After I came home from the hospital with my first child, I assumed the biggest pain hurdle I would face would be below the belt. Then my milk supply came in and, as the lactation specialist at the hospital had warned often happens, I became engorged. My normal C cup, which had bumped up to a double D during pregnancy, was now in E territory.
But then I noticed that not only were my boobs as big as cantaloupes, but they were as hard as them, too. As a serial self-diagnoser, I scoured the internet, trying to find out why my boobs were hardening. The answer (confirmed by the hospital’s lactation consultant) came to define my breastfeeding experience: plugged ducts.
Plugged ducts occur when milk gets stuck in your breast, or when a nipple blockage keeps the milk from coming out. The causes are many—pressure, going too long without nursing, oversupply, blebs—and the consequences are a drag. At the least, you’ll experience tender pain and uncomfortable hard spots. At the worst, you’ll develop mastitis, which is endearingly nicknamed the boob flu, and often requires antibiotics to resolve.
It seemed so unfair that I’d endured nine months of pregnancy, birth, and its lovely aftermath only to be met with chronic plugged ducts!
In the year I spent nursing my daughter, Jolene, I suffered so many plugged ducts I lost count. But by far the most came in the first few weeks, before I mastered how to prevent and remove these obstructions. I did what you’re not supposed to do and pumped incessantly. To avoid putting plugged-duct-inducing pressure on my boobs, I switched from side sleeping to back sleeping, which only deepened my sleep deprivation. And I almost gave up.
It seemed so unfair that I’d endured nine months of pregnancy, birth, and its lovely aftermath only to be met with chronic plugged ducts! I rarely cry, but I broke down in tears to my husband, feeling helpless against the pain and frustrated with the enormous time and energy I was spending dealing with the issue. I called the lactation specialist at the hospital, who informed me that I probably have very fatty milk and to keep nursing, working in hot and cold compresses. While this helped, it was far from enough to conquer my problem.
After more research, I discovered the closest thing to a magic bullet that a desperate nursing mom could ask for: soy lecithin. I learned that taking this nutrient as a supplement can help thin milk and prevent plugged ducts. La Leche International, for example, recommends adding one tablespoon of lecithin to your diet if you suffer from frequent plugged ducts. Within a few days of taking soy lecithin, my plugged ducts went from a near daily occurrence to a weekly or biweekly phenomenon.
I discovered the closest thing to a magic bullet that a desperate nursing mom could ask for: soy lecithin.
Here are a few tips and tricks I learned for preventing and treating plugged ducts.
Preventing plugged ducts
· Don’t overpump. You may be tempted to pump until nothing comes out when you’re engorged, but this will only increase your supply, making you more dependent on pumping nonstop.
· Don’t go long periods without nursing/pumping. Some of my worst plugged ducts came when I was away from my daughter for five or six hours during graduate school. If you know you’ll be away from your baby for significantly longer than the normal stretch between feedings, plan to bring a tiny hand pump so you can keep that milk from getting backed up.
· Avoid sleeping on your stomach or side. Especially during engorgement or weaning, these sleeping positions can lead to blockages.
· Take soy lecithin or sunflower lecithin—or both! You can find non-GMO soy lecithin capsules and sunflower lecithin capsules online and at health food stores. I take the maximum dose: one 1,200 mg capsule four times daily, spacing out the pills throughout the day. A new company called Legendairy Milk even produces organic sunflower lecithin supplements specifically for preventing plugged ducts.
· Feel yourself up. Throughout the day and night—and especially during long stretches away from the baby—I do a quick check to make sure I don’t feel any hard spots developing so I can address them before they take over half my boob.
Treating plugged ducts
· First try nursing or pumping. For me, just nursing or pumping rarely resolves all but the most minor of plugged ducts. But for others with more mild plugged duct experiences, this might do the trick. Try putting pressure on the plugged duct area with your thumb or a couple fingers as you nurse/pump. Hovering your boob vertically over your baby or the pump will also put gravity on your side.
· Massage the plugged duct while hand expressing. For me, this has been the most efficient and effective way to unclog a duct and is best performed under hot water in the shower. Lean over so your nipple is pointing to the shower floor. Holding your boob, apply as intense pressure as you can handle on the top of the duct with your thumbs or fingers. Then massage down the length of the duct toward the nipple until milk begins to squirt out. If it’s a really bad plugged duct, I’ll even use my knuckles to increase pressure. Continue expressing until the area doesn’t feel rock hard anymore. This will be pretty uncomfortable if not straight-up painful, but it does the trick. Note that the area where the plugged duct was may feel firm and remain tender for a day or two. In a pinch, you can also massage out the duct into a sink, though I find the hot water of a shower really helps.
This June, when I brought my son home from the hospital, I crossed my fingers that the knowledge I’d accrued from my first time at the nursing rodeo would pay off.
This June, when I brought my son home from the hospital, I crossed my fingers that the knowledge I’d accrued from my first time at the nursing rodeo would pay off. And thankfully, a couple months into nursing him, I’ve only had plugged ducts twice.
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