Mastitis and clogged duct: hot or cold compress?

This is a challenging time trying to figure out your way managing clogged duct and mastitis, as the Internet is just full of contradicting information. Your doctors, nurses, lactation consultants, masseurs, families and friends all giving you different opinions. If you are confused, please read on.

The reason why we have so many contradicting information is that our understanding of clogged duct and mastitis is changing. In the past, we believe that clogged duct happens because the milk is too thick, and the fat inside the milk is sticking together. So we use hot compress to "melt" the fat. But now latest research show that we might have been wrong.

As the Academy of Breastfeeding Medicine published its latest protocol for management of mastitis at the end of 2022 (click here for the link to their official website), our perspective of mastitis and clogged duct was totally turned over.

New researches show that clogged duct actually starts outside the duct - the breast tissue swells, leading to narrowing of the duct, and thus slow movement of breastmilk during pumping and latching.

You may ask what is the cause of breast tissue swelling? Oversupply was pointed out as the biggest risk factor. Think of the breast tissue as a muscle. When a muscle is overworked, it gets swollen, inflamed, and painful. When breast tissue is overworked from producing high amount of milk, it may also get swollen, inflamed, and painful.

Swelling of breast tissue may also occur from others factors, such as prolonged compression of the breast, and dragging of pumping sessions.

Now let's come back to the question of whether to apply hot or cold compress for clogged duct and mastitis. When our aim is to reduce swelling and inflammation, the choice is obvious: it is the COLD COMPRESS! Cold compress is known to reduce swelling and inflammation. It has been used to treat acute joint and muscle injuries for hundreds and thousands of years. And a clogged duct is not too different from an acutely sprained ankle or strained muscle in that case.

Hot compress, on the other hand, may promote vasodilation and increase swelling in the breast. But many moms do find a hot shower helpful to clear clogged duct. That could be due to the relaxation effect from the hot shower, which helps to promote a let-down reflex.

So next time when you have a clogged duct, grab an ice cube from the freezer, wrap a clean damp towel around it, and apply on the painful lump on the breast for 10 minutes before pumping or latching. It may take several sessions of pumping or latching to clear the blockage. Be patient. Do not massage the painful part vigorously, as that may increase swelling as well!

If your clogged duct does not clear within 1-2 days, or you start to develop fever, then it is time to seek help! Chat with our friendly therapist to find out whether you may benefit from our PAIN-FREE ultrasound treatment!