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Blocked ducts

Blocked milk ducts is not an uncommon problem, but left untreated it can develop into mastitis. Here are some tips for dealing with blocked ducts.

Blocked ducts occur when one or several milk ducts become clogged. This can happen if a breast is subjected to pressure (e.g. by the underwiring in a bra), or isn't completely emptied during feeding. If you get a blocked duct, your breast will be warm, sore, red and hard in the area where the duct is blocked. You might soon feel really ill with a fever, as if you had the flu.

Fever and tender breast
Contact your LMC, Plunket Family Centre or lactation consultant immediately if your breast starts feeling tender, and especially if you get a fever. Take something to relieve the pain and bring down the fever and keep on breastfeeding, even if it hurts; your baby is the only real cure for blocked ducts. As soon as you feel any tenderness, try these tips:
• Continue breastfeeding, preferably once every two hours. You may need to wake your baby to get help emptying the affected breast. That’s your best cure right now.
• Feed with the affected breast as much as possible. (It’s a good idea to start with this breast at every feed for a day or two.) If your baby has trouble latching onto the nipple, start by milking your breast a little by hand to make the areola softer and easier to grip.
• Make sure there’s nothing pressing against your breast. Use a loose bra that leaves no marks on your skin.
• Heat helps. Apply a warm wheat bag to the tender area (but don’t press it). You might find it relieves the pain to put the tender breast under a warm shower with a soft jet setting.
• Use breast compression while baby is feeding. Put your hand around the blocked duct, maintain steady pressure. Gently stroking the area in a circular motion towards your nipple while feeding also helps. But handle your breast gently.
• Change your baby’s position at the breast so that their chin is pointed towards the affected area of hardness. Try lying down to feed or hold baby in the football hold position.
• Sleep a lot, keep warm (especially keep your breasts warm), drink plenty of liquids and make sure you get lots of peace, rest and TLC. After all, you’re the food – and the food’s fallen sick!
• If your baby won’t suck enough, hand-milk the affected breast or use a breast pump until it feels soft again. But don’t pump too much, as this may increase your milk production.
It takes patience to cure blocked ducts. But you should start feeling better within 12 hours, and then you’ll know you’re on the road to recovery. Your fever should soon disappear and your breast will become increasingly less red and sore. Continue following the guidelines above until you’re completely better. This may well take a couple of days. The most important thing is that you keep improving.
If the blocked duct persists longer than 48 hours, therapeutic ultrasound often works. Ask a physio or talk to your LMC.

Mastitis
If the plugged ducts don’t clear up, if you have cracked nipples and your fever lasts longer than 12 hours, you could be getting mastitis. Contact your LMC or a lactation consultant immediately for help and advice. Sometimes antibiotics are necessary to clear up the infection. But there’s no need to stop breastfeeding.
Have you had plugged ducts? Tell us about it here.
If you’re having problems feeding there are lots of places you can go to get help. Your LMC should help you with any breastfeeding problems in the first instance. If you need more support, phone the Plunket Family Centre and ask to see a lactation consultant or phone PlunketLine 0800 933 922. You can find a private lactation consultant on www.nzlca.org.nz – there will be a charge. La Leche League offers breastfeeding support – visit www.lalecheleague.org.nz

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