Advanced Care for Breastfeeding Mothers with Plugged Milk Ducts and Mastitis

The specific cause of plugged ducts is not known, but incomplete drainage of the breast caused by skipped feedings, a constricting bra, poor nutrition and stress may lead to plugged ducts.

Symptoms of a Plugged Duct

• Symptoms usually develop gradually.
• A specific area of one breast may be tender to the touch.
• The affected area may feel warm.
• You may notice redness in an area or feel a lump in your breast which may become smaller after feeding.
• If the plugged duct is in the nipple, you may notice a white spot on the tip of your nipple.
• Plugged nipple pores may result in nipple pain or pressure.
• Generally you feel well except for the breast or nipple tenderness.

To Prevent Plugged Ducts

• Avoid wearing constricting clothing such as an underwire bra or tight straps on a baby carrier.
• Avoid skipping feedings or delaying feedings.
• Be sure your baby drains the breasts at feedings, particularly if a nipple shield is being used.
• Gently massage your breast during feedings to ensure your breast is drained well. Hand express or pump after feeding if necessary to drain the breast.

Treatment for Plugged Ducts

• Prior to feeding, apply a warm, moist compress to the affected area or soak the breast by leaning into a basin of warm water or take a warm shower.
• Breastfeed often, at least 8-16 times in 24 hours.
• Begin feeding on the breast that has the plugged duct.
• For at least one feeding, position your baby with his/her nose pointing toward the plugged duct.
• Try different feeding positions to find the most effective positions for draining the breast.
• While nursing, gently, but firmly massage forward from the affected area of your breast while your baby is nursing.
• Try massaging the breast in a warm shower or bath.
• Use an electric vibrator on a low setting on the affected breast. Do not use in the shower or near water.
• Apply cold compresses to your breast after feedings for 15-20 minutes to reduce swelling and inflammation.
• If you feel like your baby did not drain your breast, manually express or use a breast pump to drain your breast.
• Talk with your healthcare provider about possible use of lecithin which has been found to prevent plugged ducts.

Mastitis

Mastitis is a breast infection. Affected breast may be red, hot, painful, and swollen. You may also have flu-like symptoms, such as aching joints and muscles, fatigue, severe headache, nausea, vomiting, fever and chills. The onset is usually sudden and can result from:

• Stress or fatigue.
• Cracked and damaged nipples.
• Plugged ducts.
• Abundant milk supply.
• Engorgement.
• Rapid weaning.

Treatment for Mastitis

• Contact your healthcare provider immediately to determine whether antibiotics are needed. Do not stop antibiotics until you have finished the full course even if feeling better.
• Continue to breastfeed often to keep your breast well drained. Manually express or pump your breast if necessary to drain the breast. Breastfeeding while you have mastitis will NOT harm your baby.
• Rest often, and increase fluids.
• Advil or Tylenol may be taken to reduce fever and to relieve breast pain.

Your milk supply in the affected breast may be reduced for several weeks after mastitis, but will return to normal with stimulation from your baby.

Breast pain and redness often peak on the 2nd or the 3rd day and return to normal by the 5th day.

Works Cited

Lawrence, Ruth A. & Lawrence, Robert M. “Breastfeeding, A Guide for the Medical Professional”, Eighth edition, ELSEVIER, 2016.

Wambach, Karen and Riordan, Jan “Breastfeeding and Human Lactation”, Fifth edition, Jones & Bartlett, 2016.