#98 | Breastfeeding Mini: Prevention, Causes, and Treatment of Plugged Ducts

May 10, 2021

In today's mini-episode, Trisha explains how and why we get clogged or plugged ducts and provides guidance on how to recognize them, how to prevent them, and simple steps to resolve them quickly to keep you breastfeeding comfortably.  

If your plugged duct does not resolve within 24-48 hours seek the help of a professional lactation consultant.  

* * * * * * * * * *

If you enjoyed this episode of the Down To Birth Show, please subscribe and share with your pregnant and postpartum friends.

Between episodes, connect with us on Instagram @DownToBirthShow to see behind-the-scenes production clips and join the conversation by responding to our questions and polls related to pregnancy, childbirth and early motherhood. You can reach us at Contact@DownToBirthShow.com or call (802) 438-3696 (802-GET-DOWN). We are always happy to hear from our listeners and appreciate questions for our monthly Q&A episodes. To join our monthly newsletter, text "downtobirth" to 22828.

You can sign up for Cynthia's HypnoBirthing classes as well as online breastfeeding classes and weekly postpartum support groups run by Cynthia & Trisha at HypnoBirthing of Connecticut

Please remember we don’t provide medical advice, and to speak with your licensed medical provider related to all your healthcare matters. Thanks so much for joining in the conversation, and see you next week!

Support the show (https://www.paypal.com/paypalme/cynthiaovergard)

