Patient Guide: Plugged / Blocked Milk Ducts

By: Lindsay Davey, MScPT, MSc, CDT
June 6, 2014
Editors: Ryan Davey, PhD and Lindsay Davey, MScPT, MSc, CDT

Breastfeeding issues can arise from problems affecting either the baby or the mother. One common problem for new moms is the development of plugged / blocked milk ducts. Plugged milk ducts can be painful and distressing. By following good practices you can both reduce your risk of plugged ducts, and also quickly alleviate any blockage. In difficult cases plugged milk ducts can be treated effectively with physiotherapy involving Therapeutic Ultrasound and manual massage techniques provided by an experienced Registered Physiotherapist.

The content below was adapted from the Goldfarb Breastfeeding Clinic patient information handout (

Causes of plugged / blocked milk ducts:

Lactating mothers produce milk within specialized lobules of the breast and transport it via an intricate network of ducts to the main Lactiferous duct leading to the nipple. Unfortunately, for some lactating women the duct becomes blocked. The exact cause of this blockage is unknown, but it may arise from the accumulation of dried milk.

Risk factors for developing plugged / blocked milk ducts:

  • Breasts are not drained well (especially in the early days of breastfeeding) due to poor latch, short, infrequent, or missed feeds.
  • Breasts are under prolonged pressure from tight bras, straps or seat-belts

Symptoms of plugged / blocked milk ducts:

  • Tender lumpy areas that may be warm to the touch and reddish in colour.
  • Progressive loss of milk, usually in one breast at a time.
  • Painful whitespot on your nipple (known as a ‘milk bleb’).
  • Typically not associated with fever or sickness.

Treatment of plugged / blocked milk ducts:

  • Empty the breast frequently by nursing your baby often (day and night), and/or pumping.
  • Breast massage to loosen the blockage, including while your baby is feeding.
  • Let gravity help by feeding while leaning over your baby.
  • Try different feeding positions.
  • Wear loose comfortable clothing.
  • Soak your breasts in warm water and Epsom salts (a handful in 2-4L of water) before each feeding for 10 minutes. Rinse breasts before feeding.
  • Eat healthy and remain well hydrated.
  • Recieve Ultrasound therapy from an experienced Registered Physiotherapist.
  • For more ideas please visit

Physiotherapy and Ultrasound Treatment for plugged / blocked milk ducts:

If the plugged duct remains blocked for more than 2-3 days, seek professional help. Registered Physiotherapists with experience treating blocked milk ducts can help by:

  • Breaking up the blockage using the appropriate dosage of therapeutic Ultrasound.
  • Employing Manual Lymphatic Drainage to induce appropriate flow.


  1. Megan LeBlanc Megan LeBlanc says:

    I am a lactation consultant and nurse practitioner in NS and there is a physiotherapist in my area interested in more information on using ultrasound for the treatment of blocked milk ducts. I would appreciate any information you could provide.

    • Lindsay Davey Lindsay Davey says:

      Hello Megan,
      We follow the Dr. Jack Newman protocol on the Canadian Breastfeeding Foundation website, though we never need to go as high as 2.0W/cm2 in terms of amplitude. We do follow the ultrasound with lymphatic drainage massage to stimulate the axilla on the same side, and try to help the blockage drain in this direction, saving compression of the blockage itself for DURING nursing. I hope that helps Megan! Sincerely, Lindsay Davey

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