Hello,
I hope that you can help me--your advice has been a great help in the past.  
I am helping a mom (I have her permission to post) that has a baby that is 
three months old.  She's been fighting plugged ducts from the very beginning.  
She also says that baby chokes and gags a lot at the breast.  We initially 
decided both were most likely due to an oversupply of milk and she's been 
faithfully feeding the baby in an upright position (says it does help), using only 
one breast for three hours at a time, and pumping only occasionally if she 
absolutely needs to relieve the breast that is not being used (1/2 oz maybe).  
She is taking lecithin 1200 mg/3x/day and Omega 3's 1000mg/3x/day to 
reduce viscosity of the milk.  She says she can usually get the more surface 
plugs out with heat/massage/ and positioning baby's chin on top of the duct, 
but really is having trouble with deeper plugs.  She has not got mastitis, but is 
considering weaning due to the pain and frequency of the plugged ducts and 
the choking/gagging of the baby.  He will not take a bottle and if he chokes a 
lot at the beginning of a feeding, will get angry and refuse the breast for quite 
a while (days even with minimal nursing).  Mom has tried sage with success, 
but felt like she almost dried herself up.  Said the choking and gagging 
decreased, but wondered if he wasn't getting enough as he acted hungry.  
Says she questions the potency of the leaves and is using a tincture, but that 
she can't find much on the tincture dosage except to use what is 
recommended on the bottle.  She is trying to play with the dosage to find 
perhaps one that will decrease her supply without drying her up.  

Does anyone have experience with the tincture or other herbs that would 
work better to regulate her milk supply?  Also, she doesn't think the plugged 
ducts are related to the amount of milk she's producing as she's had them 
since the beginning and had them even when her supply was ramped down by 
the sage.  Any ideas?  As for the choking/gagging, could her milk supply not 
be the problem?  When she says she takes him off the breast when he starts 
to choke, her milk is not spraying like she thinks it would be.  Could the baby 
have issues with swallowing, and if so, who would I recommend she see? (i.e. 
cranio-sacral therapist, etc.)  Thanks so much!

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