Plugged ducts: what you can be doing today to prevent them tomorrow

My friend gave birth to her second child three weeks ago. Breastfeeding has been going well for her, except for a bit of an over supply, for which she is working with a lactation consultant to correct. We made plans to meet at B.A.B.Y. Group yesterday. A few hours before, she texted me to let me know she had mastitis and wasn’t sure she would be able to make it.

This painful experience is very common in the first couple weeks of breastfeeding because the body is just figuring out how to regulate itself. I had mastitis twice while Leo was young (and then once again right after he turned one) and let me tell you: it knocks you on your ass.

Plugged duct on breast, red area with streaks

Plugged duct on breast with red streak

A plugged duct will make the breast feel tender, hot, swollen, or look reddened. There may be red streaks extending from the affected area (see picture). Sometimes you can feel the plug, like a small lump. In my case, I didn’t notice the plugs, so the the fever and chills seemed to come on at the same time as the soreness.

Overall, the care for a plugged duct is straightforward – get the plug out. This can be done by encouraging the baby to nurse frequently, while gently massaging the plugged duct and applying warm compresses. If a fever develops, this is a sign of infection, called mastitis. Call your healthcare provider to discuss your symptoms if fever persists. Get more details about mastitis from KellyMom.

Also important is to get lots of rest, drink fluids, and lower your stress level. If ever there is a time to call someone else to do the dishes, this is it (or just don’t do them at all, to hell with them!).

But how do you prevent plugged ducts to begin with? Two tips:

One is stress reduction (see above).

Two, is lecithin.

Lecithin is a natural emulsifier found in organ meats, red meats, eggs and other sources. Fittingly, the word “emulsion” comes from the Latin word for “to milk,” because milk is a combination of milk fat, water and other components that would normally separate. When liquids that would normally separate (like oil and water) combine, it’s called an emulsion. (source: Wikipedia).

Irene, IBCLC and the B.A.B.Y. Group leader, explained it this way: breastmilk is combined fats and water, which naturally separate. This is why, after breastmilk is expressed and left in the refrigerator for a few hours, a layer of fat will form on the top. Then the fat gets stuck to the outside of the bottle and you have to swirl it to get the fat off the bottle and recombine the liquids.

This same separation can happen within your milk ducts. Lecitithin helps keep the milk emulsified, which helps prevent the fats from sticking to the milk duct walls and causing a block. (“It’s like Pam for your milk ducts!”)

With an eye on cardiovascular health, most Americans consume less eggs and meat than we did generations ago, so we are not able to “…naturally produce enough lecithin to assist with the emulsification of fats in [our] blood stream and carry out milk duct cleanup” (Lecithin: It Isn’t Just for Plugged Milk Ducts and Mastitis Anymore,” Midwifery Today, Issue 76).

The journal goes on to recommend the granular form of lecithin over the gel capsules. The gel capsules are “…primarily designed for commercial use as an emulsifier in food, cosmetics, paints and so on. It is a bad-tasting, sticky material and consists of about 37% oil and only 60% phosphatides. This combination would add to the high dietary fat content that lecithin has to clean up in the body. Capsules are a high-calorie, low-potency supplement, but if a pregnant or breastfeeding woman cannot find granulated lecithin locally or has difficulty adapting to sprinkling granules on her food, taking lecithin in capsule form is far better than not taking it at all.”

You can find lecithin at most health food stores. For information on dosage, please see KellyMom.

My friend’s fever broke and she did make it to group. Lucky me because I got to meet her new little guy – an adorable little red head.


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