One of the biggest challenges that breastfeeding women face is overcoming the many common and uncomfortable lactation issues that can occur. In fact, breastfeeding pain and discomfort affect 1 in 3 women, especially in first time mothers. While breastfeeding challenges can happen to anyone, those who take antibiotics during the last trimester of pregnancy, birth or during early postpartum are at a significantly increased risk of developing lactation issues.
A common problem lactating mothers face is plugged ducts, which happens when a blockage in the milk duct blocks the flow of milk, causing discomfort, pain, and inflammation. There are a variety of causes of plugged ducts, including oversupply, irregular feedings, tongue/lip ties, improper latch, sudden weaning, and excessive stress. If untreated, it can lead to mastitis, a painful bacterial infection, so taking care of plugged ducts as soon as symptoms arise is key.
Fortunately, there are many ways to help release plugged ducts. We are extremely lucky to have Breanna Duncan, Owner and Lactation Consultant at The Mama Mantra, LLC, and winner of Austin Birth Award for “Best IBCLC/Lactation Consultant Practice” in both 2017 and 2018, share with us her top tips for treating plugged ducts naturally.
Things to take orally
1. Daily probiotic - Probiotic supplementation has been shown to significantly improve breast comfort during lactation.
Our Mother Nutrient Breastfeeding Probiotic also includes Hereditum Lc40, a targeted probiotic strain that has been clinically proven to provide greater support compared with antibiotic therapy and offers short term and long term nursing benefits.
2. Vitamin C (upper limit ~2000mg), Vitamin D, Echinacea (as directed on package), raw garlic 2-3 cloves daily (up to 4-5 cloves per day) during acute plugged duct. Continue these remedies after the duct has cleared for about one week.
3. Homeopathic Remedies:
Homeopathic Phytolacca for when breasts are firm, lumpy, or when you experience radiating pain, especially when baby latches. Take as directed on the bottle or as directed by homeopathic practitioner.
- Homeopathic Belladonna for plugged ducts/mastitis that has an acute onset of fever, chills, and throbbing pain. Take as directed on the bottle or as directed by homeopathic practitioner.
4. Happy Ducts Tincture - A liquid herbal blend tincture that includes Poke root, which is very helpful for plugged ducts/mastitis.
5. Lecithin: The recommended dose is 1200mg 3-4x daily. After every week or so of ducts being released, decrease by 1 capsule (1200mg). For recurrent plugged ducts, mother may need to continue to take 1-2 capsules a day to keep plugs at bay.
6. Iron supplement for any history or symptoms of anemia, as anemia can exacerbate plugged ducts
Mother Nutrient Chelated Chewable Iron is highly absorbable and gentle on the stomach.
Therapies to try:
7. Laser therapy or therapeutic ultrasound treatment - If your blocked duct has not resolved within 48 hours or so, therapeutic ultrasound is a great option that helps break up the blocked duct. Most local physiotherapy or sports medicine clinics can provide this therapy for you. However, very few are aware of this use of ultrasound to treat blocked ducts so it is best to see an ultrasound therapist with experience in this technique. One ultrasound treatment is typically sufficient to help resolve your pain and discomfort. If two treatments on two consecutive days have not helped resolve the blocked duct, it is likely more treatments will not help. Your blocked duct should be re-evaluated by your doctor or by an IBCLC at The Mama Mantra. Ultrasound therapy may also prevent recurrent blocked ducts that develop in the same part of the breast. The recommended dose of ultrasound is 2 watts/cm² continuous for five minutes to the affected area, once daily for up to two treatments (from International BreastFeeding Centre).
Dr. Katherine Melot at Precision Chiropractic in Southwest Austin performs a hot laser therapy for plugged ducts and it works WONDERS. The treatment is fast and affordable.
Sullivan Physical Therapy also offers ultrasound therapy for plugged ducts.
8. Acupuncture can also be helpful to relieve pain and encourage healing for mastitis and plugged ducts. Dr. Danielle Martinez of Danielle Martinez Acupuncture is a Licensed Acupuncturist that focuses on women's health and postpartum care. Her practice is based in Austin, TX.
Massaging the breast
9. Perform therapeutic breast massage every day to help with lymph flow and release the buildup of milk
Perform manual compressions/massage while breastfeeding or pumping of any plugged areas in the breast
Use the back of an electric toothbrush on the affected area as a massage tool to break up the blocked duct.
