Monday, August 25, 2008

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.

Click here for treatment suggestions for mastitis...

Friday, August 22, 2008

Taking Your Lumps Seriously…

By Jessica Sacher, RN, MN, IBCLC

Few things are more frightening to any woman than finding a lump in her breast. Finding a lump while breastfeeding in enough to create a state of panic. Most of us are aware of the American Cancer Society's advice to check our breasts and follow up with lumps or nodules in our breasts. Just because a woman is breastfeeding does not mean that she is "immune" to more ominous findings. The questions nags at us: Is it a plugged duct? Is it engorgement? Is it something else?

In the early days of breastfeeding, the breasts are undergoing many rapid changes. The milk comes in and we experience engorgement. Sometimes we can palpate the lumps and bumps in the breast in the immediate days following the birth. Normally these "lumps" become smaller and imperceptible as the baby nurses and removes the milk. In the next several days the breasts adjust to the demands of the baby and the lumps that were of concern no longer seem important. But what if you have a lump that does not get smaller after nursing or pumping?

The prudent course of action is to follow up with any lump that persists for more than 2 or 3 weeks. We at The Pump Station & Nurtury always recommend that a woman report this to her doctor and seek evaluation. A plugged duct should not last 2-3 weeks. A woman may experience lumps in different locations in her breasts that resolve with feeding or pumping, or a woman may be prone to repeated bouts of plugged ducts, but this is different than a lump that persists for 2 -3 weeks. The hallmark symptom of a plugged duct is tenderness or pain. It is often the precursor to mastitis (breast infection). An unresolved painless lump needs to be evaluated.

Perhaps it seems overly aggressive to suggest that a breastfeeding woman be evaluated after only a couple of weeks, but it is better to error on the side of caution. Several years ago, a mother with a one year old came to see me with a "plugged duct" that she’d had for several months. She had done all the right things: saw her primary doctor, her OB, and finally a surgeon. The problem was that not one of these health care providers had ever examined her breast. By the time I saw her, the "plug” occupied over half of her breast, and it wasn't a plugged duct. She had breast cancer, but because she was breastfeeding no one took her symptoms seriously. She went on to have treatment and did well, but if someone had just evaluated the lump she would have been diagnosed so much earlier. Finding breast cancer is the exception not the rule, but it has made us very cautious and proactive. If your doctor doesn't suggest an ultrasound, ask for one. If your doctor doesn't examine your breast, ask him/her to evaluate what you are feeling. Thankfully most breast lumps are benign and we can breathe a sigh of relief, but it is never wise to assume that something is nothing until proven otherwise.

Tuesday, August 19, 2008

Fit Pregnancy – Medela Event – Win Prizes!

Hi everyone!

We've been very busy lately! As many of you know, we recently re-launched our website Our re-designed site is easier to navigate - allowing new parents to find what they need much faster. We've also got a fresh new look that mirrors the look of our remodeled stores. Come check it out and you can register to win some great prizes. Our vendors have supported our relaunch by donating over $2500 in great prizes. In addition to this, it's Breastfeeding Awareness month. So in celebration of this - at the end of the month we'll be holding 2 Sizzling Hot Topics . Peg Moline, Editor-in-Chief of Fit Pregnancy Magazine, will be lecturing on "Breastfeeding on the Go - Or, How to Breastfeed and Still Have a Life". After Peg speaks, we'll be hosting a "Milk'in Cookies Open House". Stop by and learn about Medela Products and get more tips on Breastfeeding from our Lactation Educator and Customer Service Reps. We'll be raffling off a Medela Free-Style Handsfree Pump to those who stop by. The day's events will be sponsored by Fit Pregnancy and Medela.
A few months ago we ran blog written by Wendy Haldeman, IBCLC and Co-Founder of the Pump Station and Nurtury tm, on "Breastfeeding on the Go". It got such a great response that we wanted to re-run it in support of our upcoming events. Enjoy the blog and have a great week!

Breastfeeding On The Go - Breastfeeding in Public

by Wendy Haldeman, MN, RN, IBCLC, Co-Founder of The Pump Station

A common concern among novice breastfeeding mothers is what to do when your nursing infant needs to be fed and you are away from the safety and comfort of your home, your favorite nursing chair and your breastfeeding pillow. The baby begins to whimper and show signs of hunger. Your palms grow sweaty. The baby starts to wail. Suddenly everyone is looking at you. What to do?

This is a dilemma faced by breastfeeding mothers every day. Sadly, some women decide not to breastfeed because they are so concerned about the possibility of exposing themselves in public. I can now laugh when I remember my first attempt at feeding my new baby. I parked my car in what I thought was a safe, quiet neighborhood, climbed into the back seat and "latched on". Just as I was feeling pretty darn good about my abilities, I was greeted with cat whistles, cheers and applause. I had chosen to park my car across the street from a high rise building under construction. Apparently, I was the entertainment for the morning coffee break. Oh well.

What expectant women need to know is that, unlike me, mothers are breastfeeding their babies in public frequently and the surrounding population are none the wiser. It does require some experience and knowledge before a mom can calmly and easily nurse her baby without anyone being aware that the baby is actually feeding.

Here are some simple tips to help you get started.

  1. To provide you with some sense of modesty, invest in a few articles of "nursing clothing". Our favorite is the Bebe au Lait Nursing Covers.

  2. Locate a breastfeeding mothers support group in your community. Many new mothers find great comfort in breastfeeding for the first time while among other nursing mothers and new babies in a closed room. Novice mothers can observe experienced mothers nursing without pillows in positions which allow for privacy and modesty.

  3. Once you network with other nursing mothers, you can arrange to go out for coffee with a group of experienced moms. Beginners find great comfort in being surrounded by women who breastfeed in any situation. Safety in numbers applies here. If the thought of all the other customers in Starbucks leaving in disgust worries you, stop! Think of yourself as a role model changing the culture for future mothers. And besides, you won't need to wait in line for your coffee.

  4. Next, park your car in an area where you feel safe. You are breastfeeding in public, but the car will provide a sense of privacy, unless of course you have chosen to park under a high rise building during construction.

  5. When ready, go to a park during a time when few people are around. This will enable you to feed in public, yet no one is really around to make you feel uncomfortable.

  6. Scout out department stores and restaurants that are baby friendly. These facilities will have family lounges, couches, etc. where you will be comfortable and undoubtedly encounter other nursing mothers. Nordstrom is a wonderful example of this.

  7. Find a restaurant where you can sit in the back, out of the way of most of the diners. A booth also gives a sense of privacy. Practice here.

The more you practice, the more comfortable you will become. Eventually the sweaty palms resolve and nursing your baby in any environment becomes second nature. If you would like in depth information regarding helpful tips, public breastfeeding and the law, pumping breastmilk at work and more see Our Breastfeeding Resources Page for videos and articles. Get access to thirty years of experience in guiding new mothers to breastfeed.

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