Nursing mothers generally experience breast pain at some point of time. There are numerous reasons behind this occurrence. The main cause of most of breast pain experienced by nursing mothers is plugged ducts.

What Are Plugged Ducts?

Milk ducts are tiny tubes that extend from the tissues that produce milk to the nipples. When one of these ducts is clogged for some cause, a tender lump develops as the milk backs up behind that point. These plugged ducks cause discomfort and pain, if not cleared quickly. This so happens because, when the milk is backed up for some time, it will become thicker and find hard to flow again. The bacteria can grow in this backed up milk leading to infections and also develops pain.

What Happens Plugged Ducts Are Not Treated Soon?

Plugged ducts, when not given immediate attention can progress to a condition called Mastitis. Mastitis is the infection of the breast tissues which usually develops when bacteria from the baby’s mouth enter the duct through cracked or sored nipple. In extreme cases, breast abscess develops. This is a very painful condition in which the swollen area is collected with pus. The swollen lumps look reddish and feel hot due to intense infection. Fever and flu-like symptoms can also develop during this phase.

If One Breast Has A Plugged Duct, Does The Second Also Get Affected?

No, plugged ducts usually affect only one breast at a time. But when it is left unattended and it develops to mastitis, and the bacteria that associated is strep instead of staph, both breasts can be infected and become hard to treat.

Can I Feed My Baby From The Breast With Plugged Ducts?

Yes. In fact, if you do not feed your baby with the plugged breast the matter will get worst as more milk starts to back up and the intensity of the clog will increase. Ensuring that the milk flows again is the remedy for plugged ducts and the suckling of the breast by your baby is the best way to get the duct unclogged. The antibacterial properties of the breast milk will safeguard your baby from infection even if the duct develops an infection.
The milk flow will be very slow in the infected breast and the baby prefers to drink easy flowing milk from the other breast. But you should encourage your baby to drink from the breast with plugged ducts. Even though in the beginning of feeding you experience the pain which seems intolerable, you could magically experience the reduction in the pain when your baby properly suckles the milk.

When Are Plugged Ducts Likely To Happen?

Early weeks of nursing, and during the winter months more, more nursing women are found to be prone to plugged ducts.

When Should I Start To Worry About My Plugged Ducts?

You should seek immediate medical attention if:

• Both your breasts are infected
• Red streaks or wedges develop near the area where the lump is formed
• Pus or blood appears in the breast milk
• Fever shoots up more than 101 degrees
• After trying home remedies, even after twenty-four hours, the symptoms persist or getting worst

What Are The Causes Of Plugged Ducts?

The basic cause can be the breast is not completely getting empty off the milk when the mother has abundant milk supply. Any factors that contribute the incomplete drainage of milk ducts can increase the chances of plugged ducts.

• Interrupted nursing: Missed feedings and shortened feedings increases the chances of experiencing plugged ducts. Your baby may sleep throughout the night missing his routine feeding or he may not be suckle properly because of a nose block or cold or during teething or when he begins to wean. This will interrupt with the quantity and frequency of feeding. Even when the mother is undergoing some stress it will affect the normal feeding the mother and the child follows suit. Properly scheduled feeding is not possible while travelling. That is why many mothers experience plugged ducts during holidays
• Improper latch on: For some reason, if your baby couldn’t latch properly the complete draining out of milk from the duct can get affected leading to plugged ducts
• Improper positioning: Always latching on the same position and applying less pressure constantly in the same duct will result in incomplete draining out of that particular duct while nursing. This will increase the chance of that duct getting plugged
• Compression of the duct: Sleeping continuously on the stomach results in squeezing the breast and ducts. Same way if you are using a poorly fitted bra, or even if your shoulder bag’s strap constantly comes over your breast throughout your shopping, it can compress the ducts. Seat belt of the car can also harm your ducts if not properly used. This compression of ducts generally leads to plugged ducts as the milk gets trapped inside the duct
• Breast biopsy: If you have undergone a breast biopsy for some reason, the ducts on the part which the tissues taken can interrupt the drainage of milk causing plugged ducts
• Abrupt Weaning: Instead of gradual weaning when you wean the baby abruptly the complete milk drainage does not occur ending in a plugged duct
• Stress: If you are under some mental stress, the production of oxytocin is decreased. This hormone stimulates the releasing of milk from the breast
• Vigorous arm exercises: In some cases, vigorous arm exercises is found to be one reason that leads to plugged ducts

How Can Plugged Ducts Be Unplugged?

