Breast tenderness, hard lumps, a wedge-shaped red area, warmth and inflammation—and you thought breastfeeding was going to be a wonderful experience! Don't panic, you could merely have plugged milk ducts. While tight clothing, skipped or infrequent nursing, stress or illness may cause the condition, the root problem is poorly drained milk ducts for which there is no known cause.
Usually, plugged milk ducts (among other mammary-related conditions) are caused by breast engorgement. Breast engorgement occurs in the mammary glands when too much breast milk is contained within them. It's caused by insufficient breastfeeding and/or blocked milk ducts. When engorged, the breasts may swell, throb and cause mild to extreme pain. Engorgement may lead to mastitis (inflammation of the breast) and untreated engorgement puts pressure on the milk ducts, often causing a plugged duct.
Treatment of Plugged Milk Duct
Plugged milk ducts is a common problem after birth and during breastfeeding that you can prevent and treat it at home. You don't need to visit your health professional unless you have symptoms of an infection that may require antibiotic treatment. If you're not going to breastfeed, there currently is no safe medicine available for "drying up" your breasts and preventing breast engorgement. You can instead use self-care measures to help relieve breast engorgement.
- Call your physician: She can confirm if what you're experiencing is a plugged duct. Rest; treat your plugged duct like an illness. Stay in for a few days and cancel all appointments and activities until you get rid of the clog. Doing so can help you to avoid infection.
- Call your Lactation Consultant: The second person you should call is a lactation consultant. According to the International Lactation Consultant Association, A lactation consultant is a "healthcare professional who specializes in the clinical management of breastfeeding." The ILCA website can help you find a lactation consultant in your area. From there, discuss all your breastfeeding concerns with your designated health professional.
- Breast Engorgement: If you're not breastfeeding, breast engorgement will improve as your breasts stop producing milk. Pain and discomfort should go away in 1 to 5 days. You may find home treatment helpful for relieving symptoms.
- Start Breastfeeding ASAP: Start breastfeeding as soon as possible after your baby is born, and continue to breastfeed often. Offer your baby the breast every 1 to 2 hours while you're awake. This is the best way to prevent severe engorgement. Stick with breastfeeding and eventually everything will even itself out.If you can't get the plugged duct to clear, you can get mastitis, so keep letting your baby feed the plugged side and try to let it be completely drained. Keep massaging, too. A nice hot shower and manually expressing some milk in the bathroom will help a lot as well. On that note, feed your baby whenever he or she is hungry or at least every two hours.
- Empty your breasts with each feeding: Though it may seem natural to decrease breastfeeding, it's important to continue to drain milk from the breast. It is, in fact, generally beneficial to breastfeed very often to keep the breasts relatively empty (a lactating breast is never really empty in the true sense of the word).
- Longer Breastfeeding Time per Breast: Your baby should breastfeed at least 15 minutes or more on the first breast before changing to the second breast. You'll know it's time to move to the other breast when your baby becomes less eager to suck.
- Manual Expression: If your baby becomes full before your breasts are empty, pump or use your hands to squeeze the remaining milk from your breasts to store for later use. This is especially important during the early stages of breastfeeding.
Early engorgement will decrease as breastfeeding becomes more routine and your baby is able to feed for longer periods of time. Anytime you're not able to breastfeed your baby, arrange for a time and place to manually express or pump milk from your breasts at least every 3 to 4 hours.
- Self-Care: If you're breastfeeding, self-care focuses on increasing the flow of milk out of your breasts. You do this with frequent breastfeeding, making sure that your baby is positioned properly during 'sessions.' Make sure that your breasts are soft enough for your baby to securely latch on.
If your breasts are hard and too full of milk, let out (express) a small amount of milk with your hands or a pump. Then put your baby to the breast. You can expect some relief within 12 to 24 hours, and the discomfort should disappear within a few days.
- Changing Positions: Change your baby's breastfeeding position occasionally to make sure that all parts of your breasts are emptied. If your nipples are flat, gently massage the nipple and areola. This should stimulate your nipple to become more erect. Then gently support your breast with your thumb on top and fingers underneath. This added support will make it easier for your baby to latch on.
When nursing in different positions, try pointing the baby's chin to the area. Often the baby's sucking patterns are different in various positions. If your milk is not flowing well and you are becoming overfull, place warm, moist towels on your breasts before breastfeeding. You can also apply moist heat by using hot packs or by spraying the affected area with hot water in the shower. Doing this prior to nursing aids in milk flow and may enable you to pass the plug.
- Gently Massage the Affected Area: You may be able to squeeze the plug out of the nipple pore. Use a breast pump. Try pumping for a few minutes after each nursing session if your baby was unable to relieve the plug.
- Check for a Milk Blister: If there's a small white dot on your nipple, it could be a milk blister. This clogged nipple pore restricts milk from flowing freely and adds to the discomfort.
- Lecithin: Lecithin has been recommended to combat recurrent plugged ducts. The usual recommended dosage for recurrent plugged ducts is 3600-4800 mg lecithin per day, or 1 capsule (1200 milligram) 3-4 times per day. After a week or two with no blockage, mom can reduce the dosage by one capsule. If there is no blockage within another 2 weeks she can reduce it again by one. Mom may need to continue taking 1-2 capsules per day if stopping the lecithin leads to additional plugged ducts.
Lecithin is a very common food additive that is found naturally in many other foods. There are no known risks to its use by breastfeeding mothers. The reason why lecithin may help resolve and prevent plugged ducts is not clear. Per Dr. Jack Newman of KellyMom.com, "It may do this by decreasing the viscosity (stickiness) of the milk, by increasing the percentage of polyunsaturated fatty acids in the milk."
- Mastitis Treatment: If the problem has developed to the point of mastitis, you should eat and drink enough food quality- and quantity-wise to treat the condition. Bed rest on your part and frequent nursing (no longer than 2 hours from the beginning of one feeding to the beginning of the next) are also important.
An untreated (or ineffectively treated) breast infection can develop into a breast abscess, which may require surgical draining. A breast infection that continues for more than 24 hours or gets severe should be reported to the patient's doctor—she may need antibiotics.
- Breast Cancer Warning: A very serious type of breast cancer—called inflammatory breast cancer—presents similar signs/symptoms as mastitis, including a swollen breast. Inflammatory breast cancer has occurred in women who're breast feeding. It's the most aggressive type of breast cancer with the highest mortality rate, and it's usually not recognized via mammography or ultrasound.
Consult your doctor immediately if you believe yourself to be suffering from this condition. Antibiotics are often prescribed for mastitis or a breast abscess. If the condition is not relieved after 2 weeks of antibiotic therapy, the physician should rule out inflammatory breast cancer.
With the onset of plugged milk ducts, the woman will often feel a lump in one part of the breast, and the skin in that area may be red and/or warm. If it continues unchecked, the plugged duct can become a breast infection, at which point she may have fever or flu-like symptoms. Not to worry, though; the above tips and information should help combat this malady, because being well-informed is a way of handling this condition as well. As always, consult your doctor if symptoms persist.
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