Recurrent clogged nipple pore

[@llli*numbersgirl08]

I've struggled with plugged ducts A TON. As in, I've had at LEAST 20 in the last 7 weeks. I am doing really good if I go 3 or 4 days without getting plugged. Often I'll get plugs in both sides within one day (yesterday and today). But I'm at my whit's end.

Pretty much every time I see a white dot on my nipple so I believe it's clogged nipple pores, and not a deep plug. Every time I know she's relieved it while nursing (because she all of a sudden starts gulping and the plugged spot gets softer) I can check afterwards and see the the small white dot is gone. So far, the best thing to get rid of them for me is to take a long, hot shower, and then dangle nurse IMMEDIATELY after the shower. Also note that I've never struggled with oversupply, so that's not the issue. And I've never been able to manually get rid of them by hand expressing or pumping - only she can do it.

What I'm doing to prevent:

- I've had a lactation consultant say the latch looks good
- I try to make sure she drains each breast each time
- I take lecithin supplements - 4 capsules each day (according to what kellymom says)
- I've cut a lot of the saturated fat out of my diet (I still have some, from milk mainly)
- I only ever sleep on my back
- I try to hold my purses in my hands so they don't rub against my boobs
- I have gotten a new bra that is supportive, no underwire, and not too tight
- I pump before going to bed at night so that I don't go too long between nursing sessions.
- I try to drink a TON of water every day.
- I've tried going to bed with nursing pads soaked in olive oil so that waking up the pores would be soft. Couldn't tell if that helped or not - perhaps I should start wearing pads with olive oil all the time, not just at night.

She sometimes sleeps through the night, sometimes wakes up once. She only gets breastmilk, although during the day while I work she gets two bottles (I nurse at lunch). The past two nights she's slept straight through the night and woken up around 7 to nurse. It doesn't seem plugged then (although I am engorged), but then it shows up later. It also gets plugged when she doesn't sleep through the night so I don't know if that is correlated at all. I've thought about waking up every night and pumping to keep the milk flowing, but I really don't want to have to do that forever. I hate pumping and I need what little sleep I get.

I don't know what to do. The last few weeks have been a nightmare of painfully hard breasts, hot showers with lots of massaging, dangle feeding a screaming baby who wants the milk to come faster, and constant fear of when I'm going to get plugged again. I really want to breastfeed for a whole year, but every time I get another plug I get so discouraged. I don't even know how I've made it through these last few weeks still nursing. I don't know how I can go 9 more months of this. I keep thinking "This will be the last time.... I will finally get over this... this can't be how it's going to be forever." And then as soon as breastfeeding is enjoyable again, another one pops up.

Help! How can I get this to stop (besides weaning....)

Also, is there ANYthing else that could be causing it? I've done more reading on this than I care to admit but I'm stumped. Nothing I try seems to help. Could dairy cause them maybe? Would cutting dairy out of my diet help?

[@llli*numbersgirl08]

Another thought - could we have thrush without knowing it and could that cause the recurrent clogged nipple pores? My nipples often look white, although that goes away after awhile. Her tongue is very white. She pulls off the breast a lot and often makes clicking noises while nursing, especially when the flow is fast. I can't say I feel a lot of nipple pain though - so I'd never thought of that.

[@llli*mommal]

Can you explain how you've eliminated oversupply as a possibility? You mention being engorged, fast flow, clicking noises... Those are all often associated with oversupply, and oversupply would go a long way to explaining the frequent plugs.

Has baby been checked carefully for a tongue or lip tie? Tongue tie would also go well with clicking and struggling with flow, as well as plugged ducts.

Thrush can make plugs more likely. But when your nipples look white and then the color disappears after a while, that points more to a latch issue causing vasospasms.

[@llli*numbersgirl08]

Can you explain how you've eliminated oversupply as a possibility? You mention being engorged, fast flow, clicking noises... Those are all often associated with oversupply, and oversupply would go a long way to explaining the frequent plugs.

Has baby been checked carefully for a tongue or lip tie? Tongue tie would also go well with clicking and struggling with flow, as well as plugged ducts.

Thrush can make plugs more likely. But when your nipples look white and then the color disappears after a while, that points more to a latch issue causing vasospasms.

Hmm.. I'm rarely engorged; only when she sleeps through the night after not doing it for awhile. I guess I've determined that I don't have an oversupply because it ALWAYS seems as if she wants more and wants it faster. I mentioned fast flow, I just meant that at the very beginning when it is faster, before it slows down. She does click some at that time, but she gets really unhappy when it starts to slow down. It hasn't appeared as if she ever has trouble handling it. Also, she never really seems satisfied when she's done. I feel as if she would keep nursing forever - but it's not just comfort nursing, because she's fussing the whole time, wanting the milk to come out. She just gets angry at my boobs. I can definitely tell when I'm plugged more often my supply is lower because I can tell she's even more unhappy and swallowing less.

And when I'm pumping at work instead of nursing, I'm doing good if I get 4 oz, and she typically has been taking about 4 oz each feeding we're apart, so I'm always trying to stay ahead of it. That's one reason I pump at night - to make sure I have enough for her while I'm at work. The other people I've talked to with oversupply seem to get much more while pumping.

