Plugged Ducts

Dear T.,

I was lucky enough to not experience this (my worst breast-feeding problem was blisters on my nipples - woo hoo!) I am sorry about this - it sounds miserable! I wanted to address the antibiotic issue . . . I know there is concern about over-use of antibiotic - and I am the first to get upset about it and patients insisting on them for things that they won't fix (cure) - and doctors complying just to shut them up (I AM NOT, btw referring to you - please don't think that!) . . . You say you don't have a bacterial infection, but the mastitis can become one . . . I know that many years ago, my daughter had recurring ear infections, and the doctor ended up putting her on a prophalactic antibiotic to prevent any more . . . I don't know what exactly your doctor's thought is, but I would ask him if you have any concerns . . .

good luck!
B.

T.,

check out this: http://www.kellymom.com/bf/concerns/mom/recurrent-mastiti...

Kellymom.com is a great resource for all things breastfeeding. Or go to www.kellymom.com and search "plugged ducts." I've been fortunate to not be prone to plugged ducts or mastitis but on the breastfeeding/pumping lists I belong to, I know several women take a supplement called "lecithin" and it helps them not get plugged ducts.

If your nipple is red and sore, I'd definitely treat for thrush. Kellymom has great info on thrush also. Good luck!

T.

Hi T.,

Try my trick - I call it the "Boob Bowl" - get a large, deep bowl and fill it with water as hot as you can stand without scalding your skin. Then (and this is going to sound silly - but it really works) plunge your breast into the bowl and leave it there (lean over a table or put it on the floor) for 5 minutes. Then, massage your breast from your armpit toward the nipple with oil for several minutes, and then do the boob bowl dip again. The heat and massage help to loosen the blockage, and it really works.

Good luck - it will get better.

For massage and heat I sat in the jacuzzi of our apt complex and put my breast directly in line with the jets. A nurse told me a home remedy that is stinky, but may work for you . . . take a little piece of cabbage, the size of a 1/2 dollar coin, roll it with a heavy glass jar in order to break some of the cappilaries and get it juicy, wear it over the blocked duct, hold it in place with a couple of band-aids. Call La Leche, attend a meeting and have someone help you make sure that your baby is latching on the correct way. Good luck!

Mastitis is a bear. Have you been to a lactation specialist? Have you read Total Nutrition for Breast-feeding Mothers by Betty Kamen, Ph. D., and Si Kamen?

There are ways to prevent mastitis. Specifically YOU HAVE TO GET ENOUGH REST =). Also make sure to nurse using a number of positions, never the same position over and over again. Wear comfortable bras. Watch out for situations that might cause you to burn through your energy. This next bit of advice might sound silly, but it makes all the difference. Make sure you can replenish yourself (recover fully and that includes proper self-care through nursing too) and if others are challenging or complicating your replenishing make sure you learn how to stand up for yourself, set limits, and can set that standard respectfully.

Yeast infections can happen inside the breast. Awful, I know. You sound like you have the symptoms for it. Antibiotics cause yeast to overgrow. Eat lots of yogurt and have your doctor write a prescription to rid you of yeast. There are ointments and what not. Usually if your chest is infected, then the baby, you, and your spouse will be too.

In the future if you feel like your body is possibly coming down with mastitis, 1st STOP EVERYTHING, 2nd make homemade cayenne pepper capsules and garlic powder capsules (take at least 3 of each, they are natural antibiotics and can stop the infection from invading the surrounding tissues as long as you do not have a fever yet-if you have a fever it is too late, you will have to get antibiotics), 3rd use a breast pump, 4th ice the area for 20 minutes after you pump, and 5th SLEEP!!! You can beat mastitis to the finish line this way. But you have to sleep. Growth hormone can do a lot for you to recover you when you sleep, but you HAVE to sleep.

A little more info...

