Congratulations! You have likely just delivered or are getting ready to deliver your precious bundle of joy and you are faced with starting your breastfeeding journey. You have begun to notice your breasts are growing to a possible size that you didn't think could happen. The baby is probably feeding around the clock or "cluster feeding", as you will hear, you and your partner haven’t slept more than two hours, and you assume breastfeeding is going well and a routine is established. Then, boom! You wake to notice a tender lump in your breast. You begin to question, where did it come from? Is this normal? How should I treat it? I can reassure you that you are not alone. 

Let me begin by explaining what a plugged or clogged duct is. It is a collection of congested capillaries, very full alveoli ( these are the cells that produce and store milk), tissue swelling and inflammation. An overproduction of breast milk, known as ‘hyperlactation’, can lead to the inflammation, causing a narrowing of the milk ducts, (previously called a ‘plugged duct’), and could progress to inflammatory mastitis. Clogged ducts are most commonly present in one breast, but can occasionally occur in both. The good news is that most clogged ducts resolve on their own in a few days with conservative treatments at home. Symptoms can include a red, swollen, and tender lump, a decrease in milk supply, feeling of fullness or engorgement but these are only a few of the noted symptoms we see in the clinic. 

Please remember you are not alone in this and here at Feed Well, we are here to help and support you. Since clogged ducts are caused by inflammation, they can happen even when you are meticulous about your nursing and pumping schedule. When treating a clogged duct at home remember the acronym B.A.I.T. from Dr. Katrina Mitchell.

• B-breast rest- (NO MASSAGE, do not overfeed or over pump, and downregulate production if needed but keep your normal feeding schedule. Squeezing or massaging the breasts frequently with excessive force can cause worsening tissue swelling, collapse of ducts, or possible injury to the capillaries. If you overfeed or over pump this could result in stimulating additional excessive milk production.
• A - Advil. Dr. Mitchell suggests taking 800 mg every 8 hours for 48 hours to help alleviate the inflammation in the breast and surrounding tissues.
• I- Ice. ICE< ICE<ICE baby! It is recommended to ice 10 minutes every 30 minutes or as needed for pain, discomfort and swelling.
• T -Tylenol. Dr Mitchell suggests taking 1000 mg every 8 hours for 48 hours for pain relief.

Talk to your doctor before taking any medication. 

We also suggest treatment measures like lymphatic drainage. This technique is done by a very light brushing touch or circular motion lifting the skin off of the underlying lymphatics and allowing them to move and drain more easily to the lymph nodes in the underarm area. When home treatments do not seem to help or resolve the clogged duct we can suggest you seek a medical evaluation for therapeutic ultrasound. A prolonged clogged duct can lead to mastitis… I will discuss mastitis in my next blog. 

It can be helpful to see a lactation consultant before your deliver and we'd love to help! If you need a lactation consultant in Baltimore or the surrounding areas, we're here for you! You can learn more here.