Squamish Physiotherapy Specializing in Pelvic Health & Chronic Pain
Text between Lauren and a client where she shares that the duct has resolved completely.

Blocked (Plugged or Clogged) Milk Duct Education Series, Part 2: Home & In-Clinic Treatment Options for Blocked Ducts

Blocked (Plugged or Clogged) Milk Duct Education Series: Part 2 of 3.

Home & In-Clinic Treatment Options for Blocked Ducts & Mastitis

 

Text between Lauren and a client where she shares that the duct has resolved completely.

 

 

 

 

 

 

 

If you suspect you have a clogged duct, and especially if you think you have mastitis, you should contact your health care provider to let them know. They will ask you some screening questions to determine the urgency of your case.

Therapeutic Ultrasound Machine used at Glow Physio

One treatment I offer that has helped hundreds of women is a painless and comforting treatment called Therapeutic Ultrasound. In most cases, the duct can be unblocked in 1-2 sessions. This is an evidenced-based treatment that is often recommended by maternity care providers in Squamish, who refer their patients to me for this treatment. I can also add therapeutic cupping, as well as acupuncture (with or without microcurrent/MPS), to further enhance the treatment. 

What can you do to get started right now? :

Brigham and Women’s Hospital Standard of Care states that “Ultrasound has been shown to be of benefit in the treatment of blocked milk ducts.”

La Leche League offers the following advice when you suspect a clogged duct:

  • Breastfeed as often as your baby wishes
  • Rest
  • Apply ice or cold packs to the tender area
  • If you are engorged, consider doing lymphatic drainage—a very gentle, light yet firm touch, with fingertips flat to the skin in the armpit area and upper chest. To see a demonstration of lymphatic drainage massage, you can watch this video
  • In consultation with your healthcare provider, consider using ibuprofen (Advil®) alternating with acetaminophen (Tylenol®)

There is also a supplement called lecithin (available at Nesters in the Wellness Department) which is often prescribed to women with blocked ducts. Brigham and Women’s Hospital’s Standard of Care states that “the milk secretions that remain in the breast from blocked ducts have a very high fatty composition with a higher rate of absorption. Lecithin is a phospholipid emulsifier and can be used to emulsify milk secretions to promote breast emptying. The typical dosage is 1200 mg/day 3-4 times per day.“ Please speak with your medical team regarding any supplements.

Hydrate more than usual and rest when you can!

In writing this blog post, I learned that some common advice is now OUTDATED!

La Leche League updated their post on this topic in 2023 to say that the following strategies are NO LONGER recommended:

  • Heat to the breast, or soaking in warm water
  • Vigorous, deep massage, or squeezing to try to get rid of a clog
  • Dangling over baby for feeding to try to move a clog using gravity
  • Using a comb, vibrator, or electric toothbrush on the breast
  • Trying to “empty” the breast through extra pumping or breastfeeding which increases milk production
  • Using antibiotics right at the beginning of symptoms
  • Using Epsom salts in a Haakaa or similar silicone breast pump for nipple blebs
  • Using saline soaks, warm compresses, olive oil, castor oil, or other oils on the skin of the breast or nipple
  • Removing the skin or “popping” a bleb, which may allow infection to develop
  • Routine sterilization of pumps and household items is not necessary, although daily cleaning according to the manufacturer’s instructions is important to avoid infection from dirty pump parts.3 For more general information see this fact sheet.

My next post will outline evidence-based tips on how to prevent mastitis:

As mentioned previously, in Squamish, we are fortunate to have an exceptional group of practitioners to help with lactation questions, including the new collaboration between Mountain Maternity and Roots Midwives, and Anna Turyk of Nuture Sea To Sky Lactation Consulting Services. La Leche League Squamish is also an excellent resource. 

Strategies to treat and prevent clogged ducts, including treatments I offer in the clinic, are coming up in the next post!

Image of milk ducts with showing how inflammation and skin redness can present.

Blocked (Plugged or Clogged) Milk Duct Education Series, Part 1: Blocked Ducts Vs Mastitis

Blocked Milk Duct Education Series, Part 1 of 3.

Blocked Milk Ducts Vs Mastitis:

Image of milk ducts with showing how inflammation and skin redness can present.
Inflamed Milk Ducts

A plugged (or blocked) duct often comes as a surprise to most lactating mums. It is an area within the breast where the flow of milk is obstructed. This can occur at a nipple pore (known as a milk blister) or it can be further back in the ducts. It tends to affect only one breast and often comes on gradually. You won’t likely feel other symptoms, but a low grade fever (less than 38.5 degrees) might be present.  

La Leche League states that “blocked milk ducts occur when milk is unable to flow through easily. You may notice redness, or feel a tender spot or a sore lump.”

Kellymom adds that “the location of the plug may shift. A plugged duct will typically feel more painful before a feeding and less tender afterward, and the plugged area will usually feel less lumpy or smaller after nursing. Nursing on the affected side may be painful, particularly at letdown.”

Mastitis (inflammation of the breast) happens when a blocked duct doesn’t clear and causes localized swelling and inflammation. La Leche League adds that “It is also possible for the breast to become infected .If you have mastitis, you may have a higher fever (likely above 38.5) and may feel like you have the flu.

La Leche League notes that you are more likely to develop a breast infection if you stop feeding from a breast that already has a blocked duct or mastitis. They say that “your commitment to breastfeeding [or breast-to-bottle feeding – author’s note added] your baby can be truly tested at times like this, especially when putting your baby to the breast may be the last thing you feel like doing. However continuing to breastfeed frequently is part of the solution and stopping suddenly is likely to make the problem a great deal worse.”

It is crucial to address engorgement and blocked ducts as soon as possible to avoid the progression to mastitis or even an infection, and be sure to address any possible causes.

Always contact your health care provider if you have concerns about the possibility of mastitis.

In Squamish, we are fortunate to have an exceptional group of practitioners to help with lactation questions, including the new collaboration between Mountain Maternity and Roots Midwives, and Anna Turyk of Nuture Sea To Sky Lactation Consulting Services. La Leche League Squamish is also an excellent resource. 

Strategies to treat and prevent clogged ducts, including treatments I offer in the clinic, are coming up in the next post!

Lower Back and Pelvic Pain and Pelvic Floor Dysfunction – What’s The Connection?

These two people might have more in common than they think.

If you have chronic pain in your lower back, hips, or pelvis, your pelvic floor might be trying to get your attention. A 2018 study¹ by renowned Canadian Pelvic Health Physiotherapists Sinead Dufour, Brittany and Carolyn Vandyken, and MJ Forget examined the pelvic floor characteristics of women seeking Physiotherapy for lumbopelvic pain (lower back and/or pelvic girdle pain). 95% of the women in the study who had lumbopelvic pain also had signs of pelvic floor dysfunction (as evidenced by tenderness, weakness of the pelvic floor, and pelvic organ prolapse). Of the participants, 71% of the participants had tenderness when their pelvic floor muscles were examined. What this means is that the participant had excessive activity of these muscles, or an “overactive” pelvic floor. 66% of the participants had weakness in their pelvic floor muscles, and 41% had a prolapse.

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Urinary Incontinence

According to The Canadian Continence Foundation, around 10% of the population experiences incontinence, or leaking urine without meaning to. Although it is common, it is not normal, and Pelvic Floor Physiotherapy is the first line of defense. Since there is a solution, you do not have to accept it as part of your life.

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