While some moms will never experience the discomfort that comes with engorgement and clogged milk ducts, it is pretty common, especially in the first few weeks of breastfeeding. Engorgement is often associated with milk “coming in” around 3-5 days after delivery. Engorgement can be painful, making latching difficult, and be accompanied by clogged ducts. Sometimes clogged ducts and engorgement seems to come on suddenly and when it does, moms are often confused about how to soften their breasts and clear clogged ducts. We’ve compiled a list of best practices for reducing inflammation/discomfort and overcoming bouts of clogged milk ducts and engorgement.
Proactive measures to ward off engorgement and clogged ducts
As previously mentioned, clogged milk ducts and engorgement generally occurs in the first few weeks after delivery. However, moms can develop clogged ducts and engorgement at any time during breastfeeding (and sometimes in the immediate period following weaning). Frequent milk removal is key to warding off “milk stasis” (meaning the buildup of milk in breast tissue). Milk production is continuous after the birth of your baby. As your body continuously makes more milk, your breasts and the tissue that stores breast milk fill up. This is why it is recommended that moms breastfeed, pump, or hand express their milk often while lactating. Although there is not a “magic number” of hours moms can go between feedings or pumping sessions, it is generally recommended that moms aim to remove milk at least every 3 hours during the first two to three weeks after delivery. Later, some moms are able to sometimes go up to 5 hours between feedings or pumping sessions without experiencing clogged ducts. Note: Frequently going more than ~3 hours without removing milk can decrease milk supply and is not advised in the first 3 months. Occasionally going a 5-hour stretch without nursing or pumping may be doable for some moms sooner than 3 months postpartum, but the risk of developing clogged ducts and/or engorgement increases.
Treatment options for engorgement and clogged ducts
If you’ve woken up to swollen breasts or clogged ducts after going too long between nursing or pumping sessions overnight, you are not alone. Engorgement and clogged milk ducts are more common in the early morning hours due to increased prolactin levels (which peak between 3-5AM) and the tendency to try and get more rest at night. To help reduce the swelling and soften your breasts, you may find alternating between applying cold and hot compresses to the affected area helpful.
We recommend having breast therapy packs like these from Lansinoh (link → https://aeroflowbreastpumps.com/lansinoh-therapearl-3-in-1-breast-therapy-packs) on-hand for situations just like this. Again, clogged ducts and engorgement typically come on suddenly, and when they do, you want to take action quickly to prevent worsening of symptoms and mastitis.
In addition to hot/cold therapy, it is advised that you work to remove excess milk quickly by:
- Nursing your baby as much as possible
- Pumping (depending on the severity of milk stasis, some moms will need to pump quite a few times before they are successful in unclogging affected milk ducts and softening the breasts enough to resume pain and frustration-free breastfeeding)
- Gently massaging your breasts before, during, and after breastfeeding/pumping
- Using a breast massager (or other vibrating tool) to break up the milk fat and encourage milk to flow out of the breast
- Alternate breastfeeding positions (i.e. try “dangle nursing,” the football position, etc.) to encourage your baby to suck from different angles than he/she usually does
If you are struggling with a particularly bad case of engorgement or recurring clogged ducts, it is important that you work with a lactation consultant to remedy the issues. If left untreated, engorgement and clogged milk ducts can result in mastitis (a breast infection). To receive prompt and personalized assistance with clogged milk ducts and/or engorgement, schedule your appointment today. Our friendly team of lactation specialists are ready to assist!