March 7, 2012 4:26 PM   Subscribe

RecurrentPluggedMilkDuctFilter: Help me not lose my sanity and continue feeding my child.

I am 13 weeks postpartum and have been almost exclusively pumping since the beginning.

At around 6 weeks I have started getting recurrent plugged ducts. I am not a crazy over producer - I make about 40 ounces/day, my daughter eats 30. I have a good pumping schedule (roughly 7-8 pumps a day, 2-3 hours apart), I have a fast let-down so my breasts empty very quickly, so pumping just works. Since doing research on plugged ducts, I have eliminated bras, sleep only on my back, take hot showers where I massage my udders into oblivion, take lecithin capsules, maintain a balanced diet, drink plenty of water, work out but don't do weights, and generally have thrown myself into a plugged-duct-prevention campaign.

All of this to little or no avail. I still get them every day/every other day. It has gotten so stressful and so painful I am seriously considering to wean my daughter early (now sounds great!) just so I can regain my sanity and enjoy spending time with my baby instead of being stressed about getting another pluggie. I am even hesitant about holding her close, because applying any pressure on the breast results in a plug. No joke.

So, great minds of metafilter, do you have any thoughts on this? I know formula is valid option, which I am contemplating, but since I am producing enough, it just seems like such a waste.

Thank you all in advance.

Respectfully yours,
posted by mooselini to Health & Fitness (21 answers total)
Is there any reason you're expressing and not breastfeeding? I only ask because in my experience of plugged ducts, the easiest way to clear and prevent it from occurring is by breastfeeding - the baby is much more efficient and effective than a machine.
posted by Jubey at 4:32 PM on March 7, 2012 [3 favorites]

A friend of mine had this problem and had ultrasound treatments which she says helped a bit, so it was only like once a week.

Also, just because you don't mention it: can you nurse directly instead of pumping? When I got plugged ducts, nursing my baby helped way more than pumping did.
posted by rabbitrabbit at 4:33 PM on March 7, 2012 [1 favorite]

I assume you've read kellymom and have consulted a lactation pro? My hospital allows free calls to the lactation consultants (just called them today as a matter of fact). Maybe yours does too?
posted by semacd at 4:35 PM on March 7, 2012

I had a (much smaller) problem with plugged ducts early on while breastfeeding, and fortunately lecithin & sleeping only on my back helped prevent them for me. But I have read on message boards that cough syrup with guaifenesin can help a lot - apparently it loosens all fluids in your body, not just mucus.

(Note that I personally haven't tried this and therefore can't vouch for its effectiveness. But it sounds like you're willing to try anything at this point.)
posted by barney_sap at 5:10 PM on March 7, 2012

It sounds like you are already doing everything I've heard of to prevent plugged ducts. Although if you're not night pumping an extra session might help. It might be worth it to try to get baby back on the breast one last time before giving up. I pumped exclusively for four months before my little guy and I got the hang of breastfeeding. If it doesn't work, I say build up your freezer stash and wean with a clear conscience. EPing is no picnic as if life with a newborn wasn't hard enough already.
posted by bq at 6:04 PM on March 7, 2012 [2 favorites]

Have you seen a lactation consultant?

This is both for the plugged ducts and to see about your child getting back on the breast.
posted by k8t at 6:27 PM on March 7, 2012

Oh, and I recall there was an EP - exclusively pumping LiveJournal group back in the day.
posted by k8t at 6:27 PM on March 7, 2012

Can you try latching your baby on to nurse one or twice a day? It will really help with the pluged ducts. Specifically if the baby's chin points towards the plug (increased suction). Pumping is great but a baby's latch is significantly more effective. If latching is a problem memail me and I would be happy to give any help I can. I am a peer breastfeeding suport person for my local public health unit.
posted by saradarlin at 6:48 PM on March 7, 2012 [5 favorites]

Please ignore if you are not breastfeeding at all, but the advice I remember from the bfeeding days was to point the baby's chin at the plugged duct. So if, for example, the plugged duct is on the top of your breast, you basically feed the baby upside-down. You don't hold her upside down, of course, you lie her on her back and basically kneel over her so that the chin points the right way. If you feel like mooing now, wait 'til you are on all fours. Note: this isn't something I have tried, but I did hear it offered as advice often.
posted by looli at 6:54 PM on March 7, 2012 [1 favorite]

Best answer: I don't know a lot about exclusive pumping, but it sounds to me like you do have an oversupply (overactive letdown plus stashing 10 oz a day) and in the long run what you should do is pump less and reduce your supply. Pumping less may cause clogs but hopefully only in the short term.
posted by thirteenkiller at 7:43 PM on March 7, 2012 [2 favorites]

Best answer: As a mom who pumped for 10 months because my kid wouldn't latch for love or money, I am going to guess that the advice your put your baby to breast is not relevant or helpful because if you could, you would have already tried that.

I would suggest slowly dialing back until you're slightly underproducing. I know the thought of courting disaster by reining in is scary, but you're overproducing by quite a bit and basically the less you make the less pluggy you'll get.

