Plugged Ducts and Mastitis - How to prevent and treat this common breastfeeding challenge

A plugged duct is literally that - a milk duct in the breast that becomes "stuck" with milk. It is not being drained properly due to: an ill fitting (too tight or underwire) bra; not nursing often enough; a baby who is not sucking well at the breast; not varying the position of the baby while feeding; baby carriers that put pressure on the breasts; even the mother's sleeping position.

It may present as a hard, red sore spot on the breast, or mom may not have any external symptoms. She may just have discomfort in an area of her breast. She may also notice a white dot on the end of her nipple with what looks like thickened or hardened milk or a small pimple.

To prevent plugged ducts, it's important to make sure baby is latching on to the breast well and mom is not uncomfortable during feedings. There shouldn't be anything pinching or pressuring her breast. Nursing frequently to "empty" the breast well (since the nursing breast is never truly empty) is important to avoid mom getting overly full. Nursing moms should avoid sleeping on their stomachs or in another position that squeezes the breast for a long period of time if they have frequent plugged ducts. The same would be true of underwire bras. Some moms just can't use them.

If you notice symptoms of a plugged duct, take action immediately. This condition can frequently lead to mastitis, which can make a mom feel as if she's been hit by a truck! Some steps to take to treat a plugged duct:

* Nurse frequently.
* Before nursing, use warm compresses to soften the breast. During the feeding, try gentle massage (starting at the top of the chest above the sore area and moving down towards the nipple).
* Change the position of the baby so that his/her chin is pointing towards the sore spot. This might take some flexibility! The reason for this is because the baby's suck is strongest at that point and can drain the plugged duct more effectively.
* Get in the shower and let the hot water run down the chest. Repeat the massage. This one step has been a lifesaver for moms who are in pain with a plugged duct. Often it will open up and mom will notice thickened milk or even "crystals" coming from her nipple. This is a good thing. This thickened milk will not harm the baby either.
* Tylenol and Motrin are safe for nursing moms to use if the pain is bad.
* Get lots of rest. The best course of action is to take baby to bed immediately and encourage him/her to nurse frequently. Take naps and spend the majority of the day in bed if at all possible.

These tips will usually mean the problem will resolve in a day or two, maybe sooner. If you develop fever and chills and the plugged duct doesn't resolve, it may have turned into mastitis. Mastitis feels like the flu, but it's not life threatening, neither is weaning necessary or even recommended since it would only make the problem worse.

The same tips listed above will help mastitis. In addition, you can call your Doctor and ask for antibiotics, which may be helpful if you have been exposed to some other illness. For some reason, if other family members are ill with a cold or flu or other infection, the nursing mom will sometimes come down with mastitis. This is especially true if she has been doing too much and denying herself proper rest.

Plugged ducts and mastitis don't need to be the end of the nursing experience. With the right information and support, it's just a stepping stone.