Clogged Ducts are The Enemy...

… here's how I knock out my nemesis,
GI Jane style.

By Jen Humberson, MD

I am writing this as a mother of two boys whom I nursed for one year each. I’m also a pediatrician, but I’m writing this as a mom. Some of my thoughts below might not be ones I’d share gracefully in the office.

So in two years of nursing I probably had clogged ducts 15 times. I have no idea if this is average, but I certainly know friends who’ve had 5 or so. I got to where I could tell when one was starting and begin my routine ASAP to keep it from getting worse. One thing I DID know from my medical experience: clogged ducts can lead to mastitis, and I do not ever want to have mastitis. I’ve seen lots of people in lots of pain, but none of it compares to the women I’ve seen with untreated mastitis.

How do you know if you have a clogged duct? Well read good sources of information. My signs? A vague feeling like one section (think pie slice) of one breast wasn’t emptied at the end of a feeding, and the same area feeling more so a feeding or two or three later. Or feeling a lumpy firm area (again, sometimes like a pie slice, sometimes like a rock) in my breast that became increasingly tender. Sometimes the area was starting to pink up, and sometimes the veins in that area would become a little bluer, a little more noticeable. Only once did I have the “little white spot on the end of the nipple” that some resources describe.

What to do? Simple. Get the area unclogged. How to do that? Not always easy. I would do a few things, alternating between them, until I got it completely unclogged (when the whole breast is soft, there’s little to no more milk coming, and the pain is pretty much gone about 12 hours later, save for some bruising if you had to cause some… read on.)

1.  Nurse, nurse, nurse. Let your baby drink as much as s/he wants as often as s/he wants while you’re trying to get unclogged. While nursing, as much as possible, massage (with your hand) the firm and tender part of your breast. How hard? Not as hard as you can take it- Harder than that. This is the not-fun part, but it is ABSOLUTELY worth it when you get it unclogged and you avoid further problems. Frankly, nursing alone only solved my clogged ducts once or twice

2.  Take two to four ibuprofen, ie Motrin or Advil (400mg to 800mg) with your doctor’s okay. It will make the next part more bearable.

3.  Pump, pump, pump. Find a good t.v. show, brew some tea, and pump the affected breast (you can pump both if you want to) and, with your hand, massage the tender firm area like it’s a bear about to mawl your baby. You can start gentle, but you will likely have to use a good bit of pressure (read: a heck of a lot) to get the milk to get through. Also increase the strength of the pump to the highest you can stand without harming your nipples. You will know when it really starts releasing as there is a flood of more milk (sometimes yellowish or reddish- don’t be alarmed) and the area slowly turns softer. KEEP GOING until the whole breast feels soft and there’s pretty much no more milk coming. This method worked for about 75% of my clogged ducts. The worst ones took 2 or 3 pumping sessions, usually about 30 minutes long each (one time was 45 minutes but finally worked).

4.  Shower Power. Basically, you use your hands to massage and somewhat manually pump the affected breast. I used this method more after I realized how well it worked with my second child. After trying the first two, if the area is still partially or completely clogged, turn on a steamy shower, as warm as you can take it, and step in and massage the firm tender area more firmly than you can take and use the fingers of your other hand to express some milk.

In my experience, it often took 5 to 15 minutes, and occasionally two showers, but then the area unclogged and I was able to manually express the milk until the whole breast was soft.

Re-clogging: The same area will be sore and slightly swollen for a day or two, and is also at risk of re-clogging. So try to make sure your breasts get completely emptied with every feeding or pumping over the next few days.

Be Proactive: The sooner you start trying to clear a clogged duct, the easier it will be. The longer you wait, the harder it will be (and the more you’ll regret waiting- you might get to the point where you can’t tolerate even the slightest touch to the area).

If your pain is severe, you get a fever, or your baby isn’t eating well or seems ill, call your doctor. I was able to treat all mine at home, but I was aggressive and I knew the signs of when I should call my doctor.

This post might highlight some of the rougher parts of breastfeeding, but the VAST majority of my nursing times were some of the most intimate, cozy, beautiful times I’ve had with my children.

I hope this helps if you ever have clogged ducts. Please write any other things that worked for your clogged ducts in the comments!

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Thank you for your article and your website! I also have also had issues with clogged ducts and oversupply off and on for the 4 months I've been breastfeeding. On my second day back to work and pumping, i had such a bad clogged duct i ended up with mastitis and a fever of 104! My lactation consultant recommended more frequent pumping and taking lecithin supplements three times a day while at work and alternating hot and cold compresses at home (hot before you breastfeed and cold after). However, the more frequent pumping while at work made my oversupply issues worse at night and on the weekends when i was only breastfeeding. Through trial and error (and a lactation consultant) I found a balance that worked for me. So my advice is listen to your body and be proactive if you think you're getting a clogged duct because mastitis is horrible!! And find an awesome lactation consultant!

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