Continual Blocked Ducts

Hi There,

I need help! My son is 6 weeks old and I've had mastitis twice (verging on a third dose now!). I was hospitalised the first time as it was so severe. My right boob is the only side affected and the tissue is rock hard
on the inside of the breast (as in the clevage side...) and on top of the breast. It just feels like one big hard mass. When DS feeds, the outter and under regions are soft and empty. I've had an ultrasound and it showed many blocked ducts and for two weeks I've used hot wet washers prior to a feed, massaged with olive oil during the feed and still I cannot for the life of me get rid of these lumps!

I've been on Flucloxacillin twice now and each time the dose ends (usually 10-12 days), within a day or two of finishing the dose, the redness and streaks reappear and the pain is awful, obviously because the ducts are still blocked. I've had a private LC visit and she said my attachment is fine. My bra's are fitted properly and I sleep on my back. He feeds between 6-8 times a day. I'm about to try physio ultrasound this morning but is there anything I'm missing? Will this ever resolve? It's really starting to affect me and I don't want to wean (as I fed my first DS for a year!) but I can't continue to be on antibiotics and be in agony all the time.

Thanks so much in advance for any advice!

:hug: you poor thing it sounds awful.

I'm clutching at straws here (and not an expert by any means) but is the blockage around where your seat belt sits in the car?

I had a couple of blocked ducts which took forever to clear. I found cabbage leaves in my bra worked well (no idea why). Also, if the blockage is still there when you're finishing the a round of AB's you should get a repeat and continue taking them until the blockage has cleared otherwise it will get infected again. From what I've heard the ultrasound treatment works really well for clearing blockages.

GL, you're doing an amazing job! Hopefully Barb or Manta will pop in soon and be able to offer you some better advice :hug:

Miss E - thanks for your reply. The seat belt sits well above the sore area and I've barely been driving lately as I live in walking distance to local shops, lake, beach etc. I'm also careful with my bra's that they fit ok and I go bra-free at night :-)

Do you feed lying down at all? Sometimes I find that drains the upper ducts better. I also found I would get blockages in my cleavage because my breasts were pressing against each other in my bra/clothes. Can you go bra fee? and wear loose clothes?

ouch - I feel your pain! I got mastitis 5 times in a matter of 2 months and was in agony. In the end I did wean but my DD was 6.5 months and there were many other issues too. I know how upsetting it is when you want to feed your baby but you are just in sooo much pain.

I found cabbage leaves worked well too - I resisted but once I did it was such relief - I literally cooked them on my BB's. Cause I was so hot the green leaves wilted and turned white very quickly. It didnt make the blockages go away but did provide relief between feeding. I also tried every different hold whilst feeding too and one night in desperation I sat on the pump for 2 hours and pressed on the blocked ducks and put hot and cold packs on me whilst I was reading bellybelly! For an hour nothing happened and then suddenly RELIEF!!! I had milk pouring out and this continued for about 45 minutes

Goodluck with the physio, I had heard bout it too but didnt know where to go. My GP said I would need surgical drainage or be on IV antibiotics in hosp if my last lot of antibiotics didnt help.

The nurse told my DD last week to do the hot face washer before a feed then a cold one after. Also buy a cabbage, wash the leaves then take a leaf, cut out the area that touches the nipple and place on the breast.

Thanks for the tips on the cabbage leaves. I used them to relieve the engorgement a couple of weeks ago and my boobs have certainly calmed down somewhat (whether or not this was the leaves or the magic of time!). I'm hesitant to use them too much as I know they drop your supply.

The ultrasound at the physio has certainly lessened the hardened area however the red streaks and pain (and heat) is still there. I'm wondering if I have an infection??? I finished my last antibiotics on Wednesday, so I've been off them for three days. Arghhhhhh

Arcadia, thank you - I usually feed cradle hold, change nappy, football hold and sometimes at night I'll feed lying down.