View Episode Transcript

Hey everyone, it is Trisha and I am here today in this minisode to talk about the theme of the week for me, which has been plugged ducks. So today I want to talk about preventing and treating plug ducks. For some reason, plug ducks just seemed to be the thing that every woman I was talking to was dealing with. And I realized how much misinformation there is out there about how to recognize and treat a plug duck. So we're going to take a few minutes to walk through preventing plug ducks recognizing plug ducks and what you can do when you feel when developing. So let's begin by just talking about how a plug gets started. Imagine all the milk ducks in your breasts sort of intertwining and overlapping, as they work their way toward your nipple, where where the milk comes out. And sometimes when the milk is left behind in the breast for too long, or it's not removed efficiently enough, or often enough, the milk can get a little bit sticky, and then it creates a block in your duct. And as the duck gets blocked and more milk starts to come into your breast, we as we're always making milk, that block causes the milk doc to stretch and get full and the milk pools behind the plug. So when you talk about having a tender sore spot in your breast, which is what most people think is the actual plug, it's not the plug is somewhere else the plug is somewhere in front of that stretched dilated milk duct. So one of the most common problems that I see is that when people think they have a plug doc they start massaging the sore spot in their breast, in hopes that the massaging over the sore spot is going to release the plug, when in fact massaging on the sore spot in the breast is actually just exacerbating the inflammation around this already dilated duct where the milk has pooled and stretched the duct. So let's go over what the signs of a block duct are. The most common indication that you have a plug duct is that you feel a tender firm lump in your breast that is still there after your baby finishes nursing, you may sometimes feel pain in your nipple or in your breast, you may have a white or yellow blister on the tip of your nipple. Sometimes your breast skin will turn red, especially over the tender area, or your breast could feel particularly hot. In the most severe cases, you might actually feel like you have the flu. If that's the case, you definitely need to get help right away. Plug ducks are almost always caused by leaving too much milk behind in the breast. So that could mean making more milk than your baby actually needs or making more milk than you are removing by nursing or pumping. Some women will be very prone to plug docks if they're exclusively pumping and not Nursing at all. Because our baby is actually much better at clearing plugs and preventing plugs than our pump is if you leave your breasts on nursed for more than a usual length of time. So if you're normally feeding your baby every two to three hours and then suddenly you have a day where you're just busy or working or something comes up and you haven't emptied your breasts for four hours that can lead to a plug duct. Sometimes when our babies are going through growth spurts and they nurse a lot more than usual for a couple of days. We can get a plug duct after that because they've actually driven up our production temporarily and then as they go back to feeding a little less frequently after the Grossberg we're making more milk than they need and may be prone to getting a plug duct. If you are particularly active or busy or stressed not getting enough rest, you can certainly get a plug doc from that. If you're wearing ill fitting braas brows with underwires brows that cut into the breast or creating tightness or any type of excess compression on the breast can cause products as well. Also moms that don't see breastfeeding as a relaxing activity moms who are uncomfortable in pain, or just dislike breastfeeding and maybe sometimes cut the feed short because they're uncomfortable can also be at higher risk of getting plugged ducks. The number one method for preventing plug ducks is to avoid making more milk than your baby needs to work in those first couple of weeks of breastfeeding to ensure that supply and demand are in sync. Once supply and demand are in sync, then from there it's avoiding those prolonged periods of time where milk is left in the breast and could get to that sticky place. Also, having your hands on your breasts a lot is very helpful for identifying and preventing blood ducks The more we can have our hands and be aware of what's going on in our breasts, the sooner we can catch something Doesn't feel normal. Additionally, having your hands on your breast and massaging your breast before a feed can really help to get the milk flowing more easily and prevent plug ducks. We know that stress postpartum is a major contributor, creating products. But probably the biggest reason that I see mothers get plugged ducts postpartum is their desire to make sure that they have enough milk for their baby, and they end up actually feeding the freezer instead of their baby, or both. They're feeding their baby Of course, but they're also feeding the freezer. And when we do this, we set ourselves up for having HyperX, lactation or oversupply, which means we're making more milk than our baby needs. And if we're making more milk than our baby needs, we always have to remove that extra amount of milk to make sure that our breasts don't get engorged or backed up. And sometimes when our baby isn't demanding, and we get busy with other things, and we're over producing, it's very easy to let the milk sit in the breast for too long, and then make it prone to plug ducks. So my number one suggestion for preventing plug ducks is to ensure that you are in sync with supply and demand. So let's move on to how to clear a plug doc if you sense one coming on. If you catch a plug doc early, it can be unplugged and cleared much more quickly. Sometimes in one feeding or in a matter of hours. If we don't catch the plug doctor early, and it's been sitting for a while and that milk gets stickier and stickier it gets harder and harder to remove. Sometimes it can take several days, maybe even a week to completely clear. But regardless, as soon as you notice it's there. If you start with some plug duck clearing techniques, you should begin to feel better. So to begin, just to reiterate that the tender spot that you feel in your breast is not the plug. The plug is somewhere between that tender spot and your nipple. So we really want to avoid putting pressure and massage over that tender spot, we want to find the tender spot and then we want to move in front of it and massage down and out toward our nipple trying to imagine that we're kind of pushing a little plugs sticky thing through this little tube in our breast and out the nipple. But before we even begin any sort of hands on technique, we want to make sure that that breast that is experiencing the plug is as empty as possible. And the best way to get that breath empty is your baby nursing. If you are able to get your baby's chin on the same side as the tender plugged spot that can be helpful because your baby's chin is the strongest part of the motion of breastfeeding and the most likely to clear the plug. If your baby is not breastfeeding, and you must pump then you should pump your breast to empty and then start doing the clear the path or clear the plug massage that I just mentioned. If your baby is breastfeeding, that is the ideal way. And pumping in that case is less helpful because pumping doesn't actually work to remove the plug. It just works to get the milk out of your breast. But what we really want to do is use the baby's mouth and the motion of nursing a lot and our hands to try to get rid of this plugs so that the milk can flow freely. So the first thing I recommend that moms do when they notify me that they think I have a plugged up is to get in a hot shower and let the water hot water run across the breast. And then to do the plug doctor massage. Ideally, you're doing this after your baby has fed. After this one session of heat, it isn't as helpful to continue to use a lot of heat. Sometimes it can even make it worse because the heat actually is the thing that brings in more milk. What we really want to do is get the breast empty and then use cold compresses after feeds and a cold compress is going to actually help your body to slow down milk production on that side. So that the duct can start to relax and the plug can get cleared with your hand. As far as cold compresses go, I recommend using either a frozen bag of corn or peas that really can cover the full amount of your breast and retains cold temperature for quite a while. An excellent alternative to that is the gel packs for kids that are that go in the freezer and their little round. silicone gel packs that will also stay cold for a long period of time and those can actually fit right in your bra so they're very convenient. So cold, cold, cold, less heat, hands on the breast, empty the breasts, using your hand to did massage on the empty breast. Another helpful technique is something called ultra light touch massage. And this technique uses your fingertips very, very delicately And very lightly to brush over the tender spot on your breasts toward your armpits so repeatedly and rhythmically light touch brushing over the tender spot toward the armpit. And the idea of this is that it actually helps the edema and swelling that has occurred as a result of the plug duct to drain into the lymphatic system. It works wonders and it's very easy to do and can really facilitate the plug clearing more quickly. If you have a severe plug or you are in a lot of pain, it is also helpful to take ibuprofen, if it is safe for you to take ibuprofen, you can take 600 milligrams every six hours. So that would be four times a day 600 milligrams of ibuprofen. And this doesn't just work to this doesn't just help because it's eliminating the pain. It's also very important for the anti inflammatory effect. And sometimes this is needed in addition to the cold compresses to reduce enough inflammation to allow you to clear the plug and then the milk is able to pass through. So you'll know that you are starting to get better when you feel less discomfort, see less redness, and the lump feels softer and smaller. And also you may notice that your baby is feeling better on that side. Once the plug is gone, you're absolutely fine and there's nothing further that you need to do. However, if you're having trouble clearing the plug, it is definitely recommended to get in touch with a lactation consultant. The earlier you do that the sooner and the better chance you have of clearing the plug. If you feel anything like a fever or flu like symptoms that can happen as a result of an inflammatory response that goes off in the body when the plug is more severe. This is definitely a reason to get in touch with a lactation consultant because you may be in need of further evaluation. So just in summary, real quick a few of the key points from this minisode is that the sooner you catch a plug duct the easier chance you have of clearing it. Plug ducks are most often caused from leaving too much milk in the breast and or producing too much milk for our baby's needs. And then the the misconception around treatment of blood ducks is keep the hands away from the tender spot work in front of the tender spot down and out toward the nipple when you are trying to massage and clear the plug duct. Your hands can go on top of the tender spot in the very very light soft touch method where you are actually stroking your hands back toward your armpit to facilitate lymphatic drainage of the swelling. And last but not least, when in doubt, please please contact the lactation consultant. So that's what I have to say I'm Todd ducks. I hope that was helpful and I look forward to more minisodes with you and more breastfeeding tips coming up soon.

If you enjoyed this podcast episode of the Down To Birth Show, please share with your pregnant and postpartum friends.

Share this episode: 

Between episodes, connect with us on Instagram @DownToBirthShow to see behind-the-scenes production clips and join the conversation by responding to our questions and polls related to pregnancy, childbirth and early motherhood.

You can reach us at Contact@DownToBirthShow.com or call (802) 438-3696 (802-GET-DOWN). 

To join our monthly newsletter, text “downtobirth” to 22828.

About Cynthia Overgard

Cynthia is a published writer, advocate, childbirth educator and postpartum support specialist in prenatal/postpartum healthcare and has served thousands of clients since 2007. 

About Trisha Ludwig

Trisha is a Yale-educated Certified Nurse Midwife and International Board Certified Lactation Counselor. She has worked in women's health for more than 15 years.

Want to be on the show?

We'd love to hear your story. 
Please fill out the form if you are interested in being on the show.

screen linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram