Mastitis and Plugged Ducts

  • Posted by Cheryl Taylor, CBE

Infections of the breast present themselves typically in two manners. Mastitis is a bacterial infection in the breast, typically involving a considerable quantity of mammary tissue. A plugged duct is an individual duct that is blocked, swollen and often presents as a hard knot in the breast. A plugged duct can lead to mastitis, but the two are not always presented together. The treatment for both includes many of the same measures. The differentiation is often seen in the level of a fever and length it sustains. If a woman is familiar with the symptoms of either, and begins treatment immediately upon noticing the first symptoms, it can almost always be resolved before antibiotics are necessary. I encourage all breastfeeding moms to become familiar with the symptoms, so as to be in a position to catch the first signs and avert a long and painful battle.


  1. Tender, aching breast
  2. Hard knot in breast
  3. Skin hot and red, often in a spot right above a knot
  4. Flu-like body aches
  5. Fever
  6. Red line visible on breast
  7. A blister on the nipple is often associated with a plugged duct


  1. Increase nursings on the affected breast.
  2. Point baby’s chin at any red, hot spot you may have.
  3. Prior to nursing, immerse breast in very hot water and massage toward the nipple. As often as possible, do this in a bathtub to get excellent immersion. If needed, a sink can be used with washcloths to assist.
  4. After nursing, ice the breast. You can use a bag of frozen peas set aside for this purpose and wrap it in a thin dishcloth.
  5. Massage toward the nipple while nursing.
  6. Go to bed with baby and rest and nurse if at all possible.
  7. If your entire breast is sore, alternate nursing positions to rotate baby’s chin around the breast.
  8. Take ibuprofen to assist with pain and reduce inflammation.
  9. While nursing, use a hot rice pack on your breast. A simple rice pack is to take a tube sock, place rice in it and tie a knot at the end. This can be heated in the microwave.
  10. Stop wearing a bra while fighting mastitis.
  11. Keep track of your temperature and watch for a red streak on your breast. If your fever goes up considerably or if you feel very weak, you may need to consider antibiotics.
  12. Make sure you are drinking 64 oz. water a day!
  13. If you have a blister on your nipple, it can be opened with a sterile needle. Be gentle and don’t tear the skin, merely open it. Then massage toward the nipple and the “plug” is often discharged in the form of a thickened milk that has been backed up in that duct.


  1. Take Lecithin 1200mg three or four times a day.
  2. Wear a comfortable, loose nursing bra. Avoid underwire styles. Make sure you have plenty of room in your nursing bra to expand as various times of the day according to how long it’s been since nursing.
  3. Eat a diet low in saturated fats.
  4. Rest with baby every day. Resting is vital to keeping your body healthy and producing milk easily.
  5. Limit the length of time spent doing errands in a day. Resist heading out the door with a detailed map of how you’re going to accomplish a dozen tasks in speedy fashion. You will inevitably come home exhausted and that state of exhaustion has the potential for setting you up to have a breast infection.
  6. Drink 64 oz. of water daily.
  7. Be careful regarding sleeping positions.  A sleeping position that puts pressure on your breasts is likely to contribute to plugged ducts. If you are a tummy sleeper, try sleeping on your side and put a bed pillow between your knees — it helps to keep you from flipping over onto your stomach.
  8. Be aware of how your seatbelt fits across your chest and adjust it as needed to alleviate pressure on the breast itself.  Many vehicles have adjustable heights, but if yours does not you may want to use a folded washcloth or cloth diaper to place underneath where a belt presses against your breast to redistribute the pressure.  Another obvious solution is to limit how long you are out in the car, whenever possible, and nurse well while massaging that area when you are through driving.

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