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?