By the sounds if things it us still infected or has become reinfected. I'd go back to the gp for more ab's and keep them up until the blockage is completely gone. Also keep up the ultrasound, by the sound of it your blockage is quite large and set in so it will probably take a few treatments to clear it. HTH

Hugs hun - I feel your pain (mastitis x4 including a hospital visit). Don't forget your probiotics!

I had to go to physio 3 times to fully get the lump out. I was expressing full time so didn't have the help of a baby sucking the blockage. So hang in there, but if you think you're getting sick again get on to it quickly. Will the dr give you a spare abx script in case you get sick at a bad time?

Incidentally, I was told football hold can cause drainage problems.

Good luck hun. xo

Surprised you poor thing! I also went to hospital for a two night stay. Not much fun. I had a script made up and carry them close at times like this. I haven't started taking them though yet as I have no fever or flu symptoms. At the moment it's just the lump and red marks. Did the physio work for you in the end? Did you end up carrying on feeding or was it too hard? I'm getting physio on it again on Monday and hoping that is enough to break it right down. It's fun isn't it! haha

Thanks all for your replies. Very much appreciated :-)

Hi hun

Physio worked a treat in the end! And I carried on expressing - after the 4th time I gave up even trying to breastfeed and just stuck with expressing. Finished up just before DS turned one.

Hope this current lump/redness doesn't get worse!

And don't those IV abx hurt when they're getting pushed through?

Hi Powelly,

When I had trouble with reoccuring blockages/mastitis I found the physio ultrasound was brilliant! I would go consecutive days, at around the same time each day (eg first thing in the morning) until the everything softened. I never needed more than 3 days in a row. Hope it gets better for you soo! :-)


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I get blocked ducts several times a week. The only thing that works for me is to apply a heat bag. I'm not sure how this would work with and when attaching a baby because I exclusively express so I can just pop it on whilst pumping. I tried everything else to get rid of it to no avail.

Powelly - credit to you for persisting with the breastfeeding.

This is probably a long shot, but it's my expereince with a blocked duct. I had what I thought was a blocked duct on the outside of my right breast. I was getting knife like pain in my nipple when my daughter attached, and the ducts on the outside of my breast were engorged, painful and red. What it ended up being was a small blister on my nipple where the engorged ducts emptied. I found it by looking closely at my nipples for any dry milk and I noticed a small (1mm) clear abnormality. I used a sterilised pin to pierce the skin, and then sat braless with a cup under my nipple to allow it to drain. I collected about 5ml of clear fluid, and when it stopped, I then fed my daughter. The blockage was gone instantly (with much relief). It took about three days to clear up (drained the blister each morning) and for the pain in the nipple to go away. I have no idea what caused it and it's never returned.

Good Luck - I hope you get some relief soon, I admire your persistance.

Hi and well done for persevering. I had mastitis 8 times when BF DD1 (total of 23 months) first time being at 2 weeks because of a tongue tie. After that resolved I don't know why I kept getting it (I think working had a bit to do with some of it as couldn't always pump when I wanted to).

Anyway sounds like you are doing everything you can. Things that helped me apart from what has already been mentioned - feeding baby while being on all fours, baby lying flat on a bed or something. Gravity I think helped drain the areas that couldn't be fixed with massage etc.

Also using an electric toothbrush gently on boob while feeding baby, the vibration seems to help clear the blockages.

I'll come back if I think of something else. Hugs, hope you can sort it out you poor thing!

To clear a blockage you need to get that boob empty. This means feeding bub and then pumping or hand expressing until empty. Use a hot pack beforehand and a cold pack afterwards.
And don't let the other side become over-full either - hand express that one as needed.

The ultrasound works really really well. And weaning at the moment would be a very very bad idea - as it will only lead to more and more blockages.

Over the next month or so it should settle down as your supply settles down - at the moment you have more milk than bub can drink, but that should change over the next little while.

hang in there!

