Squamish Physiotherapy Specializing in Pelvic Health & Chronic Pain
Text between Lauren and a client where she shares that the duct has resolved completely.

Blocked (Plugged or Clogged) Milk Duct Education Series, Part 3: How To Prevent Blocked Ducts

Blocked (Plugged or Clogged) Milk Duct Education Series: Part 3 of 3.

How To Prevent Blocked Ducts

 

Text between Lauren and a client where she shares that the duct has resolved completely.

 

 

 

 

 

 

 

As a reminder, if you suspect you have a clogged duct, and especially if you think you have mastitis, you should contact your health care provider to let them know. They will ask you some screening questions to determine the urgency of your case.

 

 

Therapeutic Ultrasound Machine used at Glow Physio

One treatment I offer that has helped hundreds of women is a painless and comforting treatment called Therapeutic Ultrasound. In most cases, the duct can be unblocked in 1-2 sessions. This is an evidenced-based treatment that is often recommended by maternity care providers in Squamish, who refer their patients to me for this treatment. I can also add therapeutic cupping, as well as acupuncture (with or without microcurrent/MPS), to further enhance the treatment. You can book this treatment here: 

For details on strategies to use at home right now, see my previous post

Lecithin (available at Nesters in the Wellness Department) which is often prescribed to women with blocked ducts. If you have experienced a blocked duct, there is an increased chance of it occuring again. for this reason, it is often recommended to continue to use lecithin after the duct has cleared.

Kellymom, an excellent resource, states that “the usual recommended dosage for recurrent plugged ducts is 3600-4800 mg lecithin per day, or 1 capsule (1200 milligram) 3-4 times per day. After a week or two with no blockage, mom can reduce the dosage by one capsule. If there is no blockage within another 2 weeks she can reduce it again by one. Mom may need to continue taking 1-2 capsules per day if stopping the lecithin leads to additional plugged ducts

Lecithin is a very common food additive, and is found naturally in many other foods. There are no known contraindications to its use by breastfeeding mothers”

The reason why lecithin may help resolve and prevent plugged ducts is not clear. Per Dr. Jack Newman, “It may do this by decreasing the viscosity (stickiness) of the milk by increasing the percentage of polyunsaturated fatty acids in the milk.”

Anecdotally, magnesium supplementation also appears to help. As a natural muscle relaxant and electrolyte, it might play a role. Magnesium bisglycinate is the preferred form, as recommended by dietician Lily Nichols in her book Real Food For Pregnancy.

As mentioned previously, in Squamish, we are fortunate to have an exceptional group of practitioners to help with lactation questions, including the new collaboration between Mountain Maternity and Roots Midwives, and Anna Turyk of Nuture Sea To Sky Lactation Consulting Services. La Leche League Squamish is also an excellent resource.

If you have any questions, comment below or reach out! I prioritize seeing clients with blocked ducts so contact me directly and I’ll do my best to get you in as soon as possible.

Text between Lauren and a client where she shares that the duct has resolved completely.

Blocked (Plugged or Clogged) Milk Duct Education Series, Part 2: Home & In-Clinic Treatment Options for Blocked Ducts

Blocked (Plugged or Clogged) Milk Duct Education Series: Part 2 of 3.

Home & In-Clinic Treatment Options for Blocked Ducts & Mastitis

 

Text between Lauren and a client where she shares that the duct has resolved completely.

 

 

 

 

 

 

 

If you suspect you have a clogged duct, and especially if you think you have mastitis, you should contact your health care provider to let them know. They will ask you some screening questions to determine the urgency of your case.

Therapeutic Ultrasound Machine used at Glow Physio

One treatment I offer that has helped hundreds of women is a painless and comforting treatment called Therapeutic Ultrasound. In most cases, the duct can be unblocked in 1-2 sessions. This is an evidenced-based treatment that is often recommended by maternity care providers in Squamish, who refer their patients to me for this treatment. I can also add therapeutic cupping, as well as acupuncture (with or without microcurrent/MPS), to further enhance the treatment. 

What can you do to get started right now? :

Brigham and Women’s Hospital Standard of Care states that “Ultrasound has been shown to be of benefit in the treatment of blocked milk ducts.”

La Leche League offers the following advice when you suspect a clogged duct:

  • Breastfeed as often as your baby wishes
  • Rest
  • Apply ice or cold packs to the tender area
  • If you are engorged, consider doing lymphatic drainage—a very gentle, light yet firm touch, with fingertips flat to the skin in the armpit area and upper chest. To see a demonstration of lymphatic drainage massage, you can watch this video
  • In consultation with your healthcare provider, consider using ibuprofen (Advil®) alternating with acetaminophen (Tylenol®)

There is also a supplement called lecithin (available at Nesters in the Wellness Department) which is often prescribed to women with blocked ducts. Brigham and Women’s Hospital’s Standard of Care states that “the milk secretions that remain in the breast from blocked ducts have a very high fatty composition with a higher rate of absorption. Lecithin is a phospholipid emulsifier and can be used to emulsify milk secretions to promote breast emptying. The typical dosage is 1200 mg/day 3-4 times per day.“ Please speak with your medical team regarding any supplements.

Hydrate more than usual and rest when you can!

In writing this blog post, I learned that some common advice is now OUTDATED!

La Leche League updated their post on this topic in 2023 to say that the following strategies are NO LONGER recommended:

  • Heat to the breast, or soaking in warm water
  • Vigorous, deep massage, or squeezing to try to get rid of a clog
  • Dangling over baby for feeding to try to move a clog using gravity
  • Using a comb, vibrator, or electric toothbrush on the breast
  • Trying to “empty” the breast through extra pumping or breastfeeding which increases milk production
  • Using antibiotics right at the beginning of symptoms
  • Using Epsom salts in a Haakaa or similar silicone breast pump for nipple blebs
  • Using saline soaks, warm compresses, olive oil, castor oil, or other oils on the skin of the breast or nipple
  • Removing the skin or “popping” a bleb, which may allow infection to develop
  • Routine sterilization of pumps and household items is not necessary, although daily cleaning according to the manufacturer’s instructions is important to avoid infection from dirty pump parts.3 For more general information see this fact sheet.

My next post will outline evidence-based tips on how to prevent mastitis:

As mentioned previously, in Squamish, we are fortunate to have an exceptional group of practitioners to help with lactation questions, including the new collaboration between Mountain Maternity and Roots Midwives, and Anna Turyk of Nuture Sea To Sky Lactation Consulting Services. La Leche League Squamish is also an excellent resource. 

Strategies to treat and prevent clogged ducts, including treatments I offer in the clinic, are coming up in the next post!