Breastmilk is great and all, but if you're in a state where you're afraid to hold your baby for fear of courting disaster in your tits, I hearby give you permission (if you need it) to prioritize holdi g your baby over making her food yourself. There are good substitutes for breast milk but nothing quite compares to keeping your baby close.

In any event, my sympathies, sister. EPing is a real bitch. You are a tough and terrific mama for making it this far!
posted by Sublimity at 7:47 PM on March 7, 2012 [6 favorites]

I had the same issue for about two months. Yes to the above posters who suggested lecithin and the chin pointing thing. Also, if it is just one side then start with that breast first because the baby will be sucking harder at the beginning.

It can get better I promise. For some reason I had the same thing during month six and seven, but now at eight I'm not having any problems.
posted by aetg at 8:34 PM on March 7, 2012

Hot hot showers can really help along with massage. The only thing that truly worked for ducts for me was while pumping or nursing, to locate the blocked plug and press hard on it. It was painful, like stabbing a bruise, but after ten minutes of tears, the duct would start to loosen and release. I also had lots of those sticky strands at the nipple, where it's just clogged goopy milk, and very very gently warming them with a hot wet cloth, then pulling them clear with clean hands seemed to help because the milk could then flow out.

Really nthing talking to a lactation consultant and trying some more routes but to add: formula isn't as great, but it's pretty good. And there's nothing to stop you from mixing the two together, so if your milk supply decreases with these methods and you have to supplement, better you be able to look at your baby and be happy than cringing in pain. I have an under-supply, and seeing how happy she was on formula/breastmilk has made nursing her far more of a pleasure (I nurse all night, and a couple of times in the day inbetween bottles).
posted by viggorlijah at 9:03 PM on March 7, 2012 [1 favorite]

I was going to suggest lecithin, but see its already on your list, can you increase the dosage? If you haven't found them already, I strongly suggest the Yahoo group PumpMoms. Lots of EPers on there, and lots of good advice. I learned a lot, and also found it very motivational having a community that understood my trials and tribulations.

I agree that babies are often better than pumps at clearing blocked ducts, but I know that nursing is not always possible, so I wanted to say that you are doing an awesome job EPing, because it is incredibly hard work.
posted by Joh at 9:24 PM on March 7, 2012 [1 favorite]

Best answer: Pumping and nursing less solved this for me. I now have a bit of an undersupply and supplement in the evenings when my supply is lowest, but no more plugs.

I'm sorry; I know it's hard. You're doing great.
posted by the young rope-rider at 9:45 PM on March 7, 2012

Oh, and also? My baby is not actually as efficient as a pump. It's probably true most of the time, but some babies are really inefficient eaters.
posted by the young rope-rider at 9:46 PM on March 7, 2012

Dangle your boobs. Seriously. Lay face down on the bed, boobs off the side, and pump like that. Horribly awkward, but pumping and feeding with gravity assistance has been the only way I've cleared ducts.

I refer to it as the cow position.
posted by geek anachronism at 2:48 AM on March 8, 2012

I have to contradict a lot of people here and actually argue with producing /more/ rather than less.

For reference: I pumped, did not nurse (baby couldn't latch) and also had this incredible production issue. When I was trying to pump only what the baby drank, plus a little for emergencies, I also had a lot of problems with plugged ducts, to the point that I went into the doctor to ask if I was doing something wrong.

I can't recall if this was on his advice or someone else's, but I actually started expressing more. It may seem like a waste, but did you know that you can freeze breastmilk? It is totally fine and safe, and will allow you a lot more freedoms. I built up an entire freezer's worth by the time I was done nursing, which let me wean my child, but still allow a bit of breast milk throughout the solid food process.

Also, I believe there are places you can donate breast milk-or at least there were several years ago, and I can't imagine that they've gotten less prevalent. Breast milk is like solid gold for babies. There will never be a time when you're like, "oh man, what am I going to do with this useless extra frozen breast milk."

Also, when you're taking showers, you might want to kind of check your ducts at the same time-don't squeeze, but kind of trace the lines of the biggest ones and see if anything feels thick. If it does, when you are first starting to express for the day, try to hold your breast from that area, to produce a bit more pressure.

Hope this helps, feel free to memail if you have any other questions.
posted by corb at 6:46 AM on March 8, 2012

Are you using the correct size flanges? If you haven't already tried a size up and a size down from the size you are using now, that might make a difference. It helped when I pumped exclusively for three months. I went up a size and my problems vanished.
posted by FergieBelle at 9:19 AM on March 8, 2012 [1 favorite]

Response by poster: Thanks everyone for helpful suggestions!

What I ended up doing was renting a hospital grade pump and (carefully) dropped pumps to lower the amount of milk I was producing. I am now down to 3-4 pumps a day, producing about 2 oz over what my daughter is eating and... no more clogged ducts! It is such a relief and pleasure to be able to spend time with my daughter while at the same time nourishing her. Thank you all once more!
posted by mooselini at 3:36 PM on April 11, 2012

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