An alternative approach to plugged ducts and mastitis
Anytime I’ve told somebody that I have an oversupply of breastmilk, I always get responses like, “you can’t have too much of a good thing” or “that’s a good problem to have”.
Those are half truths. But they also don’t make anyone feel any better. Yes, it’s true I have sufficient milk to feed my child, I am SO thankful for that. I can be thankful for what I have and still be frustrated with the consequences of what I’m experiencing. Even though I attended breastfeeding classes while pregnant, met with an IBCLC and read books on breastfeeding, I still didn’t fully understand the consequences of allowing my breasts to be fully engorged until it was too late.
Milk supply is a dynamic process so I hesitate to claim the “oversupply” title so directly. My child breastfeeds a lot. Then on some days, he breastfeeds less. It may take a couple days for my supply to catch up or to change my pumping schedule on the days I’m working. In the first 3 months postpartum, a new mom’s milk supply fluctuates drastically as the body adjusts to baby’s needs. I’m doing my best to be flexible while also meeting the needs of my child (and that means breastfeeding for more than just hunger. After all, 'I gave birth to a baby, not just a digestive system.’). As I’ve learned through The University of Motherhood (don’t you wish that was a thing?!), I gradually figured out how to adjust my feeding routines to reduce or increase my supply as needed.
Long story short, I’ve had plenty of opportunities to get plugged ducts and mastitis. Working so hard throughout preconception, pregnancy and postpartum to build and maintain a healthy microbiome for myself and my baby, I wanted to do my best to avoid using prescription antibiotics at all costs. I’m not against them if they are necessary, medicines always have their place, but if I can clear the infection before they’re needed then it’s a win-win: I’m out of misery and we both get to retain our healthy microbiomes.
There is only 1 time out of the 10+ times I experienced mastitis that I chose to take antibiotics and it was when more than 50% of my breast was red and there was no sign of the infection clearing after 3 days, despite these efforts.
Sometimes people wonder: if breastfeeding is a natural behavior then why would someone get mastitis so many times?
It’s worth noting that my work schedule had made my pumping/breastfeeding schedule pretty erratic and in hindsight, I wish I had known there was a limit to how much you should pump. I previously would try to pump until empty (hint: it never happened, which is why I had so many plugged ducts). With my second child, I worked from home exclusively and had more flexibility with when I could nurse him and I never got pumping-related mastitis again (though I did get it 3 times in 1 week when I was 1-2 weeks postpartum after wearing a bra that was apparently too tight and after sleeping on my side for too long). Milk supply in the initial weeks is no joke.
Disclaimer: I recognize that I am not the top expert but many of these recommendations were learned from the experts: Naturopathic Doctors (ND), midwives, IBCLCs, herbalists, etc. I share these only to share what worked for me and the other mamas who I’ve shared these tips with. Please fully educated yourself and consult consistently with an educated holistic healthcare provider or IBCLC before taking any medicines (natural or not) or drastically changing your milk supply. The following are strategies I have personally followed to clear plugged ducts and mastitis.
My most recent bout of mastitis, caused because my 11 month old (at the time) came to the realization that solid food makes him more satiated than breastmilk :)
Plugged milk ducts
A plugged duct (also called blocked duct) occurs when milk flow is cut off, like creating a dam in a river. The breast tissue where the block exists typically feels tender, warm, and lumpy. Clearing the duct is essential to preventing mastitis. This may sound like a lot of work but with
Rest!
but balance with micro movements like range of motion, gentle massage and others listed below
Minimize pressure on the breast
Wear loose fitting bras/avoid tight bras
Avoid sleeping on the belly
Avoid wrapping baby too tightly to the chest
Use the correct size flange for your breast pump if pumping.
Avoid pumping “too hard”. This is what caused most of my bouts of mastitis: I was in a rush at work and turned up the pressure on the pump. Trust me, whatever is rushing you can wait. It’s not worth the risk.
Stay hydrated
Cut down on caffeine (coffee and tea are the biggies) or at least make sure to rehydrate
Drink enough water or herbal teas (obviously ones that are safe during breastfeeding)
You may need electrolytes especially if you are following a lower carbohydrate diet. You can order some here.
Your baby is your best helper
The closer the lower jaw is to the plugged duct, the more likely it will get unplugged.
Vary nursing positions. See a how-to video here.
