Breastfeeding Moms

Mrs.Becki
Need help with a clogged duct
November 19, 2012 at 12:45 PM

 

 I went on a date with the hubbs and skipped two feedings.  I pumped after our date, but still got a clogged duct. Yesterday I had the chills really bad and breast pain, but my fever wasn't high.   I have tried a hot shower, massaging, nursing, pumping, and it keeps getting a little better but after a couple hours it's back to the same.  I don't want to pump too often and increase my supply.  How often do you think is enough?  I have so much to do before thanksgiving!  Bad time to feel sick!

Replies

  • Precious333
    November 19, 2012 at 12:48 PM

    Have you tried nursing while dangling over your baby?  That worked miracles for me!

  • FrumpyMama
    November 19, 2012 at 12:57 PM

    I had a HORRIBLE plugged duct with my dd. I actually took the time to find out which duct it was in that breast and hand extracted from the duct.   It was the gross, but it helped work out the infection in between pumping and nursing.  Lots of heat, rest and liquids. 

  • devoesgirl
    November 19, 2012 at 1:01 PM
    Applying a warm wet wash cloth while nursing or pumping then massaging the spot has always worked for me
  • gdiamante
    November 19, 2012 at 1:10 PM

    Nurse with the sore spot pointed toward baby's chin. That might require putting baby on a flat surface, and dangling the breast over at the correct angle. It works.

  • Mrs.Becki
    November 19, 2012 at 2:18 PM

     I just tried the dangling position.  Man tht hurts your back.  Still no relief.

  • Mrs.Becki
    November 19, 2012 at 2:19 PM

     I know it's under my breast on the right, but it feels like a huge knot.  I keep massaging that area, but nothing yet.

    Quoting FrumpyMama:

    I had a HORRIBLE plugged duct with my dd. I actually took the time to find out which duct it was in that breast and hand extracted from the duct.   It was the gross, but it helped work out the infection in between pumping and nursing.  Lots of heat, rest and liquids. 

     

  • newbabystarr09
    November 19, 2012 at 2:22 PM

    I hope you feel better soon..I haven't had one yet..I hope I never do..Must be painful..OUCH!

  • newbabystarr09
    November 19, 2012 at 2:27 PM

    She got the chills really bad and a fever with her breast hurting..This maybe mastitis? 

    Quoting gdiamante:

    Nurse with the sore spot pointed toward baby's chin. That might require putting baby on a flat surface, and dangling the breast over at the correct angle. It works.


  • newbabystarr09
    November 19, 2012 at 2:29 PM
    How do I know if I have a plugged duct or mastitis?

    PLUGGED DUCT
    A plugged (or blocked) duct is an area of the breast where milk flow is obstructed. The nipple pore may be blocked (see Milk Blister), or the obstruction may be further back in the ductal system. A plugged duct usually comes on gradually and affects only one breast.
    Local symptoms
    Mom will usually notice a hard lump or wedge-shaped area of engorgement in the vicinity of the plug that may feel tender, hot, swollen or look reddened. Occasionally mom will only notice localized tenderness or pain, without an obvious lump or area of engorgement. The location of the plug may shift.
    A plugged duct will typically feel more painful before a feeding and less tender afterward, and the plugged area will usually feel less lumpy or smaller after nursing. Nursing on the affected side may be painful, particularly at letdown.

    Systemic symptoms
    There are usually no systemic symptoms for a plugged duct, but a low fever (less than 101.3°F / 38.5°C) may be present.
    MASTITIS
    Per Maureen Minchin (Breastfeeding Matters, Chapter 6), mastitis is an inflammation of the breast that can be caused by obstruction, infection and/or allergy. The incidence of postpartum mastitis in Western women is 20%; mastitis is not nearly so common in countries where breastfeeding is the norm and frequent breastfeeding is typical. Mastitis is most common in the first 2-3 weeks, but can occur at any stage of lactation. Mastitis may come on abruptly, and usually affects only one breast.
    Local symptoms
    Local symptoms are the same as for a plugged duct, but the pain/heat/swelling is usually more intense. There may be red streaks extending outward from the affected area.
    Systemic symptoms
    Typical mastitis symptoms include a fever of 101.3°F (38.5°C) or greater, chills, flu-like aching, malaise and systemic illness.
    Common (and not-so-common) side effects of plugged ducts or mastitis

    Plugged duct

    Milk supply and pumping output from the affected breast may decrease temporarily. This is normal and extra nursing/pumping generally get things back to normal within a short time.
    Occasionally a mom may express “strings” or grains of thickened milk or fatty-looking milk.
    After a plugged duct or mastitis has resolved, it is common for the area to remain reddened or have a bruised feeling for a week or so afterwards.
    Mastitis

    Side effects may be the same as for a plugged duct, plus:

    Expressed milk may look lumpy, clumpy, “gelatin-like” or stringy. This milk is fine for baby, but some moms prefer to strain the “lumps” out.
    Milk may take on a saltier taste due to increased sodium and chloride content – some babies may resist/refuse the breast due to this temporary change.
    Milk may occasionally contain mucus, pus or blood.
    What are the usual causes of plugged ducts or mastitis?

