Ok, let’s get serious here. Nursing is hard work and there are some things that can definitely make it even harder and more uncomfortable. On the top of my list – plugged ducts and the dreadful and hated, mastitis. If you’ve never had either, hallelujah for you. If you’ve come to this post because you currently have either issue, I commiserate girlfriend, especially if you’re in the mastitis ballpark.
Somehow, I made it through the first two children with only a few minor plugged ducts that seemingly worked themselves out, and then there was “the dreaded mastitis of 2019“. Yes, I named it, and if you’re currently suffering from mastitis, or a particularly nasty plugged duct, you will completely understand this. So in my pain and fever induced mastitis haze, I wrote down everything that I tried, in hopes that I might save another nursing mama from “the dreaded mastitis” and I’ve compiled what I think are some of the more readily options available for busy moms – because no mom wants to pack up the kid(s) to go buy a head of cabbage for her boobs.
Plugged duct vs. mastitis
I always wondered with my first two kids how I would know if my plugged ducts had turned into mastitis. Let me tell you, you’ll know. It’s kind of like not knowing if you’re in labor – there’s a point where the switch clearly flips. I was always able to massage my plugged ducts out within a day or two, but never experienced the additional symptoms that came with the onset of mastitis: fever, chills, a general feeling of sickness. Yes, I did have warm red areas with plugged ducts, but never like what I had when it turned into mastitis. I’ve read that both can be equally painful, but personally, that wasn’t my experience. So what can you do if you’ve got a plugged duct or mastitis? Read on…
Heat and massage
One the easiest ways to work on a blockage is to use heat to loosen it. A hot shower or a rice-filled sock are often times all it takes to release a blockage that’s been caught early on. Simply allow the breast to get warm and then massage the affected area. If you can feel a lump, focus both the heat and massage on this area.
Let’s be real about this so called massage. This shouldn’t be a gentle, relaxing massage, this is more like a deep tissue, sports massage that’s hurts like h*// during and then feels better two days later.
Feed baby often
Most folks know one of the best things you can do is let baby feed often to help clear the blockage, but did you know it’s suggested that baby’s chin be facing the lump or blockage? This means you might have to change up how you hold baby. While we’re talking about this, consider that always feeding your little one in the same position may be contributing to your issues. Feeding in one position may not enable baby to completely “empty” your breast every time. This can eventually lead to, you guessed it, plugged ducts and/or mastitis.
Since you’ll want to feed baby as often as possible on the side that is blocked, you can use a pump to pump the other side and focus solely on the blocked breast. I recommend this manual pump because it’s super easy to use while baby nurses on the first side. Because we typically block feed (meaning we only nurse on one side at each feeding) I only pump the unblocked breast every other session, so as not to encourage oversupply.
Oh yes mommy friends, this one is the real glamour shot of nursing, and it’s as awkward as it sounds. “Dangle feeding” is basically putting yourself far enough above baby that your boob can dangle straight down into baby’s mouth. This allows gravity to help force the block downward. You can kneel on all fours with baby under you or if your bed or couch is high enough, you can simply lean over them to nurse. This can be really painful, as you may feel the block being pulled downward. Also, I suggest keeping a towel (like a full-size bath towel) or bowl nearby to catch the flow if the duct begins to flow freely. It can make quite the mess.
A friend suggested this one to me and I found it to work extremely well for my very deep plugged duct. My guess is that the vibration helps break up the blockage, but I honestly don’t care how it works, because it did work. Simply hold the vibrating handle on the affected area. Bonus points if you warm the area first with heat.
While the toothbrush trick didn’t completely break up my blockage, it decreased the size enough that I was able to do the rest with massage.
Lose the underwire bra. Better yet, lose the bra.
This worked wonders for me, and in hindsight, I’m fairly certain that a certain underwire bra I had worn the night before I developed mastitis played a huge role in its appearance. No, going braless is not the most comfortable thing in the world, especially when your breast is already in a great deal of pain from the blockage, however, if you let the ladies roam free, there’s less chance of more plugged ducts developing, and you’ll allow baby to better nurse from all parts of your breast. For me the restriction of the lower portion of my breast when I wear an underwire or ill-fitting (bra) band, very quickly develops into plugged ducts on the underside of my breast. Note – if you tend to leak, you’ll want to wear an old shirt around the house, and place a towel on your side of the bed when you lie down to sleep. It just makes for easier cleanup.
Call your doctor for a prescription
If it’s been 24-48 hours and you’ve had no luck breaking up the blockage on your own, or you have a fever, it’s time to call the doctor. They’ll be able to prescribe a medication that is safe while nursing and will control infection. Know that it may take up to 72 hours for some of the most commonly prescribed medications to make a big enough dent in your discomfort for you to notice. Yes, you read that right, 72 hours.
Improve your nursing habits
Once you’ve managed to clear up your plugged duct(s)/mastitis, it’s important to step back and look at what may have caused it. Revisit some of your nursing habits, as well as baby’s. Check out my nursing 101 post for some ideas to improve your nursing routine and prevent further issues.