Persistent Clogged Duct

[rolenta]

My baby was born on April 2nd, and for the most part, breastfeeding has been fine. No major latch issues and only a slight oversupply issue, but not huge. Which is interesting, because I had major, long-lasting oversupply the other two times.

Anyway, I had some clogged ducts the first week, but I dealt with it with hot compress, showers, some pumping, and so on, but it's flared up again in the right breast and I just can't get rid of it. It's been going on for about a week. Over the last week, the ducts have gotten red, hot, and hard, and I've been able to calm it down long enough to stave off infection, but it never totally go away. I've been alternating between cold cabbage leaves when I'm up and walking around and a heating pad when I'm laying down, nursing on demand (and even encouraging extra nursing), and pumping, and of course, hot showers and gently massaging the hard lumps toward the nipple. I've tried nursing on all fours, bending over and jiggling, and I nurse in all sorts of different positions.

I get some soreness in the left breast from time to time, but if it gets at all lumpy like in the right one, I either nurse, or pump just enough to relieve the hardness immediately and I've been able to keep it from getting painful.

So, what am I supposed to do?! My right breast feels bruised from the inside out. I haven't gotten a fever or sick, and I think I've kept it from getting infected, but it hurts all the time, and I get sharp stinging in that area all the time. Also, I have really painful let downs. They sting like crazy.

[CoBabyMaker]

I found taking a lecithin supplement to be VERY effective for clogged ducts. It's recommended to take one capsule 3-4 times a day. After the duct clears you can cut back but if it keeps happening, keep taking it.
Hope that helps!

[ewe+lamb]

If this keeps going then you may have to consider stripping the breast - which means emptying the breasts completely of milk, give the pp suggestion a go and then you may have to talk to an LC about this or look up how to strip on the internet - good luck - plugged ducts are horrible, other thing before I click on 'post' is are you getting enough rest - plugged ducts and the like are related to not resting enough and letting yourself get run down - could this be the case - can you take some time in bed and let the house go to rack and ruin for a week - lol!

Other thing the sharp stinging pain - is it like a deep breast pain of thrush? just thought I would throw that out there just in case! keep posting if you need more help or support.

[rolenta]

I didn't know that that was called stripping the breast, but I've tried to empty that breast entirely by letting DD nurse and then pumping till nothing comes out anymore. Then, the breast is entirely empty except for the lump, which doesn't go away.

I've never had thrush, but I only have the stinging in that area and pain during letdown (forceful letdown).

I went to the doctor and he has prescribed antibiotics and said that if that doesn't work, they will do an ultrasound to see what's going on.

I also got some lecithin. We'll see how it goes!

ETA: as for resting, over the weekend, DH took the older kids and I nurse-napped all day with babe for two days in addition to all the other measures, but the lump didn't go away.

I'm teaching myself not to worry too much about every little thing. You know, strike a balance and not do myself in over the little stuff. House is a mess, but that's okay.

[tinybutterfly]

Maybe you need a different bra. Even if it was fine before to wear, maybe this time it's causing issues? Or could you go braless for several days and see if that helps?

[rolenta]

I actually have been going braless. I've just been wearing a tank top under my shirt to keep my breast pads in place.

[goodygumdrops]

Plugged ducts can be really frustrating. It sound like your doing a lot of things to help but I just want to run through a few things. Cabbage leaves have no medicinal affect on mastitis or plugged ducts. The only purpose they serve is to provide a cooling compress to reduce swelling. However, with plugged ducts, I would suggest warm showers, hot water bottles, and even heating pads.

Another suggestion would be to breastfeed from the position of kneeling over your infant and placing them on a bed or floor beneath you so your breasts are hanging pendulous and straight down. Sometimes gravity can help loosen the plugged ducts.

When your massaging breast, try starting closer to the areola and then work back towards your armpit. It's almost like combing tangled hair...you dont want to start at the top because it will hurt....

Finally, I have never read any evidence about stripping a breast. Breast always produce milk continuously so I cant imagine that this is evidence based advice.

Bras and baby slings can both cause plugged ducts. I used to get them from the moby wrap...which I loved

Congrads!!

[ewe+lamb]

OP - Found this on Kellymom for you regarding the medicinal purposes of cabbage leaves
http://www.kellymom.com/bf/concerns/...t.html#cabbage
the other information on this page may help you as well, this one is quite interesting too
http://www.lactationconsultant.info/cabbagecure.html

regarding stripping the breast - on reading the information that I have, it mentions breast stripping in extreme cases and that it be done by a professional after the mother has nursed her baby, and then it can be continued by the mother at home always after feedings, it may not be necessary and I mentioned it because the plugged ducts are not draining, draining the breast is a must - so we need to give all the options that we know for the mother to make an informed decision.

This is also a nice article from the LLL website which may help you too - I think it's a great article and the sock and rice thing I had forgotten about but works just as well as wet hot compresses.
http://www.llli.org/NB/NBMarApr06p68.html
and this too as a plan
http://www.llli.org/NB/NBMarApr07p76.html

Here's more about massage/plugged ducts and mastitis from other sites too: http://www.askdrsears.com/html/2/T022100.asp
http://drjaygordon.com/breastfeeding/mastitis.html
http://www.pregnancy.org/article/blo...s-and-mastitis - this one is written by Jack Newman and is very well worth the read - he mentions breast compression as well and you can find an example of the on www.drjacknewman.com and click on videos - but only if your not in real pain!

Find out what works best for you there are always options and we need to see whats best for us.

Here's another site with regards to the positioning of the baby www.biologicalnurturing.com run by Susan Colson LLL Leader and IBCLC - positioning at the breast is very important in times like these, if all else fails have the baby's mouth checked to make sure that there isn't a problem.

Keep posting and let us know how you are getting on.

[rolenta]

Thought I'd update. The lump never went away, even with antibiotics. An ultrasound showed an abscess, so I had to have that drained. That was two days ago, so now I'm healing from that.

I never did get sick or anything, though, so that's really odd. I never got a fever or anything that you would expect from someone with mastitis and an abscess.

I took lecithin like crazy, and that didn't make a difference, either. I just hope that after the incision heals, that that's the end of it.

[ewe+lamb]

I'm so sorry that this turned out to be an abbess - hope that you are taking care of yourself and that you heal quickly - healing vibes for you

[rolenta]

Thought I'd update. It's not going well. I had to go back and have the abscess drained again with a syringe, I was on my third round of antibiotics, and it's still infected.

A huge blister formed and it's so so so sore. Today I was back in the ER and I'm getting IV antibiotics. Every 8 hours I have to go back for another IV for the next 48 hours. Then they do another ultrasound and decide if they want to surgically drain it again or what.

Ugh.

[ewe+lamb]

I am SO sorry that this is not healing up for you - it must be so frustrating and I admire your dedication and determination, if you have the time and energy you could maybe go to some LLL meetings just to boost your confidence and get some support whilst you're going through hell and back - huge s but not too hard that they hurt - again I really hope that you recover from this and can continue with your breastfeeding journey. Take care