Christine,
 
You don't mention what other LC's have suggested so I may be repeating some 
 suggestions, but has mom tried manual expression for just a few minutes 
mid  pumping or post pumping?  Has she tried taking magnesium and vit D  
supplements to reduce inflammation in her breasts? (per Jennifer Tow's  often 
repeated suggestion)  Are her pump flanges large enough?  I've  had success 
with some moms using different size flanges, say a 27 on R  breast and a 30 on 
L for 1/2 the pumping, then switching mid pumping so 27 is on  L and 30 is 
on R; this of course could only be done if both sizes fit  comfortably.  
Another suggestion is use of castor oil packs topically, but  the only 
suggestion that addresses cause of plugs is the magnesium/vitD for  inflammation.
 
Barbara Latterner, BSN, RN, IBCLC
- - - - - - - - - - - - - - -
I have a mother who delivered twins at 25/2 GA who are now one month  old.  
She was producing a large volume of milk from the very beginning -  over 
1000 mls a day.  She has been consistently pumping 8 times a day (she  can't 
do any more than this)  and she has recently told me that she has  been 
experiencing frequent bouts of plugged ducts.  She has become quite  proficient 
at resolving the plugs, but it is getting very tiresome for  her.  Does 
anybody have any information or suggestions for us?  We  have discussed the use 
of lecithin- am also curious if anyone out there has used  it and has found 
it to be successful.  She has not started taking them  yet.

I have reviewed this case with other LCs, but have already tried  their 
recommendations and have come to a brick wall.  

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