Mastitis? Plugged ducts?

I can’t tell you the number of times I have heard nursing moms say they have a “plugged duct” and are massaging it away. Or that they just need to press hard enough for the lump to move. Or that they bought a breast massage to “get it out”.

Unfortunately breast tissue doesn’t work like that. The breast doesn’t have isolated ducts like veins that are separated from each other. Pressing and pushing, massaging and “working out” a lump, clog or plug just doesn’t work. Breast tissue is more like a complicated spiderweb. It is absolutely impossible to separate one duct from another, they are all so inextricably woven together.

Since your ducts aren’t like that, what’s really wrong? Well, most of the time it’s not bacterial mastitis, if mastitis at all. Most of the time it’s inflammatory mastitis, antibiotics are rarely needed (and too often overprescribed and not effective since they weren’t needed). Frequently there has been a problem with feeding- a bad latch, pain, not emptying the breasts well. This feeding problem causes inflammation around your breast and that causes the pain, redness and swelling.

So what should you do when you get a lump or plug? Well first of all, be GENTLE! Start with ice, 20 mins on at a time, using a towel or pillowcase to protect your skin. Get rest if possible. Take anti-inflammatory meds like Ibuprofen or try Turmeric to decrease the inflammation. Don’t do any massage, don’t use an electric toothbrush or a breast massager, don’t ask your partner to massage out the lump. Keep breastfeeding, and don’t pump if you can avoid it. Most important, GET HELP WITH AN IBCLC!

Seriously, if you are having engorgement, plugged ducts, blebs, mastitis, or anything lactation related breast issues you need an expert, and that’s an IBCLC. Medicine changes, there are new studies, advances and understanding that we didn’t have before. You need an expert on your team that is up to date.