    Plugged duct Mastitis
    Milk stasis / restricted milk flow
    … may be due to:


    Engorgement or inadequate milk removal (due to latching problems, ineffective suck, tongue-tie or other anatomical variations, nipple pain, sleepy or distracted baby, oversupply, hurried feedings, limiting baby’s time at the breast, nipple shield use, twins or higher order multiples, blocked nipple pore, etc.).
    Infrequent/skipped feedings (due to nipple pain, teething, pacifier overuse, busy mom, return to work, baby suddenly sleeping longer, scheduling, supplementing, abrupt weaning, etc.).
    Pressure on the duct (from fingers, tight bra or clothing, prone sleeping, diaper bag, etc.).
    Inflammation (from injury, bacterial/yeast infection, or allergy).
    Stress, fatigue, anemia, weakened immunity

    Milk stasis (usually primary cause)

    Same as for blocked duct.
    Blocked duct is also a risk factor.
    Infection

    Sore, cracked or bleeding nipples can offer a point of entry for infection.
    Hospital stay increases mom’s exposure to infectious organisms.
    Obvious infection on the nipple (crack/fissure with pus, pain) is a risk factor.
    Past history of mastitis is a risk factor.
    Stress, fatigue, anemia, weakened immunity

    What is the usual treatment for plugged ducts and mastitis?

    It’s always best to treat a plug immediately and aggressively to avoid escalating into mastitis.

    CAUTION: Do NOT decrease or stop nursing
    when you have a plugged duct or mastitis,

    as this increases risk of complications (including abscess).

    GENERAL SUPPORTIVE MEASURES
    Plugged Duct
    Rest
    Adequate fluids
    Nutritious foods will help to strengthen mom’s immune system
    Mastitis
    Bed rest (preferably with baby)
    Increase fluids, adequate nutrition
    Get help around the house
    BREASTFEEDING MANAGEMENT – SAME for plugged duct or mastitis
    – important to start treatment promptly

    “Heat, Massage, Rest, Empty Breast”
    General
    Nurse frequently & empty the breasts thoroughly.Aim for nursing at least every 2 hrs. Keep the affected breast as empty as possible, but don’t neglect the other breast.
    When unable to breastfeed, mom should express milk frequently and thoroughly (with a breast pump or by hand).
    Before nursing
    Use heat & gentle massage before nursing- Warm compress. Try using a disposable diaper: fill the diaper with hot water (try the temperature on your wrist first to avoid burns), squeeze the diaper out a bit, then put the inside of the diaper toward the breast. This will stay warm much longer than a wet cloth.- Basin soak. Fill sink or bowl with hot water and submerge breast in water while massaging the plugged area toward the nipple. Some report better results when epsom salts are added to the water — add a handful of epsom salts per 2 quarts (2 liters) of water. Rinse with fresh water before nursing, as baby may object to the taste.- Hot Shower. It can be helpful to massage in the shower with a large-toothed comb. The comb should be drawn through a bar of soap until it is very soapy and then used to gently massage over the affected area in the direction of the nipple.
    Loosen bra & any constrictive clothing to aid milk flow.
    While nursing
    Nurse on the affected breast first; if it hurts too much to do this, switch to the affected breast directly after let-down.
    Ensure good positioning & latch. Use whatever positioning is most comfortable and/or allows the plugged area to be massaged.Note: Advice to point baby’s chin (or nose) toward the plugged area is not necessarily going to be helpful as it is based on the idea that the milk ducts take a nice, direct route to the nipple – recent research tells us that this is not true, and that a particular duct might begin in one area of the breast but can “wander” in many different directions before terminating in any area of the nipple.
    Use breast compressions.
    Massage gently but firmly from the plugged area toward the nipple.
    Try nursing while leaning over baby (sometimes called “dangle feeding“) so that gravity aids in dislodging the plug.
    After nursing
    Pump or hand express after nursing to aid milk drainage and speed healing.
    Use cold compresses between feedings for pain & inflammation.

Breastfeeding Moms