Massage coconut oil onto the affected area and use a wide tooth comb to sweep over plugged areas from back to front to help release.
10. Other tips
Nurse frequently! Nurse around the clock, ensuring deep latch with proper positioning, and try to do skin to skin/resting with baby as much as possible.
Stay hydrated - increase your water intake. Fresh pineapple juice (not from concentrate), which contains enzymes called bromelain, can help reduce inflammation.
This electrolyte powder contains minerals that help keep your body stay hydrated, contains very little sugar, and is sweetened with stevia. 1 package dissolved in 1 glass of water = 3 glasses of water.
Eat more probiotic foods like kefir, sauerkraut, and fermented foods.
Decrease the amount of sugar, salt, saturated fat, and dairy in your diet and increase anti-inflammatory foods like green leafy vegetables, fatty fish, nuts, and blueberries.
Potato poultice - Place either grated potato or raw slices directly on the breast to ease pain and swelling. Leave on for about 20 minutes and repeat several times a day. More detailed info here.
Dangle nursing or dangle pumping - Let gravity help encourage the milk to flow and massage the area as you pump or nurse.
Wear loose clothing to avoid compression of breast area.
REST! Take time for yourself each day, as stress and emotional upheaval can cause an increase in occurrence of plugged ducts.
Things you can do if you have a milk bleb (if you see a white pore/milk blister on the nipple):
Gentle exfoliation 1-2x per day with a warm washcloth.
Massage from behind the bleb (directly on the nipple) in shower with warm water running after exfoliation.
Use a sterile needle to prick the bleb to aid in releasing the blocked milk if needed (ask your provider to do this for you, ideally not done at home).
Saline rinses at least 3x daily with epsom salts (soaking 3-5min) - a Haakaa is very convenient for this!
After 3 or more nursing sessions per day, apply warmed extra virgin olive oil on a cotton ball and wear it in a nursing bra over the bleb until the next feeding (ideally this is done after a saline soak).
Apply prescription Triple Nipple Ointment 2-3x daily or more for 10 day span or 10% hydrocortisone cream 2-3x per day to thin the skin until it breaks naturally. You can get the Triple Nipple Ointment from your OB/midwife and it is filled at a compounding pharmacy.
If you are trying to reduce your milk supply, try the following:
Take herbs: sage, jasmine, parsley, peppermint, lemon balm, spearmint. These can be taken as a tea. Have 1-2 cups per day while reducing supply.
Use cabbage leaves - Use washed, chilled or room temperature green cabbage leaves and leave on the breast until they wilt. Repeat as often as needed.
Express just enough milk to relieve your discomfort.
Wow, what a wealth of knowledge and information from Breanna Duncan, BSN, RN, IBCLC, RLC! Through her work as an IBCLC at The Mama Mantra, she has been providing a wide range of breastfeeding support for her clients.
The mission of The Mama Mantra is:
"to provide exceptional care to help you reach YOUR goals with guidance, compassion and encouragement so that your breastfeeding journey is enjoyable and optimal. Breastfeeding can be a challenge for both mom and baby. We provide care for every situation, for full-term infants, pre-term infants, infants with breastfeeding challenges due to many reasons and for their mother's who experience difficulties."
My own breastfeeding journey
Breanna is who I credit for helping me on my induced lactation journey for Luca. I can personally attest to her incredible dedication, compassion, and knowledge, and it has been amazing to continue working with her.
If you are breastfeeding and need support, don't hesitate to seek support from a lactation consultant. Contact The Mama Mantra to get more information about consultations, online support and classes, inducing/relactation services, and LGBTQIA services.
You can also find Breanna on Instagram @theboobieninja
With support, we can navigate and overcome breastfeeding challenges and feel empowered!
Did you experience any breastfeeding challenges? What helped you? Please share in the comments!
Disclaimer: These should not be a replacement for seeking medical care (and having your care provider “ok” the supplements you desire taking) or a replacement for assistance from a knowledgeable IBCLC to determine the best course of treatment based on personal history and to ensure there isn’t another primary reason that plugged ducts are happening (like tongue ties, infrequent feeding, incomplete milk removal, etc.), as those things should be ruled out/fixed first prior to utilizing any specific course of treatment.