Diana discusses a mom with miserable plugged ducts.  I had a mom like that
who came to me with her first (oversupply was never an issue), and the plugs
finally resolved with generous doses of lecithin and gentle massage.  Baby
number two -- mom started on lecithin in the hospital!  Within about 2 weeks
the plugs started, and it didn't matter what we did, they didn't resolve.
She was on the lecithin, she used a vibrator, gentle massage, firm massage --
I finally measured one of the lumps on her breast and it was 5 cm by 7 cm.

After discussing nearly everything I could think of, she finally said
something about they seemed to get worse if she ate fatty foods.  Light bulb!
 I suggested a good Japanese diet (she is Japanese) which is relatively low
in fat.  No more peanut butter -- which she loved, pasta with marinara sauce,
no butter, olive oil, or cheese sauce -- everything I could think of that was
really very low fat.  This mom was fairly thin -- we certainly didn't have to
do this because of a weight issue, and I don't think her normal fat intake
was above whatever is supposed to be about normal -- but her breasts couldn't
tolerate ANY fat.

She called me back a week after she'd gone on this strict low fat diet --
plugs had completely cleared, and she was breastfeeding away happily.  In her
case, I think the precipitating factor was not just the fat, but the fact
that she has very long nipples, and the baby simply couldn't get enough
areola in his mouth to drain the breasts adequately -- and the pump didn't do
a very good job in her case either.

So, for what it is worth.  Interestingly enough, her OB said she'd send her
for ultrasound for the plugs, but right at that time, we figured out the
diet, and she didn't need the ultrasound.

True confession -- I was pretty skeptical, but it certainly worked for this
mom.

Jan Barger, RN, MA, IBCLC, RLC
Lactation Education Consultants
www.lactationeducationconsultants.com

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