Hi,

What you are suffering seems to be more in the realms of bad luck and management. Once you learn the ropes of preventing and treating it doesn't need to re-occur. There is no need at all to wean, and weaning in the midst of this is really not a good idea.
I think, at the moment, you might need to go back to the doctor for reassessment. And you might need another course of antibiotics now. And get your doctor to check that there is no abscess. Now don't be alarmed, it can be treated. it is important to keep your breast as empty as possible. Many mothers find that their milk supply in the early days is a bit more than their baby can handle. If your breast becomes uncomfortably full, then pick up the baby and feed him, but if he is full or asleep express some milk until your breasts are soft and comfortable

Thank you Barb for the reply - may I ask when the supply tends to settle down? I was originally told by 6 weeks and I'm past that and still no closer. DS is feeding on one boob only per feed as there is so much milk so each breast is only fed on once every 6 to 7 hours approx. I haven't been expressing as I was worried this would tell my body to keep producing the same amount of milk? It's very confusing.

Is there a way of lessening the supply or do I just have to struggle with this until they are no longer as full or he is taking more? He is putting on 150grams a week so is getting plenty of milk. I only have the problem in my right boob.

For most people supply settles down between 6-12 weeks. Mine took 5 months though and I often had blocked ducts in that time.

Hi Powelly, You sound a little *over it*. But, really, it is just like any other health and wellbeing problem. Often in these cases you need to try a few different approaches until you get the right solution for you. After all, people's bodies all act a little differently, even thought the principles are the same. As an aside, I have recently hurt my back. One health professional is suggested rest and icepacks. The other advised me to take pain relief, use warm water and keep moving. So it's just not breastfeeding. I don't see it so much as conflicting advice, as try one, then the other - see what works.
I would suggest that you feed your baby one breast, then offer the other - it might be just enough to take the edge off. And then, next time, feed him from the breast he *had a bit off* and then offer him the other. You aren't much over 6 weeks. Still the very early days. Pretty soon he will take both breasts every feed and your breasts will feel soft and normal. At this point your milk production is still relatively driven by high prolactin levels, which is normal, so if you feel your breast is uncomfortably full wake up your baby and feed him or express a little for comfort. Relieving the engorgement is the highest priority

Thank you Barb and everyone else for your posts. I really appreciate the advice and tips. I'll be continuing on with the breastfeeding as I had always intended to do. If it turns out I'm in agony for the duration then so be it. Better me than him and at least he's getting the good stuff.

Hi,

You are closer to comfortable painfree breastfeeding than you know. You are doing the right thing. Try offering both breasts (even if he just takes a bit out of the other) Breastfeeding is something that should be comfortable and enjoy, not something to suffer through!

Well it seems the medical profession had it wrong all along. After 6 weeks of agony, three ultrasounds and trying many different things to clear up my "blocked ducts", it was discovered that I actually had a breast abscess. Unfortunately after two lots of needle drainage at the surgeons rooms, it's not improving so I get one more shot on Wednesday and then if all else fails, will be having surgery on Thursday.

The doctor called to apologise, which was nice, but doesn't help me now. I have no idea whether I can breastfeed after surgery, (a) due to general anasthetic and (b) due to the incision which will be at the edge of my areola.

Gutted much! I can't believe this is happening.

Talk to the anaesthetist - the general should not be a problem (at least after you wake up). Lots of Mums have generals for Caesareans and BM shortly afterwards - and their babies are smaller and would be getting a bigger relative dose than your DS.

It is totally possible to BF from one side only. Once the incision heals that side should be usable too.

The biggest challenge that I can see would be preventing blockages in the side that is being operated on, if it is too sore to feed from. I would ask the surgeon about that before you have any surgery.

Powelly - well done for perservering.

what a relief to finally know what is actually going on! ABA has a booklet called 'breastfeeding and hospitalisation'.

