Plugged Milk Ducts

on April 22, 2014 in Breastfeeding, Plugged Milk Duct

At some point in your nursing journey, you may develop a plugged milk duct.  Milk ducts can become clogged for many reasons.  Most often this happens when a breast has been incompletely drained and thickened milk causes a blockage.  Skipping or infrequent nursings, the baby not nursing long enough to drain the breast well, wearing an under wire bra, becoming dehydrated from not drinking enough fluids or following a period of illness when a mother experiences mild dehydration.  Plugged ducts are more common in mothers who have over abundant milk supplies.

The symptoms of a plugged duct may vary from mother to mother.  Typically, an area of the breast becomes palpable and tender.  A plugged milk duct is very different from mastitis, or a breast infection.  Mastitis typically involves a not only a painful breast, but includes a tender pink area, flu symptoms, and fever.  Mastitis is best managed with many of the same treatments as a plugged duct but with the addition of oral antibiotics for 10 to 14 days.  Sometimes a plug duct if not treated aggressively, can develop into mastitis, so prompt attention is important.

Treating a plugged milk duct includes frequent breast emptying, either with a vigorous nursing baby and/or an effective breast pump.  Prior to nursing or pumping, it is helpful to place a warm, moist heat source on the affected area.  This can be as simple as a warm, wet washcloth over the area, covered with a small towel to hold in the heat for 5-10 minutes.  While you can use a heating pad, it is best to place a warm, wet washcloth first and the heating pad over that.

Start each nursing on the affected breast.  While the baby is nursing, use your hand to massage the area right behind the lump moving your fingers towards the nipple during the entire feeding.

Also, increase your fluids until you are urinating hourly.  Increasing the amount of milk behind the plugged area can help push the plug open.  Lastly, use ibuprofen.  Taking 600 milligrams every six hours helps decrease inflammation and may help open the duct along with the moist heat.

When a plug is visible on the nipple that looks like a whitehead, the problem maybe a blockage in the nipple or deeper within the breast.  Sometimes a plugged duct within the breast may lead to an overgrowth of skin over the nipple pore. These white “blebs” on the nipple may make nursing painful.  They often causes sharp, shooting or stabbing pains in the breast, especially right after nursing. With these types of blockages, typical measures will not help the problem.  The treatment that works well in most cases is using a sterilized nipple and gently scraping starting at the edge of the bleb to try and remove the white tissue.  This is usually best done at the end of a nursing or pumping when it is most visible. Doing this is usually painless, although some bleeding can occur.  It may need to be repeated a couple of times to completely remove the blockage.

Some mothers suffer with repeated cases of plugged milk ducts.  If you pump often, you might consider using Super Shields from Pumpin’ Pals. These elliptically shaped shields are inserted into pump flanges to gently milk the breast instead of pulling on just the nipple and areola. Some mothers have found that the shields seem to help prevent plugged ducts.  You can order these on line or from the company directly.

Some mothers find that taking nutritional supplements like vitamin C and/or supplemental lethicin, three capsules a day and avoiding saturated fats in their diet is helpful.  Lethicin is a common food additive and in found in many foods.  Lethicin is an emulsifier, used to keep fats dispersed and in suspension.  The usual recommended dose is a 1200-milligram capsule 3 to 4 times a day.  After a few weeks without another case, the dose can be lowered by one capsule and the daily dose can be reduced thereafter.  Some mothers may need to continue taking one or two capsules a day if stopping it completely leads to additional plugged ducts.

If after 3 days of unsuccessful home treatment, the next step should that occur, is an evaluation by a doctor.  A lump in your breast that lasts three days or longer should never be ignored.