Most of the plugged ducts will disappear in a couple of days if they are detected and treated early. Letting the milk flow freely through the ducts as soon as possible will flush the bacteria that cause the infection out of the system before allowing it to multiply. The aim of all the treatments done for plugged ducts lays emphasis on emptying your breast completely and frequently. Here are some methods that help you to get rid of the plugged ducts very fast.

1. Frequent and rigorous emptying of the breast: As we already discussed, the longer the milk stays inside the duct, the thicker it becomes. Hence, feeding or expressing the milk should be done every 1 to 2 hours to diminish the plug. Always start nursing with your affected breast when your child’s suckling strength and need of food is high
2. Varying the feeding position: Varying feeding position will help to put the pressure on different ducts there by helping to make sure all the ducts are drained
   • Positioning the baby with his chin pointing towards the area that is sore and encouraging him to latch are found effective in relieving pain and unplugging the ducts
   • One feeding position which sounds strange but highly effective is ‘hands and knees’. Put down your baby preferably on the floor after spreading a blanket. You should hover over him in all your four limbs. Let your breast hang freely from your ribcage. Now feed him from your dangling affected breast. Gravitation force also plays a vital role in this position to flush out the clog
3. Take plenty of fluids: Intake of water and fluids are very important in the production of breast milk. Likewise, if you are running a fever make sure you drink lots of water to avoid the thickening of the milk.
4. Applying heat compressor: Placing warm compressors like a heating pad, a cloth soaked in warm water before feeding is very effective in dislodging and eliminating the clog. Just remember not to use too much heat for too long as it will burn your tender skin. Applying heat compressor prior to massage increases the effect of massage. Some mothers prefer cold pack instead of a warm pack. Choose according to your comfort
5. Massage:
   • The soreness and pain brought about by a blocked milk duct can be incredibly facilitated through an effective massage
   • Dislodge and move the plug toward the nipple by applying a pressure massage. This is done by applying pressure on the edge of the lumpy area. Press and release the hand until the pain eases. Now gradually move the hand inch by inch towards the nipple repeating the process. Mostly the dried milk will come out the nipple when you squeeze the nipple. Even if it doesn’t come out the dislodged clog will come out when your child strongly suckles the milk
   • You can also try gently massage the affected area while you feeding your baby
   • Using castor oil for massaging is recommended
6. Treating milk blisters: Very rarely the plugged duct is associated with milk blisters. Usually, it develops on the end of the nipple and is very painful making the latching very difficult. This blister can be opened by a professional hand using a sterile needle. A puncture is made gently on the top of the blister and squeeze behind the blister to make the clog come out. Pumping the milk out after puncturing can also be tried
7. Ultra sound therapy: Ultra sound therapy is suggested for more stubborn plugs. This is usually clubbed with lymphatic drainage massage. Sports medical clinic and physiotherapy clinic can provide this treatment. Even though it is not that popular it is very effective and most of the plugs will vanish in two consecutive siting each of which last for only five minutes
8. Medication: Medicines to relieve pain and infection are prescribed by the doctor according to the severity. Never take painkillers yourself when you are lactating
9. Sleep on your back: Taking plenty of rest and sleeping on your back or side without putting pressure on the sore breast will help to eliminate the clog faster
10. Wearing supportive bra: Wearing a nursing bra which fits well should be used. Bras with under-wire are not preferred as it often put pressure at some points of the breast inhibiting the flow of milk at these points developing a clog

Always respond to the plugged duct quickly. You can always detect it as its formation usually occur slowly. Early detection and early treatment guarantee less pain and quick relief.
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