A clogged milk duct (plugged or blocked duct) occurs when a mammary duct becomes obstructed, causing a painful, tender lump in the breast tissue. This condition is characterized by localized swelling and discomfort, often more pronounced just before a feeding or pumping session. While clogs are typically found within the main breast area, the milk-producing glandular tissue extends into the underarm (axillary region), meaning a clog can form there. Applying gentle techniques can provide relief and prevent the issue from worsening.
Anatomy and Causes of Underarm Duct Clogs
The presence of milk ducts extending into the underarm is due to the Axillary Tail of Spence, a normal anatomical structure. This is an extension of glandular breast tissue that reaches toward the armpit, meaning milk can be produced and subsequently backed up in this location. When a clog forms here, it is often felt as a hard, sore lump in the armpit or the upper, outer quadrant of the breast.
Underarm clogs often result from external pressure that impedes milk flow. Causes include wearing a bra that is too tight, especially one with an underwire that digs into the side tissue. Similarly, carrying a heavy shoulder bag or sleeping in a position that compresses the side of the breast and armpit can restrict drainage. Incomplete emptying of the breast, such as from a poor latch or skipped feedings, allows milk to stagnate and thicken, leading to obstruction in these peripheral ducts.
Detailed Massage Techniques for Axillary Tissue
The goal of massage is to reduce inflammation and gently encourage fluid movement away from the blockage. Use a gentle touch, as aggressive or painful kneading can worsen inflammation. Before starting, stimulating the lymph nodes in the armpit with light, circular motions for about a minute can help prepare the area for drainage.
When massaging the affected underarm, use the pads of your fingers or knuckles, applying pressure that is firm but never painful. The motion should be directed away from the clog and toward lymphatic drainage points, such as the armpit or the collarbone, to clear inflammatory fluid. Gentle strokes are more effective for lymphatic drainage than deep tissue manipulation, which can cause tissue damage.
If the goal is to move milk out through the nipple, stroke from the lump toward the areola and nipple just before or during a feeding session. This is best performed while the baby is actively nursing or a pump is running, as the suction provides the most effective force for clearing the duct. A technique known as “raking,” using fingertips to gently sweep over the lump toward the nipple, can be repeated during milk expression.
Supporting Strategies for Clog Relief
Massage is most effective when combined with strategies aimed at decreasing swelling and improving milk flow.
Cold Therapy and Medication
Applying a cold compress or ice pack to the affected underarm between feedings helps reduce inflammation and pain. Apply the cold for 10 to 20 minutes every one to two hours while awake. Since a clogged duct causes discomfort, taking an over-the-counter anti-inflammatory medication like ibuprofen, which is generally considered safe while breastfeeding, can help.
Feeding Position Adjustments
Changing feeding positions helps the baby’s suction focus on the clogged area. Position the baby so their chin points directly toward the lump in the armpit. Using gravity to assist drainage, such as nursing while leaning over the baby (dangle feeding), is also helpful. Rest and adequate hydration are important for recovery, as fatigue and dehydration increase the risk of milk stasis.
Warning Signs and Medical Intervention
A clogged duct should begin to improve within 24 to 48 hours with consistent home treatment. If the lump does not decrease in size or the localized pain intensifies, the condition may be progressing to mastitis (inflammation that can involve an infection). Seek immediate medical attention if systemic flu-like symptoms develop.
Warning signs include a fever of 101.3°F (38.5°C) or higher, accompanied by chills and body aches. The skin over the underarm area may also show intense redness or red streaking extending outward from the lump. Consultation with a healthcare provider is necessary, as mastitis often requires antibiotic treatment.