I've always wondered about her latch. I had a LC tell me it was good. And it never hurts and never really has. But it does do the white thing, although it does that when I'm pumping too so.... that might just be a nipple thing? Sometimes my nipples get the lipstick-shape when she pulls off, but not all the time. I know that can indicate a bad latch.

[@llli*mommal]

Lipstick-shaped nipples definitely indicate a latch that is a bit shallow. The nipple is being compressed between the tongue and the hard palate, instead of sitting in the ideal position between the soft palate and the relatively motionless back of the tongue. And compression of the nipple and consequent trauma can definitely contribute to plugged ducts.

Sometimes babies compress the nipple because they have a tongue tie or lip tie. Sometimes they do it because they have small mouths and small mouths can't achieve the deepest latch. And sometimes they do it because they are getting a flow which is too fast for them, and compressing the nipple slows the flow. You can rule out ties with the assistance of a LC. You can deal with fast flow issues by reclining while nursing- gravity slows milk flow and reduces the baby's need to compress. If the problem is the size of the baby's mouth, time should take care of it, since babies grow fast.

[@llli*numbersgirl08]

I can try to see another lactation consultant, but beyond that, any other suggestions? It's just so frustrating because I've been told she has a good latch, but this keeps on happening, and I just expect that to happen again. I think the lipstick shape that shows up sometimes is probably because of a shallower latch - she also consistently pops on and off while waiting for letdown, or when the flow slows and she wants it to letdown again, but each time she comes back on the latch isn't as good. I try to pull her off if it appears she's shallow.

I'm just so tired of this. Woke up again this morning engorged with a plug on one side. When I go to bed everything seems fine, it appears all the milk has been drained from both breasts well. This time I don't see a white dot at the nipple - not sure if it will show up in a bit, or if it's just a deeper plug and not a clogged nipple pore.

How long is it supposed to take for your body to get used to a baby sleeping through the night? She's doing it on her own and I don't want to mess with her sleep and wake her up to nurse. But it's been several days and I'm still waking up engorged and getting plugged ducts during the day.

[@llli*mommal]

Time questions- like when will my body adjust to baby sleeping through, or how long until my supply increases, or when will my milk go away- are the hardest breastfeeding questions to answer, because every woman is different and every baby is different. Some moms will see their supply adjust to baby sleeping through in just a night or two. Others might take weeks to see an adjustment. Moms who have oversupply tend to take longer to see supply adjustments.

Waking a baby up to nurse at night is not "messing" with her sleep. In fact, it's probably the first thing to try when you're getting engorged at night. It gets extra calories into the baby, keeps the milk moving (thereby reducing the likelihood of plugs), and like it or not, it's unlikely that your baby's long sleep stretch is going to last, so you might as well not get used to it.

[@llli*numbersgirl08]

So I saw a LC on Saturday. She said her latch was pretty good and she was transferring milk well - got 6 oz while the LC was there (morning feeding). She did say it looks like she could have a midline tongue tie, so I have an appointment with the pediatrician today to look at it. She also didn't think I had an over or under supply - that it seemed like I'm producing the right amount for my baby. We talked through a few different things, at first we discussed waking up in the middle of the night to pump and keep the milk flowing, but she changed her mind on that idea - thought that rest might be more beneficial for me, since the plugged ducts started right when we started packing to move and then we moved across the country. Thinking that perhaps stress is making them worse, although we're pretty settled now. I go back and forth on that idea - of waking up at night - I don't want to tell my body to produce more, and I'm not sure it will help since I STILL get plugged ducts when she does wake up at night to nurse. Also, I don't want to wake her up at night because she has bad reflux (is on meds) and a feeding is quite the ordeal - it's no sleepy nursing session that's relaxing for either of us. It's a 40 minute long (at least) nursing session, then 20-30 minutes of burping, spitting up, and holding upright while she's crying because she hates being burped or held upright. If she's willfully sleeping through the night on her own (I have not done any kind of sleep training to get her to do that - she's too young - she just is a good sleeper), then I want to let her sleep.

I've noticed that before a plug seems to be felt in the back of my breast, I can see a small white dot on my nipple. Every single time. If I squeeze it hard, I can see it sort of popping out. It seems like I'm getting clogged nipple pores every time. The only thing that gets rid of them is a fairly long HOT shower, and then IMMEDIATE dangle nursing. I tried that this morning before she even woke up, with the goal of getting any plugged pores cleaned out in her first feeding, and it seemed to work. But I can't necessarily rely on that every day - hard to time when she is going to wake up.

So my main questions now are - could her tongue tie be contributing to the clogged nipple pores? I don't think the plugs are deep in my breast tissue, I think it's right at the nipple that the issue is happening. And how can I keep my nipple pores from getting clogged? Is there something I can do to keep the milk from hardening right there?

[@llli*mommal]

Some women definitely get literal plugs of hardened milk in the nipple area. What these plugs actually are composed of... Who knows. Proteins? Sugars? Fats? Probably a mixture. A lot of moms describe being able to squeeze out these plugs like toothpaste from a tube.

