Birth Health Life


Saturday, 8 August 2015

Common Breastfeeding challenges: Blocked milk ducts

Lecithin in my local health food shop

If milk gets stuck in the breast because you missed a feed or pressure on part of the breast trapped the milk, it can block one of the tiny milk ducts, and cause a painful lump.

Milk that thickens inside the tiny ducts in the breast can block that duct and cause a backlog of milk, which in turn sets off the inflammatory response of the body, if you don't get that blockage cleared pronto.

The plug of cells and milk components within the duct causes a localised soreness, swelling and pain.  These plugs can be reabsorbed by the body, or can be released into the milk.  The plug may be greenish or brown in colour, as well as thick and stringy..these are harmless and quite common, although your baby might not like the taste.  Get on top of the blocked duct situation as quickly as you can escalate to a larger area of blockage or to mastitis.

The inflammatory response makes the breast where the duct is blocked get hard, red and hot, and incredibly painful to massage, but that is just what you have to do, as well as applying warm compresses whilst feeding/expressing, and I would recommend cooler compresses if that feels right in between feeding.  Remember to also avoid bras, and anything constricting any area of the breast, feed and express to keep the milk moving and keep the breast soft.  Nurse your baby from above, looming over him on the bed to get gravity to assist with draining all the ducts.

If you don't get on top of a blocked duct, mastitis can follow on.  Basically, the body is responding to that blockage with an inflammatory reaction, and it can feel just like 'flu.  It comes in and hits you like a train, but fear not, it is possible to manage mastitis conservatively if no infection is present, and it can go as quickly as it arrived.  You will be surprised at how bad it can make you feel though, with shivers, and hot and cold.

Treat mastitis by getting that duct unplugged, see above, (massage, hot and cold, keep the milk moving) and use an anti inflammatory like ibuprofen to bring down the inflammation and make you feel better. Lots of TLC, rest, food, fluids and feeding baby.  Getting worse, or no better within 24 hours?  See your  doctor for antibiotics to head off infection.

Check out:
  •  your bra, (underwires, padding, wrong size) 
  • clothes (bunched up shirt under your arm whilst you feed...areas that feel tight)
  •  baby slings...hand bag straps compressing the ducts.
  •  your sleeping position...if you sleep on your side, are you squashing your breast?
  •  holding your baby in the same position for prolonged periods of time
  • are you holding your breast whilst feeding? 

Do you hold your breast during feeds? Some mums do, some feel they can't get latched unless they do. It might be an idea to go along to your local drop-in clinic and see the breastfeeding peer supporters, infant feeding adviser, breastfeeding counsellor (try the La Leche League for a local referral to knowledgeable free volunteer support) or IBCLC .  These women will be trained to help you latch your baby in a way that brings your baby to you, rather than breast to baby.  There are other techniques to making the breast and nipple easier to access too, such as rolling up a muslin into a sausage and putting it under your breast to bring the nipple into view or into a position where you can more easily bring your baby to you. All this said, there's nothing wrong with holding your breast...unless you're causing plugged ducts.  Holding your breast during latching can mean that you are loathe to disturb your baby once latched, and then have to maintain the hold all through the feed, which can be uncomfortable...and cause blocked ducts.

 Things that can help:

  • Make sure you feed on demand, and don't make your baby wait for a feed.
  • Avoid missing a feed, or pump or express to remove the milk
  • Pump or express if your baby isn't removing the milk adequately.
  • Make sure you are getting enough fluids and adequate rest where possible.
  • Massage in the direction of the plug, towards your nipple.  Do this whilst feeding, and in a warm shower.
  • Hot flannels over the area will cause the tissue in the breast to expand gently and enable the plug to move along the duct
  • change feeding positions so that your baby is draining different areas of the breast.  
  • Feed with the baby's chin pointing towards the blocked duct.  Try laying your baby on your bed and feeding her from above, looming over her to dangle your breast into her mouth.
  • Feed on the side with the plugged duct first. Babies have a stronger suck early on in the feeding, and you can take advantage of this to help shift the blockage.
  • Lecithin and reducing saturated fats in the diet...only if the problem keeps coming back.  You'll find it in the local health food  shop, and also in the pharmacy.  Lecithin is found in egg yolk, and is what helps to smooth out mayonnaise, as it breaks down fat particles, and stops them from clumping together.

Blocked ducts can be related to blebs.  These are blocked nipple pores, and where the skin closes over a pore it is called a milk blister.  What came first, the bleb or the blocked duct?  Some specialists believe that blocked ducts cause blebs, some that blebs cause blocked ducts.  More about blebs here.

These phone lines are available if you need to speak to a breastfeeding counsellor (UK)

ABM 0300 330 5453
NBFH 0300 100 0212
NCT  0300 3300 771
LLL 0845 120 2918

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