It seems it is important to let your carers know how important breastfeeding is for you. If you do need to have surgery, you can express and store some of your milk (eg for feed while you are under general anaesthetic). If your supply drops, frequent fees will help boost it again. Def talk to the anaesthetist about a drip to keep your fluids up. The booklet says that when you wake up from the general the biggest issue is your woosiness or nausea you may get (you can bf though) so you will need the support of someone to be with your baby. And to cosleep while your are under the influence of medications is not advised. Is it possible for your baby to be admitted with you? or visit frequently? You can arrange to bf just before surgery, and again soon afterwards.

I hope it all clears on Wednesday (xoxox)

Don't forget you can call the breastfeeding helpline to chat about your options, or even to find some reassurance.

xo
Catherine

Hey powelly
My attention was brought to you post and I thought I would let you know my story.
A growth was found on my nipple when dd2 was 2 weeks old. It continued to grow rapidly and surgery was booked for when dd2 was 4 weeks old.
So I told both the surgeon and the anesthetist that I am bfing and will continue to do so. They gave me minimal drugs and I fed as soon as I was out of recovery. I then gently hand expressed every feed from the injured boob while dd2 fed from the good one. After about two weeks I started to feed from the bad boob with no problems. The supply was a bit less than the good one but we still made it to 15 months bf'ing.
It is possible, you just need to be determined, and it sounds like you already are (and she didn't need any formula in that time either.) If you want to ask any questions feel free to pm me.


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Hi Ryatha,

Thank you! That's the type of motivation I need right now. I want to continue to BF (after all this, I'm not bloody giving up)!!!. I'm scared about expressing! I tried to PM you but it said your inbox was full.

Hi,
No wonder you were so low - you have had a very difficult time.
There's no reason why you should have to stop breastfeeding because of this. I know several mums who have continued to breastfeed after an abscess. The anaesthetic will prove no problem (and if anyone suggests it will then remind them that mothers are routinely encouraged to breastfeed after a c-section under general anaesthetic) Ask the surgeon to be careful not to damage the other ducts. You should be able to feed straight at the breast. If the incision is left open and packed then it can be messy but the milk will help the healing process. Good luck, and call in here to let us know how you are going and get support.

Hi Barb, thanks again for your support and help. Is it safe for him to feed on the open incision? Would he take in the blood/pus etc? And will it hurt a lot? Sorry for the questions, I guess it's just better to go in knowing what it'll be like.

Sorry, just cleared my inbox...

Hi,

from what mothers tell me, it's not painful, and there's not much puss or blood involved. Just milk leaking out of places it doesn't normally

Hugs hun. What a horrible thing you've been through! You're amazing for persevering!

Just wanted to let you know there is an exclusive expresser's thread here full of women who know waaaay too much about expressing LOL! So if you need any advice on that front jump over and we'll do our best. I wonder if the hospital might put you in the maternity ward for recovery so you'll have access to the good hospital-grade pump and lactation consultants? I was in hospy with mastitis and ended up (luckily) in maternity and it was helpful.

But hoping you can avoid the surgery! I'm guessing you've already tried physio ultrasound? oxox

Hi to all you lovely ladies.

Just wanted to give you an update. I managed to evade surgery!!! I had a total of 4 needle aspirations by my very supportive and gentle surgeon and I am on the mend finally with a boob that looks normal, no swelling, red marks or lumps and bumps! So, at 11 weeks old, my gorgeous son and I are finally enjoying our breastfeeding experience!

For anyone else who reads this who has an abscess, whilst it feels like the end of the world, it is manageable. On top of feeling extremely ill, I was emotionally contemplating giving up breastfeeding but I'm so glad I persevered as it can (and does) get better.

Thanks to all for your tips, ideas and support.

That's great news hun! You should be so proud of yourself, your DS is very lucky to have such a committed mama :clap:

That's fantastic that you were able to avoid surgery, and that your surgeon was on top of their treatment game. HOpe it's all onwards and upwards for you from here, it has been such a hard time for you. :hug:

So glad to hear you avoided surgery. Well done on persevering with bf'ing. It is it's own reward :-)


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