When there is so much conflicting advice from experienced clinicians about
where to point the chin when a duct is blocked, it tells me that there is
no right and no wrong place.  And when we apply the Donna Ramsay/Peter
Hartmann research to the problem ... ie there are NO lactiferous sinuses,
it seems to support that.
So what will clear a blocked duct?  Direct massage!  If the blockage is
close enough to the areola that the infant's bottom jaw could compress it
OK, but I've rarely seen them that close.
I prefer mothers with this problem to latch the baby in whichever position
they can do it most effectively AND will leave space for either mother or
helper to get a hand over the blockage to massage as baby feeds.  I usually
have very good success with this.

Denise

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Denise Fisher BN, RN, RM, IBCLC
BreastEd Online Lactation Studies
mailto:[log in to unmask]
http://www.Health-e-Learning.com

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