Facebook pages related to pregnancy and breastfeeding, and on many of them I noticed moms asking questions about mastitis and plugged ducts.

They had wondered what to do about these conditions.

It’s helpful to first understand the difference between a plugged duct and mastitis.

A plugged duct occurs when the area of the breast around the duct becomes swollen, inflamed and blocked. A mom may notice a small, hard lump, which can be red or warm to the touch.

A plugged duct doesn’t cause a fever, although the area itself can become sore. If it continues it can become infected, which is when it becomes mastitis.

Mastitis is an infection of the mammary gland. It has all the symptoms of a plugged duct but it can also create flu-like symptoms.

A plugged duct usually only occurs in one breast, while mastitis can be in one or both breasts.

Contributing factors

You may be wondering how you get a plugged duct or what causes it.

“The first thing you need to do is find a contributing factor,” said Cheryl Lake, RN, IBCLC, lactation consultant at Spectrum Health Gerber Memorial. “These can include things like a change in the breastfeeding schedule, improper latching and positioning, or anything that puts consistent pressure on the ducts.”

Some possible sources of this duct pressure:

  • Carrying a diaper bag for long periods of time.
  • Wearing an underwire bra.
  • Sleeping on your stomach.
  • Sleeping through the night. This changes a baby’s feeding schedule, which can contribute to creating a plugged duct.

It’s worth noting there is also a higher incidence of plugged ducts in the winter. To help alleviate a plugged duct:

  • Nurse often.
  • Use a warm compress.
  • While taking a warm shower, massage the affected area to loosen the clog.
  • Try changing baby’s position while nursing. Sometimes you can position baby to help release the plugged duct area.
  • Rest is very important.
  • Don’t wear restrictive clothing.
  • Some people use lecithin, although we aren’t sure exactly how it helps. “It may (help plugged ducts) by decreasing the viscosity of the milk, by increasing the percentage of polyunsaturated fatty acids in the milk,” said Jack Newman, chief pediatrician at the International Breastfeeding Centre. You could try lecithin in a dietary supplement.

Here are some other possibilities:

  • You could put a cabbage leaf in your bra. Strange as it sounds, it works. Cabbage leaves also help with engorgement.
  • Thin-sliced or grated potatoes held in place by your bra can also help. Yes, this also sounds strange! Leave for at least one hour to dry, and change it as needed.
  • Take a probiotic,  specifically  fermentumor L. salivarius strains. The American Family Physician Journal found that using probiotics such as these lessens the chance of a mastitis recurrence.

Mastitis is an infection that can be caused by bacteria that gets into the breast. It’s more common in the first three months of breastfeeding, but it can happen later. It can also progress from a plugged duct if that continues.

Symptoms of mastitis include:

  • Flu-like conditions with a fever.
  • Breast is hot, red, swollen and tender.
  • Pain in the breast.
  • Cracked nipple that looks infected.

In most cases of mastitis and plugged ducts, you won’t need to stop breastfeeding but you will need to contact your provider.