I have a plugged duct, now what?!

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What is a plugged duct?

To explain it simply – it’s a clog of milk that isn’t being expressed.

When you’re making milk faster than your body can express it, or something is prevent the milk from flowing, it causes this back up and created the clog. This can happen for various reasons like your supply coming in,  not  “emptying” the breast due to feeding issues related to baby’s latch, weaning, missing feedings, tight bras and shirts, etc.   No matter how it happens, when this does happen your breast tissue get swollen and creates pressure.  As a result the swollen tissue presses on your ducts and causes a back up, or what we like to call a “plugged duct”.

What does is look/feel like?

Many times you can feel a lump that can vary in size from the size of a large crumb, pea sized to a much larger lump (I’ve personally seen to the size of a golf ball!).  This lump and the area around it is usually tender and sometimes it is red/pink in color and warm to the touch. 

Some baby’s show preference to the unaffected breast because it is the easier breast to “empty”, but do note that this can further exacerbate the problem if you don’t clear the plug.  Be sure to pump if baby is not eating well on that side.

Two things that are really important for you to remember when trying to determine if you have a plugged duct:

1. There isn’t always a lump.  Well, there probably is one, but you can’t always feel it from the surface.  However, there is almost always tenderness and pain.

2. The pain, and lump if there is one, can move.  Sometimes as you nurse and/or pump the plug will try to get itself out and move as it is suctioned.  A plugged duct can come out through your nipple.  If it makes it’s way out you will may or may not notice it, but if you do it will probably look like white sticky string and is nothing to be alarmed about!

What can I do about it?

So maybe now you know that you have a plugged duct and you want to know, what next? What can I do to make this better, to make the pain go away?
There’s a few things you can do to help the plug to go away before it becomes a bigger issue.

1. Start nursing on that breast.  If you are feeding baby at the breast, their strongest suck comes  at the beginning of a feeding and that’s when you want them to be on your breast that has the plug.  Nurse frequently and try to start on that side to benefit the most.

2. Massage your breast before and during feedings.  This simply helps to loosen things up and hopefully get it moving.

3. Use combing motion starting behind the affected area and move down towards your nipple repeatedly. Simply create your “comb” with your fingers and apply light-moderate pressure.

4. Warm before, cold after.  Most breastfeeding mamas do the warm but then skip the cold.  The warm is great (warm shower, warm compress) but the cold is just as important after because it reduces the swelling (and pain) and the swelling is what is creating that plugged duct.

Tip: Try a hot shower where you have hot water hitting your back (just under your shoulder blade) on the side that hurts and your underarm area while having a warm facecloth on the affected breast in front.  Massage your breast and use combing motion while in the shower and directly after getting out.

5. Be sure to empty the affected breast.  As I noted above, sometimes baby will prefer the unaffected breast, when this happens you must be sure that the affected breast is getting the chance to empty or the problem will worsen.

6. Ibuprofen can help as it is an anti-inflammatory and pain reliever.  However, you should always check with your doctor before taking a medication when nursing.  

What should I be careful for?

We always want to be on the look out for flu like symptoms that would indicate an infection.  So, keep an eye out of fever, sweats, chills, sick to your stomach, extreme fatigue, etc. 

If you’re body doesn’t feel right and symptoms don’t get better within a couple of days, call your doctor – you might need treatment.  You know your body more than anyone else – if something doesn’t feel right, a simple phone call can’t hurt.


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