I started to feel my right (the "go to" boob or the meal boob. the left one is just the snack/grazing boob) breast get full at oh say 9 am on wednesday morning. I ignored it (an obvious mistake) thinking - my pump session is the next hour. it can wait. In hindsight, I realized I should have just gone and pump. you see, that morning I didnt nurse Jax on that side, like I normally do (another mistake). and nursed on the left one since it usually is neglected (but with no subsequent problems).

it was obvious that i had a clogged duct because unfortunately, its something i have already experienced and thus, should have known better. but when have i ever listened to my body or paid attention to the pains it has and done something about it? never. unless of course you count that time i was in labor. in case you dont know and have not experienced it (and i hope to god you never do) a clogged duct is when one of the milk ducts in your breast gets blocked and inflamed, and the milk cannot flow regularly out of the breast. The signs of a clogged duct, in my case anyway, was that some of my breast (the top part) remained hard and tender with lumps closer to the nipple (i have had the lumps in different areas and even under the arm pit - which is way more painful), that remain even after nursing or pumping. Nursing was, IS, painful but for me it was that - hurts so good kind of feeling.

one order of razor blades to the nipple please

So, how do you go about unclogging the ducts? the usual, most widely given remedy is to nurse, nurse, nurse - did i tell you how it was sorta painful? yeah, well its like razor blades. it also helps to place heat on the affected breast, or take hot showers/baths and or (almost forcefully) massage the breast while nursing or taking the hot showers/baths.

i did the hot showers AND the hot baths. hot compress, pressure massage, nursing then pumping, and more nursing and pumping and even more nursing - but i could only do these remedies properly while at home. at work? well, its just difficult. it has been 2 days and while it isnt AS bad as it was, its still not good. i know for a fact that, if i were at home instead of at work, i think i would have recovered by now, since ultimately pumping is NOT the same as nursing. no matter how great (and expensive) your pump is, it can never beat nor completely mimic your baby's sucking ability. oh and by the way, on top of all this - yesterday, probably due to a lot of side lying position nursing and other wacko nursing positions to relieve this - i have a wicked stiff neck.

since i am not the type to panic and knowing from a previous bout with a much more progressed clog (got chills, then a slight fever and other flu like symptoms. which are signs of infection!! BAHHH. having had a full day of rest - no work - and only nursing, i fully recovered after 72 hours.) i feel like if i just continue with what i am doing it will just run its course. ive been getting lunch time nursing visits with jax in order to speed up the recovery process but thank god the weekend is just about here so all i can do from 5 pm on today is rest and nurse, nurse, nurse!

one order of a paying job equals a clogged experience?

Clogged ducts will occur when your breasts arent drained completely and or properly (aka, the dreaded poor latch). some other causes are:

• an improperly fitted or poor quality bra (esp. one with an underwire)
  
• breastfeeding infrequently - missed or skip feedings, or irregular breast feeding schedules
  
• sickness and or stress (tell me mamas, when arent you stressed?)
  
• employment - yes, employment, meaning a job outside of the home (is this punishment?).
  
  From La Leche League - "Women employed outside the home need to be aware of the warning signs of mastitis, especially when they first return to work and are adjusting to the demands of work and motherhood. Separated from their babies, they need to pump regularly to avoid overfull breasts, plugged ducts, and possible mastitis. In addition, employed mothers need to schedule their days to allow adequate time to rest and care for themselves as well as their babies."

I hope you never have to experience a clogged duct, but if you are a breast feeding mother with an abundant supply, chances are you will have a few (yes, i said a few. especially if you are a working mom). Here are some things you should know and or can try:

Heat - you can use a compress, soak in a hot bath or take a hot shower, and or place a heating pad on the affected breast. Heat will help bring blood to the affected area and warm and loosen the clogged duct. No heat pad? dont worry, there is no need to buy a specifically made heat pad for the boob (but if you are inclined to buy those, you can find one here and here) you can do the following if you dont have a heat pad or hot water bottle -

1. you can make your own heat pad by filling a regular tube sock (clean ones preferably, unless you want a little flavor with yours) with uncooked rice - fill to the desired pliability and then sew the end up. You can put this in the microwave or oven (wrap it in foil for the oven NOT the microwave of course) OR place it in your freezer or fridge as well for cold use. You can also add essential oils or herbs for some soothing aromatherapy.

2. If thats not your thing you can also just fill a small mason jar (or any small type jar with a good lid) with hot water (not too hot so you dont burn yourself!) and use it to roll and massage the affected breast. I also just tuck it into my bra and it stays in place no problem. in fact, one is situated in my bra right now.

Massage - massage the clog and work your way toward the nipple. You should feel a hard or lumpy texture where your breast is clogged. It will hurt a little or a lot to massage and put pressure, but keep working at it. start behind the clog or hardened tender area and move on down toward the nipple.

Nurse and or pump - the idea is to keep milk flowing despite the clog. You want the breast to be as empty as possible, so it doesn't create more clogs or complicate the one you already have (if left untreated, it can lead to an infection). Try nursing and then pumping afterwards and nursing in different positions too - one way is to lay the baby on his/her back and you on all fours so that your boob dangles straight down into his mouth - yes, what a funny sight if someone were to walk in on you. Some sources say it helps to have your baby nurse with their chin toward the clog. yeah, i know. if this were the case, id have to hold him upside down! i know all of this sounds crazy, but once you have found yourself with a clogged duct - you will be searching for that magic cure out there anywhere by any means possible. like lick a tootsie roll upside down while singing twinkle twinkle little star? sure, so as long as it relieves the damn pain! (that is not a known remedy by the way - but it may have your baby go into a giggle fit)

you can also take tylenol or ibuprofen to bring down any inflammation or help alleviate some of the pain. i am always hesitant to take any sort of drugs (such a change from my earlier years - before kid) but even my midwives, who i trust dearly, have said that it is ok to take ibuprofen. i personally dont like tylenol as it has never relieved anything. both are said to be safe for breastfeeding.

for repeat offenders, some sources say taking lecithin helps to reduce clogged duct recurrence. Soy lecithin is a naturally occurring fatty acid and a common food additive. There are no known contraindications to its use by breastfeeding mothers. the usual recommended dosage for recurrent plugged ducts is 3600-4800 mg lecithin per day, or 1 capsule (1200 mg)3-4 times per day. After a week or two with no blockage, you can reduce the dosage by one capsule. If there is no blockage within another 2 weeks you can reduce it again by one. though you may need to continue taking 1-2 capsules per day if stopping the lecithin leads to additional plugged ducts. for more info on this subject look here.

so after all this, don't expect the clog to come right out. but if you keep working at it, eventually it will. It can take 2 to 3 days and, sadly, ive heard that it can be as long as a week. BUT if you spike a fever (or experience a low grade fever), experience body chills, and or have flu like symptoms or your the affected breast seems to be getting worse, by all means call your doctor! If nothing helps and you just want some relief (for both body and mind) - PLEASE call your doctor! or at the very least a trusted lactation consultant.

that said, clogged milk ducts are just part of the joys of breastfeeding (feign fake smile).

for more information on clogged ducts and mastitis please visit these informative sites:

kellymom

la leche league