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Thread: Blocked duct questions

  1. #1
    Join Date
    Feb 2014
    Location
    Ontario, Canada
    Posts
    5

    Default Blocked duct questions

    I think I have a blocked duct (the side of my breast is tender, less pain after feeding), but I'm finding some of the guidelines for treating it confusing:

    1. I'm reading that I should start each feed on the side with the blocked duct and make sure to empty the breast before stopping. Even to pump if the baby doesn't empty it. But when I look up how to tell if the breast is empty, everyone says your breasts are never totally empty and there is no real way to tell. So how do I do this?

    2. The best indication your breast is mostly empty seems to be that the baby stops wanting to eat from it. But my guy is something of a snacker and often will feed for just 5-10 minutes every hour or so. So I can't assume the breast is "empty" just because he's stopped, right? Is this bad for the duct? Should I be pumping after a short feed even if he'll be eating again soon?

    3. Since he usually only feeds for short periods, he rarely wants both breasts in a feed. So if I'm always starting with the affected breast, he's rarely drinking from the other. Doesn't this put me at risk for getting blocked ducts on the breast he's not drinking from? How do I avoid that?

    4. My guy is only a month old and doesn't have great head control yet, so I still need two hands almost always to feed--one to keep his head in position and one to keep my breast in position. Many of the other suggestions for treating a blocked duct seem to require an extra hand: Massaging the duct, holding a warm compress there. How do people manage this? Am I stuck just doing those things before the feeding, and will that still be effective?

    Sorry this is so long... I'm trying to make sure it doesn't get worse and am getting frustrated with the information available.

  2. #2
    Join Date
    Oct 2012
    Posts
    2,209

    Default Re: Blocked duct questions

    Hi mama, sorry about the plugged duct - I've had many!

    You're right that the breast is never truly empty. The idea is that you want to drain it as best as you can - ideally until you can get it nice and soft. Number one, using baby, because he usually is going to do the best job with draining. But, you can also use the pump or hand expression, and when you are doing that, use your other hand for massaging the breast at the same time. This can also include things like taking a hot shower or bath and massaging the breast during that time. Or, I've seen moms post on here about using an electric toothbrush or a vibrator to give some extra massage to block up the plug.

    Since your little guy is often nursing on one side, I agree, you do want to nurse the other breast too. Maybe once the non-affected side starts getting full, use that breast for that feeding.

    Keep an eye out for mastitis symptoms - fever, chills, body aches - since sometimes a plugged duct can lead to mastitis. But I've had many times where it took me a couple days to get the plug out without getting mastitis, so don't panic if you can't get it out immediately - it takes time.

  3. #3
    Join Date
    Aug 2012
    Posts
    206

    Default Re: Blocked duct questions

    Agree with PP about suggestions. I had lots of plugs when I was bfing. Try keeping a heat pack (not too hot) on the breast all the time. Heat will do a lot to help with a plug. You might also try manually expressing from that breast--you should be able to see milk flowing from each duct, and once experienced, know when milk is not flowing from a duct. You may also see that one duct is white and nothing is coming from it; this happened to me all the time. I would gently put pressure on the duct and eventually be able to work out the plug, which came out like a little white grain of sand or crusted up milk (yes, gross). You can also try supplementing with soy lecithin, which helps to break down plugs and prevent new ones from forming. I think this helped me, but I was not always consistent in its use.

    You will know if a breast is "empty" if it feels soft. If it feels hard like a rock, that is a problem! Definitely try heat and massage. I also used both hands: one on baby, one on the breast. I was able to hold the breast with one hand in a position where I could massage it while also holding it in baby's mouth, so you might experiment with this too.

    Call your doc if you see signs of mastitis--redness spreading over the breast, fever, chills, feeling like you're getting the flu. It can creep up on you fast, so be watchful until you feel the plug pass.

  4. #4
    Join Date
    Nov 2012
    Location
    Montreal
    Posts
    106

    Default Re: Blocked duct questions

    A position I found useful for draining a plugged duct was - gonna sound weird - on my hands and knees on the bed, with baby lying underneath, sucking up. No head control required The idea being that gravity helps in this position and you can more easily massage the breast to release the plug.
    Mama to a sweet kitty born July 2012.

  5. #5
    Join Date
    Jun 2009
    Posts
    5,334

    Default Re: Blocked duct questions

    I would like to point out that some newer ideas for plugged ducts include cold compresses rather than warm with the idea that cold will reduce swelling and open up the duct and of course is also a comfort measure. And the other one is vibration- using a electric toothbrush or personal massager on the area to break up the plug. For a good list of ideas for both plugs and blebs (which are milk blisters-basically plugs that appear on the nipple) look up the PDF file on the tearsheet toolkit area of this website. Just put toolkit into the search engine
    Just as with most breast-feeding issues, how to approach dealing with plugs needs to be individualized a bit for each mom. So yes sometimes the suggestions do seem to conflict that is because different things work best for different moms.

  6. #6
    Join Date
    Oct 2012
    Posts
    2,209

    Default Re: Blocked duct questions

    Quote Originally Posted by @llli*isabelofmtl View Post
    A position I found useful for draining a plugged duct was - gonna sound weird - on my hands and knees on the bed, with baby lying underneath, sucking up. No head control required The idea being that gravity helps in this position and you can more easily massage the breast to release the plug.
    Yes, I've used that position too (my husband seems to find it amusing) - good suggestion! It can be really effective.

    Here's the tearsheet Meg is talking about:
    http://www.llli.org/docs/00000000000...plugsblebs.pdf

    Good to know about the cold compresses.

  7. #7
    Join Date
    Jan 2014
    Location
    NY
    Posts
    248

    Default Re: Blocked duct questions

    Also, lots of people online make it sound like in one session the baby "nursed out" the plug and voila, you're cleared. It doesn't always work that way. For me, every time I have a plugged duct, it'll take a solid day at least for the clog to work its way out. It doesn't just pop out in one feeding. What works for me is this:

    First using the affected breast for the feeding. Then using the second breast if he still wants. If he does, I won't offer it until two feedings from now.

    Feeding so often will increase milk production, starting the cycle all over again, so I feed just a little more frequently than normal. Like every 2 hours instead of every 2.5-3 hours.

    Using one hand to hold my baby's head, and the other hand that supports my breast will firmly squeeze the breast. I use the thumb to massage the blockage. I usually get my blockages on the top inner side of the breast so it's not too hard to use my fingers to support breast and thumb to massage downward towards the nipple.

    Also you won't "empty" your breast but it'll feel softer after a feeding. I don't always have that sensation. For example, if it's already feeling so soft (which happens later) then I wouldn't notice the difference when it got emptier.

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