There are many reported tools to empty a plugged duct. Unfortunately, there is very little research to say which are the most effective and safest. As plugged ducts can be hard to settle, mothers may benefit from using more than one. Any treatments should be gentle and if mothers are using warmth, they should be careful to not burn themselves.
1) Anti-inflammatory medication
Mothers should consider anti-inflammatory medication, such as ibuprofen, to decrease the inflammation that may be the cause of the blockage and to reduce pain.
2) Opening milk pimples
If a milk pimple is present along with a plugged duct, it should be opened as it may be contributing to the plug.
3) Generally safe and accepted tools
Other generally safe and accepted ways of treating plugged ducts include:
- Putting warm compresses on the breast or resting the breast in a bowl of warm water before breastfeeding to encourage the let-down.
- Changing the baby’s position at the breast at each feed so that the baby’s mouth rotates around the breast.
- Dangle feeds in which the baby is below the mother’s breast. Commonly, the baby lies on their back while the mother crouches over the baby on all fours.
- Using a warm water breast bath in a constant-suction pump after breastfeeding.
- Using cold cabbage compresses to decrease pain and swelling.
4) Breast manipulation
Mothers with plugged ducts have a lot of breast swelling (inflammation). Aggressive breast manipulation, such as massaging between breastfeeds or compression during breastfeeding or while expressing, can further increase the amount of inflammation and result in pain, delay healing, and possibly cause tissue damage. Any breast manipulation should be gentle, done for only a few minutes, and stopped if not effective.
5) Health-care providers
Please see your health-care providers if you notice any of the following:
- The plug does not improve significantly within three days. This can mean:
- Signs of an infection(mastitis or an abscess):
- The lump is becoming larger or more painful.
- The lump involves more than one quarter of the breast.
- The skin overlying it becomes red.
- You have a fever or feel unwell.
- There is bleeding from the nipple. This too can be a sign of cancer.
Health-care providers may recommend an ultrasound to examine the plug or use it to guide the needle as they drain the milk from the plug. Ultrasound has also been reported to treat plugged ducts (Cooper 2015; Lavigne 2012).