Pam wrote about the mother with recurring plugged ducts who "discovered that
the gel pads that cover the whole breast which can be microwaved or
refrigerated did the trick for her,  much better than hot wash cloths, a
heating pad or hot water bottle".

I recently heard Donna Ramsey Geddes speak.  Using ultrasound imaging, she's
found that the area in which a mother feels the lump or mass of a plugged
duct (the backed-up area) may be an entirely different quadrant of the
breast than the place where the actual obstruction in the duct is.  And so
using massage or heat/cold in the area that one feels the mass may not even
be near the plug itself. This is because of that wonderful twisty tangle of
ducts that Hartmann, etc have found on ultrasound as opposed the the more or
less linear path from outer breast to nipple that we used to picture.

When I heard about the gel pads that covered the whole breast, it occurred
to me that perhaps covering all of the breast meant it affected the area
that actually had the plug--as opposed to otherwise traditional advice where
massage, heat/cold might be applied more locally to the palpable/painful
mass area which would not necessarily be the obstruction itself.

She also mentioned that from what she could see on ultrasound, cold was more
effective than heat with plugged ducts. Another interesting observation she
mentioned was that when a mother has a wedge-shaped mass, the plug is often
seen in the nipple itself.

My understanding is that this isn't published research but observations from
having lots of mothers referred to her to just to have an ultrasound peek on
what was going on inside there. Hopefully, I'm accurately restating what she
said.  Thought-provoking...

Susan

Susan Lawrence, RN, IBCLC, LLLL
Berkeley, California

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