A tongue tie can definitely contribute to plugs. Sometimes TTs will result in nipple blisters, which are like callouses or skin overgrowths that block a duct. These can usually be broken with a fingernail or a sterile needle, or by baby's suckling. But that doesn't sound like it's the case for you.

Can you squeeze them out without the hot shower-nurse rigamarole? If so, I'd just keep doing that.

ETA: some of the best information I have gotten about lactation comes from the dairy industry. Generations of research on lactation in cows and goats... Might as well take advantage, right? Anyway, this seemed like an interesting avenue to look at: http://www.homesteadingtoday.com/liv...ged-teats.html

[@llli*numbersgirl08]

We went to the doctor Monday and they said she had a slight tongue tie and went ahead and clipped it. I can tell a difference in her nursing after that - she seems much quicker and more efficient. However, I've still gotten 3 plugged ducts since then. I've been told that the latch looked good and the last time we had a weighted feeding she transferred 6 oz (it was a morning feeding when I normally have higher supply).

I've cut out almost all saturated fat from my diet. No more red meat, no more sweets, no more cheese. The only saturated fat I'm really getting is in the milk I get in a day - which is only about 2 cups a day. I'm still doing all the things I mentioned above. Still getting plugs.

The last thing I can think of is that I wake up very full, almost engorged, every morning. Perhaps my milk just cannot handle sitting that long. My last ditch effort is to wake up and pump at night to keep the milk flowing. I'm a little wary as to how effective that will be because yesterday it appeared that I only had one plug when I woke up and nursed her. Another showed up that evening, that I got out in her 5:30 feeding. Perhaps it could have been starting earlier - except that I'm really good at spotting them. I had to take 3 showers yesterday - one in the morning to try to help get any plugs out when she first woke up, which didn't work. Then one at 10:00 to help get the first plug out, and another at 5:30 to get the second plug out. Both of those were in my right breast. This morning I woke up to one in my left breast. The hot shower didn't work this morning, so I'm taking another one before she eats (sometime around 9:30-10ish typically).

But now my plan is to nurse at 7:30 for bedtime, pump at 10:30 before going to bed, then pump 4 hours later at 2:30, and then nurse her when she wakes up (typically around 6:30/7ish). So the gaps between keeping milk moving will be 3 hrs/4hrs/4-5hrs. Do that until it feels like my breasts aren't getting engorged or full or I go a week without a plug, then change it to pump at 10:30, and then pump 3 hours later at 1:30, so the second stretch is longer (3hrs/3hrs/5-6hrs). Once that seems to be working, switch it up to nurse her at 7:30 before bed, and pump again at 1, and then nurse when she wakes up (5.5hrs/5.5-6hrs). Once that is working, nurse at 7:30, pump at 12, and nurse when she wakes up (4.5hrs/6.5-7.5hrs). And then move to nurse at 7:30, pump at 10:30, nurse when she wakes up (which is what I do now). And all of these plans could change completely if/when she starts waking up at night again. I mentioned this before, but the reason I don't want to nurse her at night is because of her bad reflux turns it into an hour long affair and seems to bother her when she nurses at night. This is just another issue I have to deal with - if we had relaxing nursing sessions that only took about 20 minutes and she could sleep through it all and go right back to bed, I would not mind waking up at all! But that's not the case for us

So my questions now are: Do you think that might help? How should I pump when at night, so as to keep my body from thinking it needs to continue to produce more milk. I guess my goal right now is to get my body to the point where it doesn't get engorged, but that eventually I can sleep through the night if she is. When I pump for a missed nursing session I pump almost 20 minutes. Should I pump less - like 10 minutes? Should I hand express instead? Although if I'm going to the trouble, I think it'd be nice to collect the milk I'm pumping, especially since I'm considering weaning earlier than I'd like - it'd be extra breastmilk on hand if I have to wean.

Are there any other suggestions you might have? Clearly, I'm desperate. I'm thisclose to giving up. The hot shower/dangle nursing combo is the ONLY thing that I've found that works - and I've tried EVERYTHING else to get rid of them when they happen. That's just not very conducive to living life, when you get multiple plugs a week. I've tried to squeeze them out but that has never worked for me.

Your information from the dairy industry was interesting. I couldn't really find anything that helps me, although I think there is clearly something in my milk that makes it harden or get sticky more than normal. I wish I knew what to do to keep it from happening. I wish I knew exactly what is causing it. I love nursing when things are going well, but I absolutely hate when I'm plugged (which seems like most of the time now).

Right now my goal is to make it to 6 months. That's only a little over 2 months away. I keep thinking - if I can just make it there, and say I EBF for the 6 months recommended, then I can give myself grace to stop. The thought both makes me really excited and really unhappy at the same time. I can't wait to be free of the burden of constantly painfully hard boobs, but I get so upset thinking about stopping early when I originally wanted to go 12 months. I'm so jealous of those people who have a good experience breastfeeding. I feel like I'm never going to get there - I'm always going to be battling plugged ducts.