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What is the Difference Between a Clogged Duct and Engorgement?

The opportunity to breastfeed your little one is a gift that comes with a few caveats. Although health experts agree that breastmilk is the healthiest nutritional choice for your infant, there are obstacles you may face throughout your breastfeeding journey. From the early days of learning to latch and cracked nipples, to the bittersweet decision to wean, many mothers experience issues with clogged ducts and engorgement along the way. So how can you tell the difference between the two? What’s the treatment for a clogged milk duct? And how do you relieve engorgement pain? We’ve broken that down for you here with some information on symptoms, treatments, and how to (hopefully) avoid these situations throughout your breastfeeding experience. 

Engorgement vs. Clogged Duct

Although the terms are often used interchangeably, engorgement and a plugged duct are two different issues that can be treated in different ways.  

Engorgement typically happens in the very early stages of breastfeeding when your mature milk first comes in. As blood flow increases to your breasts after delivery they will become engorged. Engorgement can be painful and lead to plugged ducts if your baby isn’t getting a proper breastfeeding latch or failing to empty your breasts with each nursing session. Although engorgement is more common at the beginning of your breastfeeding journey, it can happen any time you skip or drop a feeding, or your baby’s nursing habits change. If your baby is efficiently emptying your breasts with each feeding, and your body is quick to adjust to changes in feeding patterns, engorgement may not be a problem for you. 

Signs of engorgement include: 

  • Uncomfortably full breasts.
  • The skin of your breasts is stretched tight.
  • Your areola is hard and darker than normal.
  • Both breasts are wholly affected. 

You may find some breast engorgement relief by:

  • Icing your breasts. Wrap a clean towel around an ice pack and put the ice pack on your breasts for 10 - 15 minutes. A bag of frozen vegetables can double as an ice pack if you don’t have one readily available.
  • Gently massage your breasts until milk drips from your nipples and your areolas become softer.
  • Putting a warm, wet washcloth on your breasts for 5 - 10 minutes to encourage milk flow, then hand expressing to relieve pressure.
  • Nursing more frequently, you should aim to breastfeed every 2-3 hours. If your baby drops a feed you can still hand express to relieve the feeling of engorgement. 

If you choose to pump to alleviate your engorged breasts, try and keep it to 5-10 minutes (maximum) at a time. Pumping for longer periods can have an adverse effect –you may actually end up encouraging your body to produce more milk and prolong your engorgement. If engorged breasts are left untreated it can lead to a clogged or blocked milk duct.

A clogged or blocked duct presents itself as a small, hard, often painful lump or knot in your breast. This is a result of either waiting too long to empty the breast or failing to empty the breast at each feeding. Once a blockage has formed, pressure builds behind the duct and the tissue around it becomes irritated. Unlike engorgement, this sensation typically happens unilaterally –or in one breast at a time. The best way to clear a blocked duct is to nurse frequently. Pumping can help to alleviate a blockage as well. 

Things that could be contributing to a plugged duct are:

  • Tight clothing or undergarments.
  • Not alternating breasts while feeding.
  • Skipping or dropping feedings.
  • Severe engorgement.

Some ways to relieve or avoid a clogged duct include:

  • Applying a warm compress or taking a hot shower, bonus points if you hand express the affected breast while showering.
  • Drinking our Clogged Duct Support Tea with sunflower lecithin powder, this delicious orange cream flavored tea can reduce the stickiness of breast milk to deter fats from clogging milk ducts and support breast milk flow.
  • Massaging the breast from the blockage down toward the nipple.
  • Trying new breastfeeding positions or breastfeeding holds.
  • Offering the affected breast first when your baby is most eager to feed.
  • Ditching your underwire bras or anything too tight –like a sports bra.

For more information on breastfeeding and how to make the most of your experience, we suggest you check out:

What You Need to Know About Breast Engorgement

What is in Pink Stork Clogged Duct Tea?