Recurring clogged ducts

[@llli*starfish]

I have a 14 week old and have had issues with recurring clogged ducts. I've done everything the books and online sites suggest doing to avoid them but it wasn't helping. I was lucky to go 24 hours without one for the first 10 weeks. Since nothing else was working, my midwife thought I might be having an inflammatory response within my breasts to my milk. I started taking 400mg ibuprofen every 6 hours and that helped - I was down to about 2 clogged ducts a week. But now I am getting small itchy bumps on my torso which is likely a sign of an ibuprofen allergy. My midwife suggested taking turmeric as an alternative anti-inflammatory but the online sources I found say there's no good data on taking it at medicinal doses while bf'ing

Has anyone else had this issue and were you able to resolve it? I've been on 4800mg lecithin for more than 6 weeks, I rarely wear a bra so I can avoid any constriction, I've had an LC, 2 LLL leaders and my midwife say that my latch is fine, I don't believe I have an oversupply issue, don't carry a purse or bag that would cause them, etc. The fact that the ibuprofen helped makes me think there is some kind of allergic response going on. I'm out of ideas and hope someone here can offer another solution. I really don't want to give up bf'ing but I can't go back to the daily clogged ducts, which I assume is coming now that I've had to stop ibuprofen. Thank you for any advice you can offer.

[@llli*aprilsmagic]

Do you wear nursing tanks? Those gave me a plug every time.
Watch how you sleep. Sometimes I would lay wrong and get one.
Do you babywear? I had one sling that always caused one.
Cut all saturated fats from your diet. Like just a bite of ice cream would give me one.
Maybe try Tylenol, sicne it's a different NSAID than ibuprofen, and not related and thus should not cause an allergic response
Massage your breasts before and after nursing.
Wool nursing pads.

I suffer quite a lot from them. With my first, I pretty much had a plug somewhere for the first 10 months. The above helped. but time just is what helped the most (along with cutting most dairy and red meat).

[@llli*mommal]

with the PP. Clogs are more commons when you have a small baby and your supply is really abundant (as is usual with a very young baby) so you may have passed through the window when they are likely to trouble you. Fingers crossed, and let us know how it goes!

[@llli*starfish]

Thanks for your replies. I did cut dairy and saturated fats for about two weeks and it didn't help - just lowered my supply and I had to fight to get it back. I would love to babywear but I can't - even if I hold her to my chest to carry her across the room I might get a clog where she presses against me. I wear a nursing tank maybe once a week - usually spend the day topless at home, which is a huge majority of my day. I will look into Tylenol but I am leery of possibly creating another allergy by taking it so much.

What is the advantage to wool nursing pads? I tried some cotton ones but hated them because they wouldn't stay in place.

I don't think I can deal with the physical pain of clogged ducts until 10 months! I don't just get little ones here and there - half my boob gets hard and painful for at least 12 hours. I am tired of crying and constantly working at resolving them. They keep me from going anywhere since I don't want to put a bra on when I have a clog. I really don't want to give up bf'ing but the daily struggle is taking a toll.

[@llli*lllmeg]

Wow you are having a time of it! So sorry you are having such a hard time, while plugged ducts are pretty common and even recurrent plugged ducts happen fairly frequently, a recurrent plugged duct situation that never improves no matter what mom does is quite rare. So this is really tough, I am sorry.

I looked up recurrent plugged ducts in the breastfeeding text Breastfeeding Answers Made Simple and the two recommendations ( for recurrent plugs) were lecithin and reducing saturated fats in moms diet. These are common recommendations because they usually help, and they usually help because (presumably) what is inflaming your breast is a high fat content in your milk. I have never heard of reducing saturated fats causing low supply-were you not able to replace them with other foods?

OK some other ideas-there are other diet changes you can try. See links below.

Have you ever had mastitis? How was it treated? Is it possible you have mastitis but at a very mild level without the usual symptoms? (subclinical?) Unresolved mastitis has been linked to recurrent plugged ducts.

Latch and nursing frequency-How often does baby nurse? Would baby possibly nurse more often? What about positioning baby different ways at the breast? Great the latch looks good, but does the latch FEEL comfortable, to you?

Do you let baby control the feedings? Are you pumping 'extra'? (on top of full time nursing?) Do you experience engorgement as well or just the plugs? Yes, I am getting at the possibility of oversupply. Many moms (and even health care professionals) have difficulty accurately assessing milk supply, low, normal or high. I am wondering how you take the measure of your supply.

