Blocked breast duct - what can I expect?
August 17, 2010 2:21 PM   Subscribe

Experiences with mastitis?

I am a new mum to a gorgeous 10-day-old baby. Breastfeeding has been going really well, with lots of help and support from experts. The last of these (two days ago) warned me to look out for blocked milk ducts which could lead to mastitis, saying that I would know these by warm, red, sore patches on my breasts and I should make sure that baby drained the breast at every feed to help avoid this problem.

Sure enough, today I woke with a sore lump in my breast and it's now hot and red to boot.

I will call the doctor in the morning (NB we have a form of socialised health care here in NL which means that money is not an issue in this) but in the meantime I'm kind of wondering what to expect and what, if anything, I can do to help myself. I think I am suffering from oversupply (judging by the baby's inability to drain the breast, his occasional green poo and not infrequent tummy cramps), but have pumped after the last two feeds in order to drain the breast completely. However, I worry that this is not helping the oversupply issue much. The internets tell me that I should try taking a hot shower, but I'm still pretty hot and tired after the birth and can't really see myself staying in there long enough for it to be effective. Do you have any other tips or experiences to share?

Just a final note - if I start to feel really sick or anything I will call the night doctor service, don't worry. The pain is unpleasant, but nothing that can't wait until morning.
posted by rubbish bin night to Health & Fitness (14 answers total) 3 users marked this as a favorite
Best answer: I'd really recommend the shower route. Also make sure that you are consuming an insane amount of water. I'd even recommend the 'smart' or somehow enhanced water. Just chug chug chug.

But in the meantime, KellyMom is awesome. Here is the page on lumps/ducts.
posted by k8t at 2:28 PM on August 17, 2010

Best answer: You can sometimes manually unplug a blocked duct if you can see it (and the blockage is near the surface of the nipple). You can try massaging the lump while standing in a warm shower to break it up and get things flowing. Encourage baby to nurse on that side to try and unplug it, and pump it, although you are right that if you do have oversupply this will just make it worse, but consider it a short term fix until you clear the duct. Very worst case, some women have enrolled their partners to help clear a really stubborn plugged duct, but it depends on your partner's squeamishness at the idea :)

If you turn out to be prone to clogged ducts, taking lecithin supplements helps some women.
posted by Joh at 2:34 PM on August 17, 2010

My midwives advised me that, at the first signs of mastitis (I would start running a fever and my breasts would feel hot and very sore), to start taking the maximum dose of Tylenol every four hours. It's happened to me at least three times and every time, regular Tylenol dosing has stopped it in its tracks (I'd take it for a couple days until everything went back to normal). I suppose it helps with the inflammation.

You can also try pumping first, before the baby nurses, for a couple minutes to get the foremilk out so the baby will drink more hindmilk, which will help with the green poo/tummy cramp issues.
posted by flex at 2:37 PM on August 17, 2010

Be careful about the breast pump-- mine actually made blocked ducts worse, especially at first, by pressing on the breast in a way that prevented everything from draining evenly inside. Make sure you're not ramming it up against the boob as you use it.

Your best bet is to massage the duct very firmly (read: hard, possibly so hard that it really hurts) while removing milk. If you can get your baby to nurse while you massage, that might help; you can also get somebody else to help knead while you pump. It took my husband kneading as hard as he could (cue much screaming and cursing on my end) to clear one of mine, so don't be bashful.
posted by Bardolph at 2:41 PM on August 17, 2010

Re: the advice above about tylenol, there's been a lot of stuff recently linking early acetaminophen use to asthma and other nasty things. Not sure how much of it finds its way into your breastmilk, but just to be safe, you might want to try ibuprofen as an anti-inflammatory instead.
posted by Bardolph at 2:44 PM on August 17, 2010

Best answer: Just checking about the overactive letdown: you know to nurse from only one side each feeding, right? I had it too -- my newborn put on a pound a week as a newborn, had the green poop, all that good stuff -- and switching to one-side-at-a-time fixed that. You'll soon learn how tell which side's turn it is, but some women keep track by putting a diaper pin on the bra strap of the side they've just finished with.

