Plugged Ducts

A plugged or clogged duct usually feels like a hard, tender swelling in the breast which often feels painful while breastfeeding. The skin over the affected area may be red and the area around the plug may feel full even after a feeding. Sometimes a small whitish-yellow milk plug can be seen at the opening of a duct on the nipple. Plugged ducts occur when milk flow is restricted, leading to poor drainage of the breast. Contributing factors may include:

• Missed or irregular feedings and/or an unusually long interval between feedings.
• Pressing the breast to provide nostril space for the baby.
• Wearing a tight or poorly fitting bra that impedes milk flow.
• Having an overabundant milk supply and insufficient breast drainage.
• Practicing vigorous upper arm exercise.
• Extreme exhaustion.
• Rapid weaning.

An untreated plugged duct can quickly lead to a painful bacterial infection in the breast called "mastitis". The suggestions below will hopefully help you avoid this. If there is no change in your breast in two days or you begin to notice signs and symptoms of infection, notify your physician. Antibiotics may be indicated.

Treatment suggestions for a plugged duct:

• Nurse more frequently than usual, every 2 to 3 hours.
• Do not miss any feedings.
• Start each nursing on the affected breast. If using only one breast at a feeding, nurse on the side with the plug at each nursing and pump the other breast as frequently as you would have nursed on it.
• Apply moist heat to the breast for 15 to 20 minutes prior to feeds, or take a hot shower or bath. Heat helps fight infection and may help resolve the plug more quickly. Massage the breast while in the shower or between compresses, pressing with your thumb from behind the plug toward the nipple. A warm compress can be easily made by pouring water into a paper diaper and heating it in the microwave for a few seconds. Be careful not to overheat the compress as it could burn you.
• Try gentle continuous hand pressure behind the plug while nursing.
• Try a vibrating massager over the lump to help dislodge it.
• Use a hospital grade pump to facilitate breast drainage if the baby doesn't nurse well or if you cannot tolerate feedings. You can also pump after feeds for 5 to 10 minutes while applying continuous pressure behind the plug.
• If a plug appears at the nipple, soak the breast and gently rub the plug to remove the thin layer of skin covering it. Follow with gentle hand pressure behind the plug to force it out.
• Vary nursing positions. Use gravity to help move the plug by nursing on all fours with the baby on pillows below you. Have the baby's nose or chin pointed toward the plug.
  Increase your fluid intake.
• Increase your intake of Vitamin C rich foods and juices (citrus, cantaloupe, strawberries, dark greens).
• Take Echinacea according to package directions to boost your immune system after checking with your doctor.
• For repeated plugged ducts, some women find that lecithin is helpful in lessening the liability of a reoccurrence. Soy lecithin is a naturally occurring fatty acid. It is available in capsule or liquid form from health food stores and pharmacies. The dose is 1 tablespoon, 3 to 4 times/day; or 1 to 2 capsules (1,200 milligrams each), 3 to 4 times/day.
  Watch for signs of possible mastitis.

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