La Leche League USA strives to provide parents with the most current information about human milk and human milk feeding, whether that is through direct communication with volunteer Leaders or through information on the LLL USA website and social media pages.

Recently, the Academy of Breastfeeding Medicine (ABM) updated their protocol regarding treating mastitis and plugged ducts. For years, La Leche League Leaders and others in the lactation field shared information about “plugged” ducts and how to remove the “plug” before it became infected.

The new protocol from the ABM shows, though, that what once was thought of as a “plugged” duct is actually a series of tiny ducts that have become inflamed and narrowed, hindering milk flow.

The updated LLL USA page – Mastitis, Slowed Milk Flow, and Milk Blisters – states:

“Milk flows through a duct system in your breasts. Sometimes inflammation of the surrounding breast tissue causes narrowing of the ducts which causes milk to stop flowing well. Depending on your skin tone, a section of your breast may or may not be redder than usual. If you have a duct where the milk is not moving freely, your breast will usually be tender, though the pain will be localized. If the inflammation is not addressed or allowed to rest, the area may become infected. You may also hear people refer to clogged, blocked, or plugged ducts. Since there isn’t really a clog, blockage, or plug, all of these terms can be misleading.”

Laid-back breastfeeding, a great way to nurse and rest

The LLL USA website explains the best course of treatment:

“Whether you have a sore breast, a slowed milk flow, or a breast infection, they may all be related to inflammation in the breast causing narrowed milk ducts (tubes), and the initial care is similar: nurse on cue, rest, and apply cold to the tender area.”

If you are experiencing inflamed milk ducts, the best course of action is to use gentle, therapeutic breast massage rather than “aggressive” techniques such as squeezing the breast. Also, continue to nurse on demand but avoid frequent feedings in an attempt to “empty” the breast as that can make inflammation and ductal narrowing worse. You may also wish to use an anti-inflammatory medication to help with any pain you are experiencing. Be sure to consult with a health care provider if you are unsure about any medication – either over the counter or prescription.

For more information about this updated protocol, go to lllusa.org/mastitis/. You can also read about this new protocol from the Academy of Breastfeeding Medicine at www.bfmed.org/assets/ABM%20Protocol%20%2336.pdf.


Please send your story ideas to Amy at [email protected].


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