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Monday, November 12, 2012

Unplugging the Plugs

I am prone to plugged ducts - particularly my left breast.  More so because I am a pumping mama and I pump about 4x per day.  Not more than one breastfeeding expert (Lita Nery, Nanay Ines, etc. etc) has told me that pumping makes me more prone to plugged ducts because a breastpump is not as efficient and effective as a baby in draining out milk.  However, I never learned the art of hand expression and I work outside the home Monday to Friday.  So to keep my babies well-fed, I rely on my pump.
Hence to counter my increased risks for plugged ducts, I take measures like taking lecithin every day and pumping on schedule - never missing a pump.  Plus I nurse E as soon as I get home and nurse throughout the weekend.  Kellymom has this excellent list of risk factors and treatments for recurrent plugged ducts.

I have also noticed that I am more prone to plugs whenever I am under the weather.  Such was the case last week.  E caught roseola or baby measles while N also got the same virus which developed into fever, coughs and cold.  Because I had too much on my plate, my weakened immune system caught the viruses also and on Monday, I already had coughs and colds.  I still had some stuff to do at the office so I had to go in Monday and Tuesday.

photo from
This was a bad idea.  My first pump on Tuesday morning resulted in plugged ducts and throughout my entire pumping day, I could feel the plugs becoming bigger and hardening as the pump just couldn't unplug it!  Plus I could feel a fever coming.  Previously, the plugs developed in the lower part of my left breast.  This time, it was at the upper part, still of the left breast.  And what's worse, it started early in the morning and I had no choice but to rely on my pump for the rest of the day.

When I got home that night, I refreshed myself on the possible treatment to plugged ducts and went to work.  I took an extra dose of lecithin.  It is important to keep the breasts as empty as possible.  To soften the breast, I applied warm compresses about 5 minutes before putting E on the affected breast to nurse.  But nursing was not enough.  While he was nursing, I was massaging the plugs on the affected breast.  IT IS PAINFUL!!!  Yes - very painful.     Massaging is like kneading dough - I could feel the plugs getting softer as E was nursing while I was massaging at the same time.  Unplugging is not a piece of cake.  I was literally writhing in pain.  But it is important to keep massaging to "push" the plug towards the areola so baby can "unplug" it.

Usually, it takes E about 2 nursing sessions to remove the plug.  But the plug this case was bad that it actually took all night.  After about 3 sessions, the milk flow was faster and I could see a white bleb on my nipple.  I continued to nurse E all throughout the night and by morning, the plug was gone.  However, I could still see the white bleb.

By Friday night, the plug was back and it was bigger! No amount of nursing could remove it.  So I called Nanay Lita of IMA Lactation to help me resolve it.  However, until we could remove the milk bleb, no amount of lactation massage could take out the plugs.  So we had to remove the milk bleb and followed instructions here.  Once we released the bleb with a needle (which we soaked in alcohol for 5 minutes), Nanay Lita was able to release all the stuck and sticky milk.  Yes, it is painful but it must be done. (Edit: This method is also recommended by the La Leche League as provided in their tear-out sheet.)

Plugged ducts are an "extra challenge" that I will bravely face again to keep nursing my kids.  Is it worth it?  Seeing my healthy E growing each day definitely makes the sacrifice worth it!
Swimming in our bath tub with HN's Body Wash from Tita Rone
Do you have plugged ducts? What do you do to resolve it?

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