Christmastitis: Plugged ducts around the holidays

ABM #36 reframes clogged ducts as part of a mastitis spectrum, not a single hard plug that needs to be “worked out.” What we used to call a clogged duct is now understood as localized inflammation and narrowing of milk ducts, often caused by milk stasis, swelling, or changes in feeding or pumping patterns. The milk is still moving, just less efficiently in that area, which is why parents may feel a tender lump, fullness, or soreness without fever or systemic illness.

The protocol emphasizes reducing inflammation, not aggressive removal. That means:

• Gentle, normal feeding or pumping based on baby’s cues, not over-emptying
• Ice or cold packs after feeds to calm inflammation
• Anti-inflammatory support like ibuprofen if medically appropriate
• Light lymphatic drainage or very gentle massage, avoiding deep or painful pressure
• Supportive bras and avoiding tight clothing or compression

Importantly, ABM advises against older recommendations like forceful massage, vibration, aggressive pumping, heat before feeds, or trying to “push out” a plug, as these can worsen inflammation and increase the risk of mastitis.

If symptoms do not improve within 24 to 48 hours, or if fever, flu-like symptoms, redness spreading, or worsening pain develop, the protocol recommends evaluation by a healthcare provider to assess for inflammatory or bacterial mastitis and guide next steps.