Clear + Prevent Clogged Ducts
Left untreated, clogs can cause mastitis. We usually assume mastitis = infection, but in fact mastitis starts as inflammation (may cause low fever <100.4°F, body aches, breast tenderness, etc). Prolonged inflammation (length of time varies by person) can lead to bacterial growth and infection. If you are concerned about an infection, please call your provider (OB/midwife/PCP).
The goals here are to…
Remove milk frequently, especially in any areas of congestion/clogs
Decrease inflammation & swelling to prevent recurrence.
Tips for Managing Clogged Ducts
Here is a helpful resource if you’re trying to decipher clog vs mastitis (and inflammation vs. infection).
It is very important to keep moving milk regularly. It is totally safe, even on antibiotics, to continue breastfeeding or pumping and feeding that milk to your baby.
If it’s an option for you, breastfeeding your baby is usually more effective than pumping at clearing congested milk.
TOP PRIORITY = Treat the swelling & inflammation with NSAIDS (ie ibuprofen/Motrin) and ice x10 mins to the breast a couple times a day. Tylenol may help pain, but will not address the underlying inflammation.
Gentle massage to the area during pumping/feeding can help move milk but avoid vigorous massage (see Note below).
Breast Gymnastics: a range of motion technique to help clear swelling - try this immediately before nursing/pumping
Dangle Breastfeed: Exactly what it sounds like - nurse or pump using the benefit of gravity to help draw the milk out
Lymphatic Drainage Massage: massage techniques to help clear swelling & congestion from breast tissue - this can be done a few times a day in between feedings
This is also something you can have professionally done by specially trained massage therapists.
If you are more of a audio/visual learner, consider this "Mastitis Rescue" course for $12: https://yourtwojugs.com/product/mastitis-rescue/ - This includes detailed explanations of what’s going on, what to look for, clogs vs mastitis and demos of the massage techniques above.
Choline: Lactation Hub (choline + pre/probiotic) | Life Extension (1 cap 2x/day or 2 caps 1x/day)
While our old notion of getting clogs due to "sticky" or "fatty" milk has been largely debunked, it is still true that this product - which helps dissolve fat into your milk more readily -- can be helpful in promoting milk flow and addressing or preventing clogged ducts. If you have an active or persistent clog, take 1 capsule 3-4x/day. For maintenance or prevention, take 1 capsule 1-2x/day.Traditionally we have used sunflower lecithin for this purpose, but what we know now is that sunflower lecithin works by breaking down into choline. Therefore, taking choline in a more readily available form allows your body to benefit not only from improved milk flow, but also a boost of a nutrient many moms and babies are somewhat deficient in and can benefit greatly from.
Therapeutic Ultrasound: Ultrasound can be used as a therapeutic tool to stimulate the tissue and essentially “break up” a clog a bit. Many physical therapy offices offer this (especially if they also offer pelvic floor or other OB/GYN specific services). Tricky clogs may require 2-3 treatments.
Liberty PT: Jersey City near Grove St PATH offers this and has gotten my clients in quickly
*Note* If you Google clogs and/or mastitis, you are likely to find a lot of recommendations of vigorous massage, heat, vibration, etc. This is outdated advice and we now know this approach is more likely to make the inflammation worse, leading to recurrence and a higher risk for an infection.