Ever since hearing Donna R Geddes talk on her experience with plugged ducts I 
have been advising moms to use cold packs between feedings for edema reduction 
as the build up of edema squeezes the milk ducts and prevents thorough movement 
of milk. I hope I am explaining that correctly. She also said she recommends a 
regular use of ibuprofin -type anti-inflammatory, and not hard massage as I was 
originally taught, but  a jiggly massage. I often suggest a small electric 
massager they sell with three legs. My clients have been getting good responses. 
Some have used heat for plugged ducts in the past and really find this method 
better. They have actually called back to say they are doing better, usually 
within 12 hours. JANET FISHSTROM DOMBRO,IBCLC,RLC





________________________________
From: Anne Brown <[log in to unmask]>
To: [log in to unmask]
Sent: Fri, May 11, 2012 8:13:32 AM
Subject: Breast inflammation

Permission to post:
35 year old primip with 12 week old, History of early hyperlactation.
Mother developed symptoms of plugged ducts 5 weeks ago in left breast.  Did 
rest, heat, massage and increased pumping/breastfeeding without a significant 
difference.  Plugged ducts occurred in right breast shortly afterward but 
resolved with above treatment.  Left breast remained uncomfortable.
Mother had already returned to work part time and had baby on a schedule of 6 
feedings daily, 2 at breast and 4 at bottle of EBM, partly because baby was very 
uncomfortable at breast (probably because of hyperlactation.)  Mother had full 
freezer of milk.
Sent to physical therapist for plugged duct ultrasound treatment which patient 
said was extremely painful and resulted in more pain thereafter.
Symptoms continued for 3 more weeks with subsequent reduction in milk 
production.  No fever, no chills, no body aches.  Mother has mild nipple 
soreness from pumping.  Encouraged to let baby to breast more often and 
explained about biological norms for feeding frequency.
Mother given script for antibiotics to start if she felt it was not improving so 
she began taking it 10 days ago.  Some improvement but not significant.  
Considered switching antibiotic but client declined.  No signs of yeast in mom 
or baby.
Now on last day of antibiotics and has suppressed lactation (just used last 
bottle of EBM) and still has an uncomfortable left breast.  Baby is going to 
breast more often now but still takes milk in bottle while mom is working and 
sometimes after breastfeeding.  Mom's pumping sessions are less productive (2oz 
several times daily) and she is stressed.  Has been on mothers milk tea and 
doing hand expression after pumping but not seeing an increase in production.
Exam shows fullness and tenderness but no distinct masses.  Has been taking 
advil on and off for inflammation which helps but not curative.
My next step would be to send for an ultrasound but I don't expect to find 
anything.
Thoughts from the collective wisdom of this wonderful lactation community? 
Annie Brown, FNP, IBCLC
Greenwich CT

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