Plugged Ducts Prevention and Treatment Tips
The best remedy for plugged ducts is prevention which starts with the first latch in the first hour or so after birth, adequate support during those first days, and no practices that limit the baby's time at the breast. Moms need to understand basic milk removal early in the breastfeeding relationship to prevent plugged ducts, prevent mastitis, and prevent various common breastfeeding issues such as milk supply and nipple pain.
Causes of Plugged Ducts - Plugged Ducts vs. Mastitis
This is a peeve of mine... just about every case of plugged ducts is diagnosed and treated as the bacterial imbalance [infection], mastitis. While they can coincide, they are not the same thing. They may both show similar symptoms of pain and discomfort, sometimes fever (though rare) - plugged duct symptoms tend to be localized to the one area that is plugged. You most certainly can have plugged ducts without causing an infection and you most certainly can get a mastitis infection without a plugged duct (and without even breastfeeding or being a woman because men do have milk ducts). As with most western approaches, everything is treated as an infection or an infection waiting to happen. Antibiotics are prescribed even when not necessary, increasing things like yeast infection, thrush, and overall body imbalances and negative impacts on gut health... the snowball just keeps getting bigger...
Plugged ducts are when the breastmilk, basically, doesn't stay mixed well (breastmilk is not homogenized) and the fatty parts of the milk plug up a duct and prevent milk removal. Removal of the plug can take one nursing session or it may take a few days. The longer the plug remains, the more of a chance a mastitis or other breast duct infection may occur.
Plugged ducts are often caused from:
- Inadequate milk removal
- Breastfeeding latch
- Breastfeeding position
- Artificial Nipple use such as pacifiers, nipple shields, and bottles or thumb sucking - all of which reduce the time at the breast and change latch
- Limited nursing
- Separate sleeping spaces (which reduces night time nursing and milk removal)
- Breast pressure such as underwire, sports bras, sleeping positions...etc.
- Less than nourishing food choices, particularly those low in vegetable and unbalanced starches, breads, and sugars or other processed foods
Generally, if one area of the breast feels a smidge tender, treat it like a plug and start massaging and using the following methods. Nip it in the bud and don't let it progress into something more and don't wait to try anything.
Latch & Position
The baby's ability to efficiently transfer milk from the breast to the baby and swallow is the biggest factor in preventing and remedying plugged ducts. If the breasts aren't being adequately removed of milk, they can get clogged up. If nipples are damaged, milk may not flow as effectively. Have tongue ties assessed by someone that knows how to properly assess them (and understands their connection with breastfeeding) and remedy these through massage, cranio sacral therapy, adjustments, and revisions as necessary. Bodywork is often an important part of newborn care, especially if there are latch issues and after tongue or lip tie releases. If baby's nose touches the breast, improvements can be made. Get in touch for Skype sessions to help with specifics.
Dangle feed with you hanging over the baby to let gravity support.
Move baby's chin near the plugged side, and all around, to let baby work the plug out. Try various different positions when nursing as the ducts aren't perfectly lined up in your breasts and that web may cause a plug anywhere.
Shake 'em & Massage
Between nursing sessions, breastmilk fat separates a bit. The longer you go between nursing sessions, the more this will separate. You also tend to see less separation throughout the day after you've been nursing on and off all day. Shake your breasts. Grab them, and shake them... before a nursing session, after, and in between. Though there aren't really studies that back this up - many cultures have done this as a traditional breastfeeding practice historically. It can't hurt, and it may help, so why not. If you feel like you have "foremilk hindmilk inbalance" (despite the inaccuracies of that term), shaking your breasts may help.
Some moms find plug relief through this same concept by using an electric toothbrush or other vibrating mechanism over top of the plug while nursing and throughout the day to help move the plug out of the ducts.
Massage the breasts towards the nipple. Get in a hot shower or bath with the water running over your back and massage your breasts.
No Artificial Nipples
Artificial nipples change latch. Period. Please.... PLEASE... stop perpetuating the myth that this is not so. If you use artificial nipples of any kind and experience pain or milk supply issues PLEASE STOP avoiding that detail when describing your issues, sharing your story, or telling other mothers that it's going to hurt for a while until baby's mouth gets bigger or that its tongue tie...etc...etc. Choosing to use artificial nipples and bottles is your choice but having the correct information helps OTHERS make their own informed decision as well. Artificial nipples - including pacifiers, nipple shields, and bottle nipples and even thumb sucking - cause shallow latch, change palette structure, increase gumming of the nipple and increase nipple pain through damage from latch and suck mechanics that literally change the structure of the baby's face. All of this decreases milk transfer and nipple damage leading to increasing plugged ducts.