Don't pump to drain the breast, as that just makes your boobs think that OH MY GOD THE BABY IS HUGE IT NEEDS MORE MILK MORE NOW NOW NOW which is the opposite of what you want.

I had mastitis once or twice and ended up taking antibiotics for it, which took care of the situation. With luck you won't have to, but it's not a big deal if you do.
posted by The corpse in the library at 2:59 PM on August 17, 2010

Disclaimer: Not only am I not a doctor, I'm a male non-doctor. But I teach natural childbirth classes with my wife, so hopefully I get to answer anyway. Here are some of my memories of how my wife dealt with mastitis.

Moist heat did help, and if the shower wasn't workable she would try a hot, wet washcloth.

I think you're aware of the supply/demand feedback loop in breastfeeding, but just in case you're not, pumping completely out after feeding will not tell your body to reduce supply. Hand-expressing is more directable, and doesn't mess with supply as much. Not to say you shouldn't pump - your call - but maybe experiment to see what works best for you.

Another way she used to handle the emptying issue is to alternate sides - left breast this feeding, right breast next time. That way, each breast was more likely to be fully emptied.

Pay attention to what you're eating - it may be that some foods you're eating are causing the baby's cramping/gas pain. Gastric upset may play havoc with his appetite.

Finally, position matters. The baby's jaw is where the greatest pressure is exerted on your breast. So she would rotate the baby so that the jaw was pointed towards the area showing the clogged duct, and feed like that. This may require setting the baby down and leaning over him to feed, but it really helped her on several occasions.

Good luck and don't give up, you can do it!
posted by richyoung at 3:01 PM on August 17, 2010

Moist heat did help me loosen things up, but a bag of frozen peas felt wonderful at times. (Too much heat was really uncomfortable for me.)
Ditto "don't overpump", in fact I would only express the remaining milk rather than pump it out.
When I had plugged ducts I used what I like to call the "around the clock" method: Lay baby on the bed and lean over him to nurse, then move around his body like the hands of a clock. That will help to empty the ducts from different "angles", if you will.
Hope you get some relief soon and congrats on your new baby!
posted by Ochre,Hugh at 3:50 PM on August 17, 2010

Nthing the alternating which breast is first (put a rubber band on the wrist you start with to help remember), and aiming the babies chin towards blocked duct -- made all the difference for me.
posted by MeiraV at 5:23 PM on August 17, 2010

Cabbage leaves.
posted by Brody's chum at 5:39 PM on August 17, 2010

Moist heat helped with the swelling and pain for me, but if you start running a fever please do get to a doctor. I got a tip somewhere to wet a newborn-size disposable diaper with hot (or very very warm) water and use that instead of a washcloth--I just stuck one in my nursing bra. It held the heat longer than a washcloth.

If it's a plugged duct and not mastitis (in my experience, a PAINFUL lump with redness and a single pinpoint of *extreme* pain), massaging it in a hot shower really did work for me...took awhile but was worth it!

And CONGRATULATIONS on your new little one!
posted by devotion+doubt at 6:01 PM on August 17, 2010

Congratulations on the baby!!

I would put a warm washcloth under my tank top, take some Tylenol, and go to bed. This helped me a ton, but obviously everyone is different. My midwife said not to worry about chin position, as milk ducts are not as linear to the nipple as they were once imagined to be.
posted by Nickel Pickle at 7:04 PM on August 17, 2010

Congrats on your new baby! Hot shower stream on the breast, position the baby's jaw so its chin is pointing to the blocked duct, and Tylenol worked for me. Oh and massaging the breast a little from radius to nipple, especially from the armpit out, for a bit while nursing is really good at keeping this at bay.
posted by mdiskin at 10:12 PM on August 17, 2010

Response by poster: All fabulous answers, thank you! The feedback convinced me to take a shower, tired as I was, and I massaged the lump with a well-soaped wide-toothed comb as per the advice on The next morning, the lump was gone - just like magic! I have used this method several times since, it works like a charm.
posted by rubbish bin night at 7:42 AM on September 18, 2010

« Older What should I ask before buying this apartment?   |   SKUH, RUDE, SCREWED Newer »
This thread is closed to new comments.