There’s so much conflicting advice out there about blocked ducts. Do they always need treating? Do they always lead to mastitis? Do you need to do anything at all? What about the old wives tales, the alternative treatments? What about antibiotics?

Blocked ducts:
Well, truth is that many women have blocked ducts while they’re breastfeeding and most go away spontaneously within 24 hours. It’s just where the milk hasn’t been emptied as well as it should be, often because the latch is poor or the baby’s position means that a particular duct isn’t being ‘milked’ as well as it could be.

Sometimes they just feel like a little pea sized lump, sometimes they’re uncomfortable and sometimes they’re downright painful! Often the baby won’t feed as well while there’s a blocked duct because the swollen duct presses on other ducts, meaning the flow isn’t quite as fast as usual and baby can seem fussy or distracted.

So… what to do about it? Well the most important thing is to keep on breastfeeding so that the duct is emptied as much as possible, because if it’s not, then that’s when mastitis could set in. Make sure that the position and latch is as good as it possibly can be (get some support for this if necessary). It’s worth changing the position that you feed baby in, aiming to get baby’s chin and lower jaw between the nipple and the blocked duct. This is because wherever baby’s chin is, that area that gets ‘milked’ more effectively. Even if the blocked duct is up between your breast and your shoulder, it’s possible to lie down and position baby so that she’s lying over your shoulder with her chin above your nipple. (It looks weird and you might need someone to help you make it comfy for you and baby, but it works really well!).

Massage or compress the swollen area while you’re feeding and also while you’re showering or expressing to encourage the milk to flow freely through that duct. Heat helps too, maybe a hot water bottle (not too hot!) or a heat pad. And rest, rest, rest. It’s not always easy with a new baby I know…. but try to give yourself a day where you don’t do much else but lie down and feed your baby. Maybe call in the troops to help you out by taking care of everything else while you just rest and feed. Sometimes the milk can look stringy or lumpy, but it’s nothing to worry about.

Usually it’s just these simple measures that will unblock the duct…. however, if it’s a persistent one there are a couple of other things you can try:

  • Lecithin (a food supplement) may help some mums by making the milk less ‘sticky’ (it increases the amount of polyunsaturated fatty acids in the milk). It’s thought to be safe (although if you’re allergic to soya’ll you need to find one that’s not soya based), it’s not expensive and it’s taken as a food supplement (1200mg twice a day, although some manufacturers suggest you can double this). However there aren’t any good scientific studies yet on its safety or effectiveness.
  • Ultrasound can also work well for some women, although it’s not widely known about by ultrasound practitioners. It needs to be done for just 5 minutes, for two consecutive days. If that doesn’t work, there’s no point continuing with any more. It may also be possible to get a similar result using the flat end of an electric toothbrush! Weird as it may sound, some Mums have found it helps!

Persistent breast lumps that are still there after a couple of weeks without other symptoms should be seen by a doctor just to be safe, but you can carry on feeding. You might need a scan just to make sure it’s all ‘normal’.

Mastitis:
So…… when does a blocked duct turn into mastitis? The answer is not always…. and sometimes mastitis develops without having a blocked duct! The difference is that mastitis makes you feel lousy…. really, really lousy! The symptoms are pain in the breast, a red area of the breast and a fever. It’s the fever that makes you feel so awful (although it actually helps to fight the infection) but the fever itself doesn’t cause the milk to go bad and doesn’t necessarily need to be brought down. However, you might want to bring it down with some painkillers – paracetamol and ibuprofen are both fine to take while you’re feeding, within the recommended dosage.

As with a blocked duct, rest up (go to bed), continue breastfeeding (or expressing if feeding is too painful) and try alternating feeding positions. Use heat and massage the area regularly. Sometimes the milk can taste more salty than usual and baby might be a bit fussy as a result, so express if this is the case (you can still feed baby with it).

Old wives tales….? Well there’s some evidence to show that slices of raw potato contain a substance that can help! Soak the potato slices and then place onto the painful area for 20-30 minutes, then repeat with fresh slices 3 times.

Antibiotics….? Well they’re not always necessary as often mastitis will simply resolve by itself. And taking them can sometimes lead on to other unpleasant problems, such as breast thrush. However, if the symptoms have got worse after 8-12 hours, then it’s best to start a course of antibiotics. If you’re no worse, but no better after 24 hours then start the course. However, if your symptoms are starting to improve after 24 hours then you won’t need to start taking antibiotics as it will probably get better by itself. Don’t worry if you still have a lump for up to 7 days as it can take the body a while to break down the inflammation.

Once you’ve had mastitis you’re a bit more likely to have problems with that duct blocking up, so get some support from a breastfeeding specialist to help with positioning and latch in order to prevent recurrence.

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