Use Contrast Hydrotherapy
Only heat it while you’re nursing or pumping because heat can increase flow (and thus production). Use cold to slow the flow once you’re done nursing or expressing milk.
Warm compress, bath or shower 10 min, frequently throughout the day
Contrasting compresses: freeze grated potato then put that on the plugged duct(s) immediately after a bath/shower/hot compress. Allow your body to heat up the frozen potato then remove and apply heat. Alternate for at least 24 hrs or until the duct clears. (The grated potato helps draw out the inflammation and loosen the rigidity of the duct. Potato also holds on to cold temperature well like cabbage leaves but doesn’t directly decrease production like they do.)
Adjust milk supply, if necessary
Block nursing to decrease supply: Nurse from one side for 3 hours then switch to the other side. It’s all about feedback inhibition: if your breast is full, it will signal the body to decrease production. On that note, if you keep pumping, you will continue producing excess. So there’s a fine balance between allowing your breasts to stay full enough to signal slower production but not too full that it promotes plugged ducts.
Cold Cabbage leaves can be used to decrease supply but they can work quickly so be mindful to only use them as necessary. I once used them while alternating heat for 24 hours and saw a significant reduction in my supply, which was desired but also shows how powerful they are.
Herbal Remedies /Supplements
To support lymphatics, milk flow, milk thickness, and immune response.
Herbal tincture: “Happy Ducts” by Wish Garden, promotes lymph flow. 2-3 droppersfull in hot water 3-4x/d
Galium (Cleavers) tincture 1 tsp 3-4x/d. I recommend the Wise Woman Herbals brand, offered in my online dispensary.
Vitamin C- 500 mg 3x/d or to bowel tolerance. I use liposomal Vitamin C for better absorption and less impact on bowels (offered in my online dispensary).
Colostrum- 2 capsules/d (offered in my online dispensary)
Homeopathic phytolacca and phytolacca infused oil topically
Sunflower lecithin may impact the viscosity of the milk, possibly reducing recurrent plugged ducts though it may not do much in terms of treating an already plugged duct. For prevention: 3600-4800 mg lecithin per day or 1 capsule (1200 mg) 3-4x/day. You can purchase one through my online dispensary here, categorized under the “women’s health” favorites.
Manual Therapy
Massage gently from the sore area toward the nipple
Use a dry skin brush to promote lymph flow. Watch a tutorial here.
Cupping may prove beneficial for helping to clear the plugged duct. Work with a trained provider (acupuncturist or massage therapist). I recommend Thrive Integrative Health locally.
Mastitis
Milk stasis can occur if flow does not resume promptly after the duct has become plugged. Just like a body of water that remains still with no inflow or outflow of water, bacteria from your skin can enter the duct and stimulate flu-like symptoms. You may feel like your life is ending, I know I did. The headaches, joint-pain, fever and weakness were so debilitating, I could hardly get out of bed. This is the body’s way of making you rest, so listen!
This is the protocol I used:
Work diligently to clear the plugged duct
20-40 drops echinacea tincture 6x/d. For prevention: 10-15 drops 2x/d for at least 5 days. You can purchase one through my online dispensary here, categorized under the “women’s health” favorites.
Allimax (concentrated aged garlic extract) 2 caps 4x/day (found in my online dispensary) has also been extremely helpful as an herbal antimicrobial
Inflammation is necessary to fight an infection, but sometimes if the bodyaches and headaches were too intense for me to sleep, I would take Anti-inflammatories like ibuprofen and/or curcumin at therapeutic doses, please use with caution.
Pulse Electro Magnetic Field (PEMF) Flex Pulse on continuous mode at 10 Hz, applied to the site of the plugged duct
In the past I had used essential oils topically but, understandably, they cleared my skin microbiome so effectively that I cleared mastitis but it become an opportune environment for fungal overgrowth to occur. Within a day of recovering from mastitis, I would experience severe itching on the breast that I had used topical essential oils. I personally have relied solely on the Allimax internally for antimicrobial needs since then.
Closing Thoughts
I don’t wish mastitis upon any woman. Though, I imagine if you’ve made it this far, you’ve needed these suggestions and you’re not just reading it for pleasure. I’m sorry.
Every day I’m working with mamas-to-be and new mamas to optimize health and minimize illness. Nutrition can be a major piece in the wellness puzzle. If you think our philosophies might be congruent and you’d like to work with me, consider scheduling an appointment. If you found this article helpful, please share in the comments below what tips helped most and share this post with a mama in need.
