Chele Marmet recommends that these need to massaged out.  Sometimes much
massage, if you've seen her slides the mother looks way uncomfortable as
a male doctor (he was visiting the Lactation Institute from out of the
country) massages the breast with much pressure, with oil on the breast.
This was the case with one of my clients too, who I referred to the
Institute.  The milk comes out looking like a limp spaghetti noodle and
then fresh milk can come out.  If the mother can't do the massage
because of discomfort the suggest her male partner try.  Massage from
the chest wall to closer to the filled duct.

Katherine Catone, LLLL, IBCLC

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