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It happens to even the most cautious of us. Whether its at the beginning of your breastfeeding journey or when you start to wean at some point you are going to experience a breast clog, also referred to as a plugged duct. Most women experience their first one between 8 to 12 weeks postpartum (if they’ve continued trying to breastfeed that long). It’s around this time when babies tend to start sleeping longer stretches and Mamas breast milk supply tends to regulate. Interestingly, it’s also around this time when many women give up on breastfeeding. Traditionally, women had been advised to do things like, apply heat, use a hand pump in a hot shower, and massage the “clog” out but a recent study is contradicting that advice. Thanks to this study a few months ago new guidelines were issued for treating clogged ducts which consists of an anti-inflammatory protocol. You can find the whole report and study here.
From week 8 postpartum to week 11 postpartum I have dealt with 3 bouts of plugged ducts and terrible breast pain. For the first two I followed the old advice: warm compress, pump it out, massage, Hakaa and epsom salt, warm shower…warm, warm, warm. The idea behind most of this advice was that your breast milk is fatty and it’s stuck so you have to melt it out. Well I was left with several days of pain and in the second round a bruised boob. So this last incident I decided to go with the new guidelines and see what happened.
The new guidelines consist of reducing inflammation. The study basically concluded that what we call clogs is actually, inflammation of the duct. This inflammation if left untreated can turn into inflammatory mastitis, which is actually what most women are suffering from when they get diagnosed with mastitis — not bacterial mastitis which is what the antibiotics they are receiving would actually treat. So in order to combat the inflammation you should ice, use anti-inflammatory medication like ibuprofen, rest, not pump extra, and avoid harshly manipulating your breasts to “get out” the clog. Again in most cases there’s really nothing to get out, you just have to wait for the inflammation to go down so that milk can continue to flow.
This last round of clogs I spent all day doing the old things — I even took an epsom salt bath but nothing was progressing and it felt like my boob was hard as a rock and so right before my 6th pump of the day, I gave in. I decided I would only do the anti-inflammatory things. Within 18 hours my boob was all better.
Now I get it if you are nervous to try these new guidelines. If you’re like me you had probably heard that ice is something you use to slow down or stop your supply but let me encourage you to find reflief with these methods. If you keep your icing to 10 mins or less at a time you will not lose supply but it will help the inflammation go down and therefore allow the milk to continue to flow. It’s recommended to do the icing after you pump. If I am within 30 minutes of my pump time I hold off on icing until after I have pumped — to be on the safe side.
So what exactly are the new guidelines:
- Do not do extra pump sessions – stick to your typical pump schedule.
- Do not use warm compresses – use ice packs for intervals of no more than 10 minutes at a time.
- Take an anti-inflammatory medication like ibuprofen or acetametiphen.
- Do not wear tight restrictive garments, though a light support, cotton bra can provide some relief during the day and protect your breast tissue from the weight of carrying the extra milk.
- Rest (I know this one can be hard with a new baby).
- Resist the temptation to “rub the clog out” – light massage or breast gymnastics is okay.
- Ultrasound therapy if no improvement after a couple of days of the above treatment.
I did this with my last bunch of clogs that I had in my right breast after exhausting all the old remedies. Within 12 hours half the breast was soft again and by the next day everything had gone back to normal but the best part was I did not have any residual bruising or soreness like I had gotten the previous times.
Breastfeeding is hard whether you nurse or you pump or do a combination of both. But I want you Mamas out there to know that if you can get over the hump at the tail end of the 4th trimester that you can provide for your baby breast milk pretty successfully and without a ton of discomfort or antibiotics.
So next time you feel a clog coming on break out your Lansinoh Gel packs from the freezer and slap those on for a few minutes (set a timer) pop a couple Advil and call me in the morning. You can do this Mama!
Keep flowing,