Unlimited Nursing, Rest & Co-Sleep
Take a day, lay down in bed, and nurse. Many times being on the go reduces the amount of time you're nursing which causes slight engorgement and more chances for plugged ducts. If you're limiting nursing time lengths in anyway (separate sleeping spaces, pacifiers, timing each breast...etc.) - stop. Baby will regulate their intake - but they need unlimited access. This is beneficial to their development and if there are any latch issues going on, limited sessions will reduce your supply.
Sometimes, after a growth spurt when babies no longer need the extra energy, you may experience engorgement which may lead to plugged ducts. Follow all the remedies and if this is a recurrent issue *after* a growth spurt, a cup of sage and peppermint tea 1-3 times per day may help reduce the supply created during the growth spurt. Just please be careful and don't overdo it - you don't want to reduce your supply too much! Having someone guide you may be necessary.
If your oversupply issues are not related to growth spurts, various oversupply remedies may help including balancing breastfeeding between both breasts, block feeding in some cases, or the previous recommendation of tea. Please get in touch for a Skype session or contact your local recommended breastfeeding professional to work with you through this process.
Fibrocystic Breast Treatment
Sometimes, fibrocystic breast conditions will cause plugged ducts. Fibrocystic changes are typically hormonally influenced causing fluid and tissue build up in the breasts. They may be painful and can mimic cancer symptoms though are more influenced by cycle changes and are benign. However, seeking guidance with breast changes is ideal to rule out any other possible conditions. Fibrocycstic breast conditions can occur at anytime, but symptoms tend to increase during the luteal phase of the cycle (prior to your period - when other "PMS" is experienced due to the hormone changes during this time). Treatment for fibrocystic breast include food and lifestyle chances as listed throughout this article. This tissue may block ducts causing plugged ducts, especially if they're recurrent.
Fibrocystic breasts are similar to other immune system weaknesses, arthritis-like conditions, adrenal fatigue, and liver congestion-related conditions that are caused by chronic inflammation (i.e. constant immune system responses from allergens and toxin loads). Eliminating all artificial foods, reducing processed foods including sugar, balancing whole foods and herbal therapies are wonderful ways of remedying these conditions. Aviva Romm has some great guidance as would any clinical herbalist needed beyond the scope of this article and general wellness counseling.
Some basic daily regimes for fibrocystic breasts are:
- THRIVE Herbal Smoothie Powders
- Evening Primrose Oil (topically and as a supplement)
- General liver, immune, and adrenal support herbal blend such as:
- 3 Parts Dandelion Root
- 1 Part Burdock Root
- 1 Part Ashwagandha
- Blend the above then place 3 tsp. of the blend in 3 cups of water (or 1 tsp. per cup - its just easier to make a bigger batch at once if you'll drink more than 1 cup and warming it up throughout the day as desired). Simmer very low for 10 minutes and turn off the heat steeping covered for 10 more minutes. Strain and drink 1-3 cups daily.
Burn the bras! Just kidding... sort of... reduce usage of any type of bra altogether and definitely avoid underwire or stiff supporting and compressing bras. While pregnancy can influence the "sag" of the breast, lack of muscle and ligament strength will do much more for breast health overall. By using a bra, you're telling your body to stop creating its own strength to support the breasts while at the same time compressing tissue that can increase plugged ducts. Ducts can reach all the way towards the armpit so any unbalanced compression from positions used throughout the day, resting habits, or sleeping position can increase plugged ducts.
Sugar is evil. Sweeteners of various kinds cause body imbalances and change the fat types in breastmilk. Don't get me wrong, it takes a very malnourished mom to make breastmilk that isn't high quality - but you do change the milk content by your personal food choices. Sugar, fat content, processed foods, and overall imbalances influence you more than they influence the baby, including dealing with plugged ducts.
Eat a rainbow of properly prepared vegetables and fruits. Be sure you're eating enough healthy fats and staying hydrated. Many vegetables digest easier and release more nutrients through steaming. Increase natural sources of lecithin such as: eggs, olives, low mercury sea food including seaweed, greens and other vegetables and fruits, and [sprouted] legumes.
Lecithin is known as an emulsifier. It's what makes chocolate, chocolate instead of gritty cacao in milk sugar. For this reason, some have success preventing recurring plugged ducts with lecithin supplements in addition to the previous recommendations to help prevent the fatty parts of the breastmilk from separating too much (what people refer to as "foremilk" and "hindmilk"). Lecithin supplements may also be used for fibrocystic breast conditions.
Keep in mind that soy mimics estrogen, and is in mass amounts of processed foods, so using a sunflower lecithin may be more ideal.
KellyMom.com explains the dosage of lecithin supplements for plugged ducts:
[pullquote align="left" width="400"]"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."[/pullquote]
Have you experienced plugged ducts while breastfeeding? What remedies have helped you prevent and treat plugged ducts?