The latest (August, 2014) Journal of Human Lactation has, among many, many excellent articles,  a study that may be of interest in this discussion: Six-Step Recanalization Manual Therapy: A Novel Method for Treating Plugged Ducts in Lactating Women J Hum Lact August 2014 30: 324-330. It includes data, pictures and diagrams to clarify the six steps, and was conducted with “3497 lactating women with plugged ducts” in China.

 

It seems that this is a method similar to the one Nikki Lee provided of Dee Kassing's recommendation.  I believe this method would be more effective if preformed in the tub as Dee recommends, however, in a study of this size, it would have been hard to control for cleanliness, etc.  

 

One of the best clarifications to describe it to moms that I heard was “imagine you have a knot in your hair – you don’t start at the scalp to fix it – you start at the end and work your way up.” 

 

Another option if this method does not work (the JHL study  reported “52 showed unresponsiveness”)  was in the Abstracts of the Academy of Breastfeeding Medicine's 17th Annual International Meeting poster sessions for 2012.  It was a very small study, but some of you may find it useful as a last resort:

 

Breastfeeding Medicine. October 2012, 7(S1): S-1-S-17. doi:10.1089/bfm.2012.9983

They used first a punch biopsy (to 5 women who “requested excision of the lesions”): "Every woman’s symptoms resolved shortly after removal of the rubbery, scar-like tissue."  However, their finding that " immune cells [found in the tissue in the punch biopsies] indicated a tissue reaction to milk that has leaked from ducts into surrounding tissue".  So they treated “subsequent patients” with "a short daily course of a very thin layer of a mid-potency steroid under occlusion to enhance penetration into the inflamed and fibrotic tissue" with good results.  

 

I have shared this information with physicians who have been trying to help moms through repeated bouts of nipple blebs, and so far this has helped when nothing else had.

 

Jeanette Panchula, BSW, RN, PHN, IBCLC

Vacaville, CA

 

 


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