Complications that Can Occur

• Plugged Ducts

  Plugged ducts occur when the breast is not drained effectively. A plugged duct can be caused by any of several things – your baby not draining the breast, the duct getting compressed while sleeping, a bra, stress, getting a cold or the flu, etc. Some moms will feel a hard knot, others will feel a tender spot, with or without redness.

• Suggestions for Unplugging Ducts

  Nursing when you have a plugged duct can be painful. However, it is very important to continue nursing and/or expressing breast milk when you have a plugged duct. The goal is to get the milk flowing again from the duct. If the duct remains plugged, it can lead to mastitis, a serious breast infection.
• Here are some helpful suggestions for unplugging ducts. Not all of them work for every woman and not every one works each time. Try as many as you need to get the duct unplugged.
1. Nurse your baby with the baby’s chin facing the plugged duct. You may have to lay your baby on a bed and position your breast over the baby (be sure not to put your weight or the weight of your breast on your baby.) You can try various nursing positions as well (the cradle, the football hold, etc.)
2. Soak your breast and nipple in a bowl of very warm (not hot) water (lean over a bowl placed on the counter.)  You can also add some Epsom Salt to the water according to the directions on the package.  After soaking your breast for awhile and while still soaking it, massage the area, gently using your finger pads to massage from the base of your breast toward the nipple (as if pushing the milk out of the breast.)  Keep doing this as well as compressing your breast in different areas, making sure to use gentle pressure to not cause tissue damage. Then, try nursing, hand expression, or pumping for a short time.  If pumping, reposition your nipple in the breast shield a couple times during this short pump session, mimicking a baby latching on a little differently each time.  Do not pump longer than a few minutes if it has not unplugged.  Resoak the breast, gently massage it more, and then try removing it again by nursing, hand expression or pumping.
3. Compresses: Apply warm, moist compresses to the breast (e.g., a warm washcloth covered by a heating pad on low heat.) Apply cold compresses to the breast for the reduction of pain and swelling (e.g., a small bag of frozen peas or a wet washcloth placed in a zip-lock bag and frozen then bent a few times to make it more flexible.)
4. Gently massage the area of the plugged duct (it may be painful but often helpful.) Make sure not to massage too deeply or strongly to avoid damaging your breast(s).
• Sometimes you can actually feel the plugged duct “release.” Drain the duct as thoroughly as you can either by letting your baby nurse or pumping the milk out. This release of milk may look stringy or otherwise different from your regular breast milk; this is normal and is the result of the milk sitting in the duct for an extended period of time.

• Mastitis

  Mastitis occurs when a plugged milk duct becomes infected. You may experience flu-like symptoms such as headache, fever and/or achiness. Mastitis often comes on very quickly. If you experience any of these symptoms, call your lactation consultant or medical practitioner. Mastitis can progress into an even more serious condition and therefore needs to be treated immediately.

• Next...

Breast pumps are available for purchase through local nursing/baby stores, pharmacies, hospital gift shops, some lactation consultants, as well as on-line.