Help! Plugged duct or engorgement? (And why???)

[sarahsthreads]

I woke up this morning feeling like my left breast was one enormous painful lump, and it's easily two cup sizes bigger than the right at the moment. I don't *think* anything was off about our typical three nursing sessions yesterday, so I'm at a loss. And DD hasn't nursed on that side *all day* because it's so full and the nipple is so flat that she can't latch on, and she's doing that obstinate almost-two thing so I can't convince her to even try. I can manually express a little bit, but not nearly enough to get any relief. The pump was put away many months ago, so even if I thought it would work (doubtful, since I put it away after I could only get like 1/2 ounce in 30 minutes) I'd have to dig it out and sterilize it.

In the past when I've had plugged ducts they've been really close to the surface (more like a clogged pore, just with dried milk) and fairly easily dislodged. There's so much swelling right now I can't even tell where a plug might be. It reminds me totally of the day my milk came in, except we've been nursing for nearly 22 months and as far as I know I'm not pregnant - and even if I were, I'm assuming this wouldn't be caused by that.

Help, please? I've had mastitis once (7 months ago) and I'm terrified of repeating that experience. At least then DD was willing to nurse on the affected side. I'm sitting here with ibuprofin in my system and an ice pack on my boob, and no idea how to fix this. :(

Sarah

[jillc]

Hi Sarah,

Sounds to me like you need to work out a plug somehow ~ I always tried expressing in a warm shower in this kind of situation & it seemed to help. I kind of had to apply lots of pressure starting next to my chest & pushing towards my nipple.

Or like you said, you could dig out the pump. Such a pain to sterilize - I'd just pump & then get rid of the EBM if you're worried about it not being sterile. Tough to throw out EBM, I know, but I'd be more concerned w/the plugged duct & potential mastitis.

Try to get lots of rest & nurse/pump/express from that side as much as possible. I remember reading that a heating pad for 20 min after nursing/pumping/expressing was recommended in The Nursing Mother's Companion. I always did this instead of ice.

I hope things get better soon. If you develop a fever & chills, you'll probably want to get in touch with your MD if the symptoms don't subside within a day.

Take care,
Jill

[miki]

If your DD won't nurse, I think you really need to try every other way to move the plug along. As PP said, dig out the pump and try it even if it's not sterile. Massage in warm shower or after a hot compress from the outside in towards the nipple. And cabbage leaves are supposed to relieve engorgement as well. Good luck. I was very prone to plugs. I know they are miserable.

[xmasbabycomin]

IMO, it sounds more like engorgement, although who knows why. I think a plugged
duct is more localized, and if you feel like you did when your milk came in, well,
it's probably milk. When I'm engorged, I get a decent size hardness toward the outside of my breast, which at first I thought was a plugged duct. Usually it doesn't seem to happen for any noticeable reason. Sometimes breasts have a mind of their own!
Definitely go for massage, and if you can stand it dig out the pump. Pump and dump is a good idea from PP. Some people say alternate hot/cold

good luck

[sarahsthreads]

Thanks - I have no idea why I thought I'd need to sterilize the pump, since I wasn't planning on keeping the milk anyway. Silly!

Pumping did help a little. DD still won't nurse on that side, but I don't feel quite so...unbalanced. ;)

Sarah :)

[sarahsthreads]

Thanks, Lisa.

I'm leaning towards thinking it was engorgement. Things are much better today after pumping each time DD didn't nurse on that side, and I didn't see any sort of plug or thicker milk come out. There's a little soreness left, but the swelling has subsided for the most part.

What seems to be working for me is heating pad for 10 minutes/pump for 10 minutes/cold pack for 10 minutes.

Maybe tonight she'll finally consent to nurse on that side. I'm almost to the point where I'm ready to be done with this anyway, and since she barely nursed for 30 seconds on the other side at naptime before she said "close the milk!" (meaning close the nursing flap) and asked for a story, I'm kind of hoping she's almost ready to be done too!

Sarah :)

[sarahsthreads]

Cabbage leaves, huh? That must be an interesting aroma. ;) I was plagued with plugs for months 6 through about 12, and then I've only had maybe two or three since then. I still don't know if this was one or not, but at least it seems to be getting better.

Sarah :)

[jennifer13]

I just wanted to mention that my plugs were always pretty deep, and I don't know how you could possibly be engorged w/o missing feedings? Glad things are better. One great piece of advice an LC gave me was to bend at the waist and let your breast hang down so that the lymphatic system drains. She also recommended bending like that into a tub so you are soaking your breast, and also pumping while bending at the waist. I know that sounds like a lot of acrobatics, but it really helped me a number of times.

Oh and cabbage leaves definitely help but you have to be careful not to adversely affect your supply. Glad you're better!
Jennifer
Mom to Norah 5/23/03
and Leah 3/24/05