I think it’s finally time to admit to myself that I’m having an issue with plugged ducts. A plugged duct is when one of the milk ducts becomes blocked and milk can’t exit the breast. A hard, painful lump can form as the milk backs up. If the milk isn’t removed, a plug has the potential to develop into mastitis, which is an infection of the breast. Think fever, chills, nausea, etc. Plugged ducts are not fun.
I’ve had six instances of plugged ducts in the last month and a half, which is more than I had the entire three and a half years of nursing Gabi. Twice now, the plugs have been especially exciting because I’ve gotten a bleb along with them. A bleb is a hardened bit of milk that forms a blister right at the nipple. Once, I got a mild case of mastitis and ended up missing work because of it. Obviously, there’s something going on.
I brought it up the last La Leche League meeting, and I got some great help. We really thought together about what kinds of things I notice before a plug occurs. Here’s what I came up with. My plugged ducts coincide with:
- Juan travelling for work
- Eating fast food
- Especially wakeful periods for Katie
- Missed pumping sessions at work
- Feelings of stress, anger, and disconnect
- Allowing Katie to roll her lips in for a lazy latch
In doing some online reading, it seems like these items play into the risk factors for developing plugged ducts: sleep deprivation, stress, poor diet, bad latch, failure to remove milk.
Priority number one with all of this is to clear the plug and remove the milk. Easier said than done. My old stand-by trick is to lay the baby on her back on bed, turn myself around so that her chin points at the plug, and nurse over her so that her suction and gravity can clear the plug. Trouble is, that hasn’t worked the last two times. The resulting let-downs from the nursing just seemed to make the plug worse.
At this point, hand expression seems to work best. I express most of the milk out (or have her nurse for a while). Then I start hand expressing very gently over the area. If you don’t know how to hand express, here’s a YouTube video. This is an incredibly valuable skill.
Once I get to the point where I can look really closely and see the pore that is clogged (I typically see a bit of white that just isn’t coming out), I gently squeeze on the nipple to work that bit out. A warm wet washcloth or even getting into a warm bath really helps with this. Typically, that bit will come out with a POW! and I’ll be able to very easily hand express the backed up milk out. Massaging at the front of the plug, instead of trying to push it from the back), can also help loosen things up and get it moving.
If you have a clog that you just can’t get out, get help! Find a lactation consultant. Ask for help from (dare I say?) your husband. Don’t let it sit around. Having a plug long-term is not only really painful, but it can lead to mastitis.
At this point, I’ve got my plug clearing routine down. But how do I keep from getting them in the first place?
Here’s what I’m doing to try to prevent plugs from forming:
- Removing milk often (as in, no more skipping pumping sessions)
- Taking a lecithin supplement
- Trying to eat healthier, whole foods
- Paying careful attention to Katie’s latch
- Taking a few minutes each day to relax and have some time for myself
So far, this seems to be helping, but I think to a certain extent, the occasional plug may just be part of my landscape right now with my oversupply. I’m okay with it happening once every few months, but I’m looking forward to a few plug-free weeks.
Here are some more resources that I found on plugged ducts.
- Lecithin treatment for recurrent plugged ducts - from KellyMom.com
- Recurrent Mastitis or Plugged Ducts – from Kellymom.com
- How do you treat a milk blister? – from Kellymom.com
- Dealing with Plugs and Blebs (pdf) – from La Leche League
- Blocked Ducts & Mastitis – from the International Breastfeeding Clinic (Dr. Jack Newman)
Have you had plugged ducts? How did you deal with them? Do you have any tricks for getting rid of them?
April 23, 2012 at 6:11 am
I experienced recurrent clogged ducts for about a year. After a few months of trying the usual recommended methods for getting rid of clogs, I finally found a trick that worked religiously for me, thanks to a lactation consultant in the know! The LC told me that the literature hasn’t caught up with actual practice yet & still advises using heat to help work out clogs. She told me this is no longer a practice recommended by LCs because heat can actually increase inflammation (and inflamed ducts can make it harder to work out the clog). So she advised me to do this:
20 minutes prior to nursing or pumping, take one green cabbage leaf and put it directly over the clog. Then place an ice pack on top of the cabbage leaf. Leave these in place for the whole 20 minutes, then immediately pump or nurse as usual. She said to massage while nursing or pumping. She also advised me to take a daily lecithin capsule.
The cabbage & ice pack worked for me without fail. Typically I did it 3 or 4 times a day for only a day or two and then the clog resolved. I wasn’t the best at remembering the lecithin capsule, but I tried to take it at least when I felt like a clog was forming or on a day when Jax wasn’t nursing so much, and then for at least a few days after that.
April 23, 2012 at 3:51 pm
Oh, now that is really interesting. You’re the second person to mention cabbage to me. I’m going to have to look into what it is about cabbage that makes it do what it does. I’ve never gotten on the cabbage bus because I always thought it was something to do with engorgement or what moms do when they wean, and I was worried that it might kill my supply. But that’s 100% my ignorance. I’m going to do some poking around about cabbage and see what I learn.
April 24, 2012 at 5:40 am
I was afraid to try it, having heard about it only for intentionally drying up your supply. But the LC told me that a mere 20 minutes a few times a day for 1-2 days wouldn’t affect my supply drastically–Jax was more than a year old at that point, and I was still nursing a lot, so I gave it a go. Whenever I had a clog, I pumped much less than my usual amount anyway, so I really don’t know whether the cabbage decreased my supply while I was using it. However, once the clog went away, I went right back to pumping my usual amount.
May 1, 2012 at 12:09 pm
Often, for me, when I got clogged it was due to me getting lazy about changing up our feeding positions- I loved the laying down together position, because I could nap while she nursed. Changing to a football hold or a hold that put baby in a position closer to the clog helped a great deal.
May 8, 2012 at 3:27 pm
I’ve actually been focusing really hard on positioning. That seems to be key in all of this.
June 3, 2012 at 2:07 pm
So sorry to hear this! As you know, plugged ducts were the reason we stopped breastfeeding. I didn’t get help in time and even with my husband’s help clearing them I was suffering from at least one plugged duct every second day, sometimes more, for a good six weeks before I finally caved to the psin, exhaustion, and guilt as Oscar was getting colic all the time from the forceful letdown once a plugged duct cleared. I wish I had known more and got help earlier. The help I did get was poor and then it was too late. We comfort fed fo a while then Oscar got sick and went off the breast entirely and despite my best efforts to relactate he continued to forcefully refuse the breast. Broke my heart so I know how important it is to reduce the frequency of plugged ducts so your breastfeeding relationship continues going from strength to strength! I hope you get some relief from them soon x
June 7, 2012 at 3:30 pm
I thought about you so much as I wrote this post. I wished that I had lived closer to you and could have helped you in person. Or refered you to this person I know, or that LC I know, or this other person I know. We have so many local resources that I wished you could have had, too.