This article on lecithin includes some other ideas for supplements for battling plugged ducts. http://kellymom.com/nutrition/vitamins/lecithin/

When you get a plug, how quickly can you resolve it? Have your tried vibration to break it up? (massager, electric toothbrush, etc?) Has anyone suggested seeing a physiotherapist for ultrasound to break up plugs? What about "bag of marbles" massage technique? Heat before nursing, cold packs other times to reduce swelling? Nursing "upside down"? (see last link below.)

If the ibuprofen was helping, is it necessary to stop using it due to itchy bumps? There must be a half dozen things that would explain an itchy bump rash. Are you sure it's an allergic reaction to the ibuprofen?

I assume you have gone over the following articles on dealing with plugged ducts and recurrent plugged ducts. I would suggest looking over these again, maybe something will jump out at you.

http://kellymom.com/bf/concerns/mother/mastitis/

http://kellymom.com/bf/concerns/moth...rent-mastitis/

http://www.llli.org/docs/00000000000...plugsblebs.pdf

[@llli*starfish]

Re: fats. Yes, I'm a picky eater so that was probably part of the problem - finding alternative foods. I've always been a healthy eater and lost my baby weight in a month. Like I said though, cutting them out didn't help.

Mastitis - never been diagnosed with it or had a fever. Mentioned that to my midwife and she didn't seem to think I had an underlying infection, although that has always been my suspicion. How would I confirm that?

Latch has felt fine the past month or so. Had a rough time at first with lots of milk blebs and I get occasional pain with a new bleb. I feed on demand. She usually nurses for 30-75 minutes with a 1-2 hour break in between feedings. She nurses for close to 2 hours before bedtime in the evening. I don't pump, only now and then to relieve engorgement in the morning if she falls back asleep before getting to the other breast. And when I pump, I can't get more than half an ounce or so. Morning is the only time I'm engorged, and only if she happens to sleep 6 or more hours.

Feel like I am an expert at working on the clogs - have done all except ultrasound. I can't afford to go there daily. Some smaller clogs I can get out in one or two feedings, but some take up to 36 hours.

I risk anaphylaxis if I continue with the ibuprofen. There have been no other changes in my diet, soaps, etc so that was our guess. I will give it a few days for the bumps to disappear and re-evaluate my use of it.

And yes, I read those links (except the last one) about once a week.

Thanks for your help and detailed post!

[@llli*aprilsmagic]

Have your milk cultured to rule out underlying infection.

I was in severe pain, but stopping was not an option. I had quit my job, and we could not afford formula, bu we made too much to qualify for WIC. And I had major plugs too, and they turned into raging mastitis a few times.

The wool nursing pads help keep your breasts warm, which Scandanavian midwives swear contributes to clogs Dunno, but I only had like a handful of clogs with my second and third babies versus nonstop clogs with my first, and I found those between my first and second kids.

I have never heard of decreasing saturated fats (not all fats) leading to a decrease in supply

[@llli*lllmeg]

Surely it is not the entire issue but when battling plugs you want to try to avoid any engorgement or overfull feeling in the breasts. It does not matter how much milk you get when you pump (although if you are getting very little when really full I wonder about pump performance or if you may need to work on typical engorgement strategies to relieve congestion.) But the main idea of pumping when engorged (if baby will not nurse) is to pump (or hand express or simply massage the milk out if that works better for you) just enough to soften the breasts and relieve the engorgement or overfull feeling.

How long did you eliminate the sat fats for? I have no idea how long it takes to usually see improvement in plugs from diet changes. Anyone have exp. with that?

[@llli*aprilsmagic]

It took me some weeks to see an improvement, but if I ate anything with milk, butter, red meat, etc, I'd have a clog practically immediately.

And DH reminded me that if I went around braless I had one (yes, I mentioned plugs to him). Probably from the pressure my full breasts exerted on themselves. I did much better with just this one soft bra, and I'm not all that big. Maybe some constant support would help versus going braless all the time

[@llli*starfish]

I cut sat fats for 7-10 days. Since the ibuprofen helped, I can't imagine sat fats are really the problem? Unless they cause inflammation in breast tissue itself? I thought fats got deposited in the ducts, causing the clogs.