TWO PAINFUL BREASTFEEDING ISSUES: PLUGGED DUCTS & MASTITIS


TWO PAINFUL BREASTFEEDING ISSUES: PLUGGED DUCTS & MASTITIS
By Maureen Mills RN, IBCLC and Natalia Darling PA-C 
You’re so excited because you actually slept long enough to have a dream. But, the excitement doesn’t last because you realize that one of your breasts hurts BAD.
You may have a plugged duct. And you’ll know you have it because your breast hurts, it may be warm, swollen and may even look red.
WHAT’S A PLUGGED DUCT?
Plugged ducts often happen when your baby has slept longer than normal and you wake up feeling pain and a “knot” or hard lump in your breast.  A plugged duct is a section of the breast where the milk is “stuck.” The milk duct is blocked or partially blocked. It comes on slowly and is usually just on one side.  You may find that your pain is a lot higher before you feed your baby when your breasts are full of milk and you get some relief after you feed your baby when your breasts have less milk.  It’s always best to treat a plugged duct immediately to avoid it turning into mastitis.
WHAT TO DO IF I HAVE A PLUGGED DUCT?
1. Do NOT stop nursing!!
2. In fact, nursing more will help. Start on the affected side every time you nurse.
3. Point your baby’s chin to as close to the lump as possible.
4. Increase your hydration (take your weight in pounds, cut it in half and that is the amount of ounces of non-caffeinated liquids you should have in a 24hr period.)
5. Massage the plugged duct gently and push towards the nipple while your baby is nursing (to push the milk out) or you while you’re pumping on the affected side.
6. Place warm heat at the site of the knot before a feeding. After a feeding if there’s still pain, use a cold compress.
7. After a nursing session you can pump while massaging the plugged duct.
 
WHAT’S MASTITIS?
Mastitis is when the plugged duct becomes infected. Symptoms are similar to a plugged duct but also may include a fever over 101 degrees and flu like symptoms (chills, aches, malaise).
Mastitis may require antibiotics to help resolve the infection.
WHAT TO DO IF I HAVE MASTITIS?
1. Do NOT stop nursing!!
2. Call your OB/GYN. You may need antibiotics. Make sure you tell them you are breastfeeding so they prescribe a safe antibiotic for you and your baby.
3. Rest, increase fluids and make sure you have adequate nutrition.
4. You may take a pain reliever/anti-inflammatory (for example: Advil, Motrin). Second choice would be acetaminophen (for example: Tylenol).
REMEMBER:  HEAT,  MASSAGE,  EMPTY BREAST