What is a plugged duct? Cells and other milk components are constantly shedding within the milk ducts. Sometimes these cells etc will form a blockage, causing localized pain, heat, swelling and lumpiness in the breast. This pain should not be accompanied by any other symptoms such as fever, body aches or feeling shaky which are usually present with a breast infection (mastitis).
Most breastfeeding women will experience a plugged duct at some stage. It may be very uncomfortable and painful but it may also be so mild that one does not even notice that it is there, and before you know it, the plug has been absorbed or moved through the duct and out the nipple. Plugged ducts are most commonly caused by incomplete milk removal or pressure placed on the breast by an ill fitting / under-wire bra.
The best treatment for a plugged duct is milk removal – this should dislodge the plug and help it to move through the ducts. If you breastfeed off of both breasts at each feed then make sure that you start with the plugged breast. If you only feed off of one breast at each feed then expressing from the affected breast at every other feed will help to ensure sufficient milk removal. Expressing and feeding should be accompanied by regular massage (this will help to dislodge and break down the plug) I find it best to massage with something like an arnica oil. Be sure to massage from behind the plug toward the nipple. Heat (place a warm face cloth on the breast while massaging and expressing, changing feeding positions (this helps to drain all of the milk ducts) and good old cabbage leaves (store in the fridge and score the leaf before placing in your bra to release the healing properties).
The plug may very well dislodge and exit the breast during a feed (it may present itself as a grain of sand or as a string of mucous) It is completely safe for baby to ingest the plug and will cause absolutely no harm – though some babies may notice the plug and want to spit it out, they will generally return to nursing normally once the plug has been removed.
If you are experiencing plugged ducts on a regular basis it may be a good idea to evaluate your diet and to make sure that you are not eating too many saturated fats. You may also want to up your intake of foods such as eggs, organ meats and red meats as these contain lecithin (a natural fat emulsifier.
A plugged duct should ideally be dislodged and cleared 24 hours from when it was first noticed. If you have tried all of the above for 24 hours and you are still experiencing pain/ lumpiness, or if at any time you experience fever or flu-like symptoms be sure to contact your doctor as this may mean that an infection is present.