Soon after I had my first daughter, a nurse taught me about the garlic and the cayenne pepper technique. If you can find capsules at a health food store all you need to do next is find powdered garlic and powdered cayenne pepper. Then you fill the capsules yourself. I have also found raw garlic to work in an emergency, but it really doesn't taste as good, as you can imagine. Hopefully someone at the health food store can walk you through some techniques of filling the capsules without making a monster of a mess. It does take some finesse. I usually take 3 of the cayenne and 5 of the garlic. Then a nap. If I wake up and still feel at risk a couple hours later, I will do the routine again. Warning: don't take the capsules on an empty stomach and be aware you may smell like a garlic factory for a day or two. It is worth it to avoid over exposure to antibiotics though. My daughter kept nursing just fine though it.

Hopefully you are one of those that can pace yourself well. For me it has been a bit of a jungle to cross. If you can avoid mastitis through rotating nursing positions and getting adequate sleep-that is best. But if you find yourself riding on the brink of mastitis at times, the "natural antibiotic properties of garlic and cayenne pepper plus sleep" technique does wonders.

by the way, my comment about icing for 20 minutes after you pump...

Forgive me if this is old news =). Icing lets your body know the extra nursing you did is not something to add to the daily routine. You don't want to inadvertantly increase your milk supply. It is a basic rule of thumb, ice tells your chest to slow down, warmth tells your chest to speed up. If you ice just after you pump during mastitis, it will tell your body to just keep at a constant rate for milk production. Hopefully you can avoid the typical overproduction that accompanies pumping during mastitis that so many others suffer through before things finally balance back out to normal.

I was on antibiotics for a urinary tract infection. My lactation consultant recommended acidophilus from Whole Foods (she said they have the best, you want something with at least a million live cultures). Don't buy anything freeze-dried. You want live cultures; freeze-drying defeats the purpose. She said to keep taking it for at least 6 weeks after I stopped the antiobiotics. I did, and actually I stopped buying the acidophilus at Whole Foods because it was so expensive and instead bought some capsules off Costco's website, which I am still taking. I never had a problem with yeast/thrush.

As far as the clogged duct, use a warm compress prior to pumping/feeding the baby. A clean diaper moistened with a cup of water microwaved for 10-15 seconds works really well. Put it on for 5 minutes prior to feeding/pumping. Try to position the baby so the baby's chin is opposite the clot, and massage the clot while you feed/pump. You should always massage toward the nipple.

When I had a plugged duct I was told to let the baby nurse all the time, to use heat, and take tylenol. Your situation might be different since you may have an infection. I think that you should talk to a Lactation Consultant or someone from La Leche League (this is usually a free service). They have lots of advise and right now is a critical time for you to keep nursing if you want to fully develop your supply. Hang in there; nursing is hard work but worth all the effort.

Not sure about the white spots, but for the mastitis make sure you always massage your breasts when you are in the shower. Let hot water run on them and then put some soap on and go in long stroking motions. I have had a couple of clogged ducts and I got rid of them that way before they turned into mastitis. If she put you on antibiotics you may already have an infection though. As far as what you can do for preventing a yeast infection. Go to Henry's if you have one near you and look for something called Jarrow-dophillus and take that daily as indicated. It is amazing. It is all the natural "good bacteria" you need. It is a bit expensive ($20.00 or so), but I would pay alot more than that to avoid a yeast infection. It is in the refrigerated section. My daughter had gone through 4 courses of meds from the doctors for thrush(yeast infection in the mouth if you don't know) and after 2 months of battling with it this stuff was recommended by a friend and it was gone after a week of treatment. I also got rid of it from my breasts(had it there too, not fun). Well best of luck to you. Hope this helps. Mastitis can be really bad, I had a friend go through four cases of it before someone told her about the massaging. : ) Congrats on your new little one by the way.

