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Plugged Ducts

Remember the milk ducts in your breasts? They're the ducts that carry milk down to the pores in your nipples and, ultimately, into your baby's mouth. Well, like a kitchen-sink pipe they can become plugged, causing a lump or hard area on your breast that feels sensitive.

If you have plugged milk ducts, don't panic. They're common in the early days of breastfeeding, as your milk supply adjusts itself, and they're easily treated. As a rule, there's no need to visit to your doctor for this condition.

Plugs occur when something makes milk to "sit" in your breast rather than move through the ducts. This can be caused by something as simple as sleeping on your stomach or wearing a tight bra or baby carrier. It can also occur if your baby isn't draining your breast enough at feedings or isn't feeding as often because he's sleeping longer stretches at night, has a cold or is becoming more alert.

If you think you have a plugged duct, the best cure is good drainage. Always offer the affected breast first at feedings, since your baby eats more vigorously at the beginning.

Other ways to help treat a plugged duct:

• When breastfeeding, try to position your baby's chin so it lines up with the part of your breast where the plug is. Wherever his chin is on your breast will get the best drainage. For example:
  • If the plug is on the outer part of your breast, put him in a football hold for the first part of the feeding.
  • If the plug is on the inner part of your breast, use the cross-cradle hold.
  • If the plug is underneath, try to get him in a modified football hold where he's more upright and his chin is at the underside of the areola.
• As he nurses, massage the lump using a downward stroke toward the nipple. Sometimes putting a little olive oil or lotion on your fingers reduces the friction on the breast as you massage.
• Lecithin (also known as soy lecithin) might be helpful too. It's an over-the-counter pill found in the vitamin section of drugstores or health food stores. Take one capsule three times daily or one capsule every hour for three hours around the time the plug appears.

The plugged duct should resolve itself quickly if you treat it right away. However, if it isn't treated quickly or it's stubborn, it could turn into an infection called mastitis.

You'll know when a plugged duct has become infected: the area will become very tender and might hurt when your baby latches on; it might also look red and feel warm to the touch. The main sign of mastitis is flu-like symptoms, so you'll have aching bones, chills and a fever. If you think you've developed mastitis go see your doctor, who will probably give you a prescription for antibiotics.

Tips for success:

• Always try to drain your breast thoroughly at every feeding. This ensures the milk won't sit in the ducts and become plugged.
• Wearing a bra or baby carrier that's too tight or sleeping on your stomach can cause plugged ducts. Make sure your bra or baby carrier isn't putting too much pressure on your breasts and try to sleep on your back or sides.
• If the plugged duct doesn't go away on its own or becomes sore and red, and you have a fever and flu-like symptoms, see your doctor. It probably has become infected, and you'll need antibiotics.

This information is courtesy of Bravado Designs, the brand synonymous with women's breastfeeding success for 18 years.

Source: Heather Kelly is an International Board Certified Lactation Consultant (IBCLC) who also sits on the Bravado Breastfeeding Information Council Heather has been practicing in New York City since 2001.