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Thread: Recurrent Plugged Ducts-I'm at the end of my rope!

  1. #1

    Default Recurrent Plugged Ducts-I'm at the end of my rope!

    Hi all,
    This is my first post here so I hope this is the right section.
    My son is 6 months old and we have been exclusively breastfeeding up until Thanksgiving when we started exploring baby food, but no regular feedings with that.
    We have never had an easy breastfeeding relationship. He was born by c-section and the first few weeks were an exhausting struggle, first waiting 5 days for my milk to come in (which seemed a lot longer with the pediatricians breathing down my neck to get me to supplement with formula) and then trying to get the latch right. Then for about 8 weeks things went well with the exception of massive spitting up after feedings which at the time I attributed to his digestive system needing to mature and managed by holding him upright after every one. He was gaining about a half a pound a week.
    At about 11 weeks he started sleeping 12 hours through the night. The first night took me by surprise and I woke up in sooo much pain. After that I started waking up in the middle of the night to pump but everything seemed to continue fine until he started fussing at the breast, maybe 2 weeks later. He would suck to get a letdown then after letdown suck a few times and maybe swallow, and maybe do that twice before getting upset and pulling off crying. Since it seemed like he was still getting milk I thought it was gas because when he pulled off he arched his back and straightened his legs. Then his bowel movements changed from liquidy mustard color 3-4 times a day to a brown/green toothpaste consistency once every 2-4 days. I asked the doctor about this and they said it was fine as long as he seemed generally happy and had enough wet diapers, which he did. Shortly after that, I got my first bout of mastitis. I took to bed, massaged, heat, etc and it cleared in a day. The fussing has continued off and on since then. and each time it recurred I tried something different. I alternately cut dairy, honey, nuts from my diet with no change. A few days fine, a few days to a week fussy. Around 5 months I finally scheduled an appointment with a LC. While waiting the week or so for my appointment I did more research and thought it must be over supply (he had all the symptoms going back to the first weeks where he was spitting up a lot). I started block feeding which was an arduous task since to get him to stay latched on between let downs I had to walk/bounce/entertain him usually all at the same time, in addition to taking him off during initial letdown and leaning back to slow milk flow for the first few minutes. This was the greatest improvement we had and when we went to the LC he nursed perfectly. It could have been the video they use to teach breastfeeding! That lasted about a week. Since then we have one good day, one mediocre, one terrible, one improved, one good etc. I've tried continuing to block feed. I've tried switch feeding in case my supply got too low. I now realize that I have had varying degrees of blocked ducts the entire time I've been breastfeeding. After feeding, even during that glorious perfect week, the bottom of my breast feels empty but there's still a firm portion at the top middle. It feels solid and not like the little lumps of blockages I identified before. I always thought that was just normal anatomy since I always had it, at least that I can remember, but there's a lot I don't remember from those sleep deprived first 4 weeks. I now realize that firm portion is several blockages grouped together. After 2 hours of nursing and massaging last night I finally managed to clear my entire left breast, only to wake up 4 hours later with the same blocks! Which I just spent another hour massaging to clear. After more research last week, I found that recurrent plugged ducts can be caused by high fat content to for a week now I have been on a no saturated fat diet, taking 1200mg of lecithin 4 times a day and 400mg ibuprofen every 6 hours, and apply a heating pad to my breasts a couple times a day including when I go to be and sometimes before I nurse/pump. The only change I've noticed it that the blocks clear more easily and quickly, but they keep returning. And Monday, I had another bout of mastitis.
    I have been wearing gently fitting tank top style sports bras. I don't wear tight clothing or regularly carry any type of bag. I was baby-wearing but I've stopped.
    I love nursing (you'd have to to put up with all this) but my son is not gaining weight as he should. He has dropped from the 90% of weight at his 2 month wellbaby to the 10-25% now. I don't know what else to do. I don't know if I all the effort I'm making is making a difference. The diet is difficult, the massaging is time-consuming and I'm still having to do nursing acrobatics to keep him latched on between let downs. I'm exhausted and starting to feel really guilty that I haven't supplemented or switched to exclusively pumping earlier. I always thought he would let me know if he was still hungry but now I'm not so sure. After his last shots I realize he has a really high tolerance for discomfort. (He had a fever and must have been uncomfortable but I never would have known if I hadn't taken his temperature because he was his usual happy-go-lucky self). I feel like I've tried everything and I'm starting to believe that after 6 months my ducts are so distended from being blocked that they'll always get blocked. I really want to keep nursing but because of my concern over his weight I feel like that's selfish and I should give up and transition totally to solids and maybe pumping. Please, any new suggestions or words of encouragement or stories of other moms who overcame recurrent blocked ducts would be really helpful.
    Sorry for writing a book I just don't want more suggestions of what I've already tried.
    Thank you all so much!

  2. #2
    Join Date
    May 2006
    Posts
    20,965

    Default Re: Recurrent Plugged Ducts-I'm at the end of my rope!

    Welcome to the forum! I'm sorry you've had such a rough time with nursing, and I have to commend you for sticking with it for so long and trying so many different things.

    Would you consider posting your baby's weight history? Birth weight, lowest weight, weight at each check-up? There's a phenomenon called "catch-up/catch-down" growth that causes babies to grow at one pace inside the womb and another outside. Variations between charts can also explain many apparent declines in growth rate.