Hi T.! I had plugged ducts A LOT during the first few months, what worked for me was to massage the plugged area before you're getting ready to nurse, then as the baby's nursing, press down from the top of the plug towards your nipple like you're trying to push it out. That way you get a push and pull action, the baby's pulling out the milk while you're pushing it out of the plugged duct. If I had a plugged duct on 1 side and not the other, I nursed more on that side until the plug went away. If your baby's not emptying your breast, pump until you're comfortable, if you overpump, your body thinks it needs to make more milk and it will, and you might end up with more plugged ducts.
I massaged while in the shower too to help stay unplugged. After a few months when my supply was established, I didn't get them anymore. Good luck!

i suffered great engorgement those first weeks and i did what everyone else is saying... MASSAGE and HEAT.... apply the heat first, like a hot shower with your breast in the stream and try to massage the duct the best you can... then nurse as soon as possible after that...

contact your la leche leauge for advice. they have emails and phone numbers you could call and contact... they can offer advice on the antibiotic too, pros and cons.

good luck!

pain and redness can be a sign of mastitis. it's probably a good idea to stay on the antibiotics. if you do have an infection and it gets out of hand, that means a hospitalization and IV antibiotics.

to get rid of the plugged ducts, try feeding him different positions and massage the firm area while he's nursing. changing his position will pull the milk from that duct in a different way. if you have various plugged ducts, then try alternating positions for each feeding.

goodluck! check out drjacknewman.com for other breastfeeding solutions and good information to get you more aware of breastfeeding.

I had mistitis after I had my first child. It was horrible, so I feel for you. My lactation consultant told me to get tons of rest and to nurse the baby as much as he would nurse, and if he's had enough, jump into a warm shower and let the water run gently over your breasts or use a warm washcloth on them and think about nursing your baby and massage your breasts to work out the clogged areas. Yes, nursing and massaging is going to hurt at first, but it will help soooo much faster than anything else you can do! Keep plugging through it and it will get better.

I have plugged ducts quite a bit with my current baby. I am to the point where I can actually feel them coming on. Once I realize I have plugged duct, I bomard the infected site with heat. Hot water bottles don't really work that well, we have those re-usable hand warmers that you pop the disc and they get hot for a couple of hours. This I just stick in my bra and let it set. I also do maniacal pumping when I have them. I squeeze the infected site and try work it out as best as I can while pumping. It takes a day or two, but eventually works it way out.

I didn't read the responses yet, so someone might have mentioned it, but I had the same symptoms and I didn't get it checked out for 2 MONTHS! yeah, ouch!
Well, I spoke with the La Leche League lady in my area (try google) and told her all the symptoms and she new what it was right off the bat. Mine turned out to be yeast. She recommended a treatment (um, ginseng violet, I think it was called) that treats both my nipples and the baby's mouth at the same time. It really worked out for us. I've kept it (it doesn't expire) just in case it reoccurs (it did once). But the pain is gone. I think I cried the first time I nursed him with out pain. It was wonderful. Good luck! Don't give up. Where theres a will theres a way!! A.

I wouldn't use the antibiotics if I were you. Antibiotics should only be prescribed to treat an actual infection and overuse of antibiotics can lead to antibiotic resistance. I would only use it if you've had mastitis already and you are prone to it for prevention. (if you have an active infection, take the antibiotics though and please, please, please, finish the prescription even if you feel better!!)
I used warm compresses on my plugged ducts and LOTS of massage on the plugged area. I got them quite frequently in the first several months of breastfeeding.
I would also make sure your son is emptying each breast on feedings. If he isn't, massage the rest of the milk out after each feeding to prevent the plug in the first place or if there is a lot of milk, pump the rest out and freeze it. Also when you're in the shower, massage the areas that tend to plug up more. Eventually, I regulated my milk (but I never could pump extra) and the plugged ducts went away.
I can't say this enough, MASSAGE, MASSAGE, MASSAGE. Even during feeding...
I never developed Mastitis.

There are a lot of ways you can treat this without antibiotics, you're right to be concerned about yeast infections. If you do have to take the antibiotics, eat LOTS of yogurt or other probiotics. For the clogged ducts, try heat, massage, NEVER wear an underwire bra. Continue to nurse/pump, and use a warm compress for 5 minutes before each time you nurse.