    Persistent plugs and Mastitis can often be traced to something called subclinical mastitis- you can read up on it here: http://kellymom.com/bf/concerns/moth...rent-mastitis/
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3

    Default Re: Recurrent Plugged Ducts-I'm at the end of my rope!

    Have you taken any antibiotics yet? I've been getting recurrent mastitis / clogged ducts for the past 3 months and I think there is an underlying infection which is causing it to return so after trying pretty much all the things you've described I've taken antibiotics now to clear this on my doctor's advice.

  4. #4

    Default Re: Recurrent Plugged Ducts-I'm at the end of my rope!

    So after reading your posts, I went and looked at some weight charts myself instead of just taking what the doctor said and as it turns out there's been very little fluctuation in his weight percentile, with the exception of his birth weight and the 1.5lbs he lost while waiting for my milk to come in. When the doctor said he went from 90% to 40% he obviously used his birth weight not his lowest weight. This is what I hate about being assigned to an Army hospital with a "care team" and providers who don't really know us! The 10% I looked up before writing my post was just a matter of difference in charts because looking at all his past weights based on that same chart he's stayed in the same percentile as well. I feel a little silly, I should have done that first. Man, my hormones are really getting the better of me, lol.
    Since my post I have continued to frequently massage out blockages (like before &/or after every feeding) and there was marked improvement both in the number and severity of blockages and in how he nursed. Today though, my left breast was red and tender so I went to the doctor to get antibiotics. I will let you know if this clears everything up. I'm hoping it will because if the cause of all the trouble has been subclinical mastitis and not high fat content I don't want to miss out on all the Christmas goodies!
    Thank you for your help!

  5. #5
    Join Date
    Jul 2010
    Location
    New York
    Posts
    860

    Default Re: Recurrent Plugged Ducts-I'm at the end of my rope!

    You are an awesome mother for sticking to your commitment to breastfeeding. Your baby is thriving because he is being nurtured the way nature intended. Plugged ducts and recurrent mastitis are indeed obstacles that sometimes feel insurmountable. But look how great you are doing. You are trying all the known tips for overcoming and avoiding these problems. But your LO is not still sleeping the whole night through, right? Too many hours of sleep can be the starting point for plugs. 6-8 hours overnight is the longest your LO and your breasts may be able to tolerate. Do you and your baby sleep with in arms reach? One extra feeding during the overnight hours might be just the fix needed to avoid the plugged ducts/mastitis spiral.
    DD#1 July 1986 VB
    DD#2 April 1988 c/sec
    DS#3 April 1990 VBAC
    DS#4 June 1993 VB
    and suprise!
    DD#5 April 2001 c/sec
    BTDT scars and stretchmarks,: wrinkles and grey hair

  6. #6
    Join Date
    Dec 2012
    Posts
    77

    Default Re: Recurrent Plugged Ducts-I'm at the end of my rope!

    hi there! as someone who has suffered from mastitis 4 times, and plugged ducts more often that i can count on my hands and feet, i want to step in!
    i don't believe that high fat causes this, but i do know that unhealthy fats can contribute.. really, think about how long humans have been breastfeeding their baby, and we never lived on low fat diets. it just isn't historical. cave-mamas would never have survived on low fat! i think really the issue is real fats vs. junk fats. so this means heated soy and corn oils, deep fried anything, and breaded stuff. so no corn dogs, no fries, no onion rings. no fast food. but please do eat fat, it does help us make really beautiful healthy milk for little baby. olive oil, coconut oil, sesame oil, that's the great stuff. i think low fat diet is hooey. but that's your call!
    second, i wanted to share with you that my 4 month battle with plugged ducts ended when i realized that it was happening on the side i was sleeping on. sleeping on my right side was compressing my right breast all night, and same went for the left. i started sleeping on my back and have never felt better. no mastitis, no plugs, nada. i'm almost 8 months into nursing now, and it took us 4 months to figure that one out! my LLL and doc agreed that the side sleeping is likely what did it.
    hey, you're awesome for investigating and not giving up. i don't know how many times i threatened to quit. stay strong, no matter how horrible your boobs feel.

  7. #7

    Default Re: Recurrent Plugged Ducts-I'm at the end of my rope!

    Thank you all for your help! After trying to manage this for several weeks, I thought I would update in case anyone else out there is dealing with a similar problem. So although my DS dropped from 90% to 30% in weight around 3 months he has steadily maintained in the 30% since with the exception of one month. I started going in in the middle of the night and nursing him in his sleep and now he's returned to a one waking in the night to eat, which isn't too bad and with some pumping, storing and supplementing and beginning to transition to solids, we've had no more problems with weight. My supply has been a different story. It has continued to yo-yo. I do notice a difference in how easily I can massage out blockages as long as I keep my saturated fat intake below 10g a day. The lecithin also helps. But the biggest difference has come recently when I realized I have off and on had what appears to be a subclinical yeast infection on my nipples. There's not always pain but I've noticed when they're pinker my flow is stifled, often only getting one letdown on each side, which improves immediately with the application of a topical antifungal and goes away completely after a few days of twice a day applications. I've only discovered this in the last 2 weeks and still seem to be passing it back and forth a bit with DS but it really seems to make the most difference with anything I've tried. Also, setting aside time every day to pump and check my breasts and massage out any firm spots. This also provides me with a good supply from which to supplement when I'm having problems. So thanks again for the support and I hope my experience can be of help to someone else!

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