Dear Dr. Cordes, Is your patient a candidate for lecithin
supplementation, as recommended for recurrent plugged ducts? Is she
taking vitamins? The only other thing that came to mind (besides the
"needs more rest and a better fitting bra") is the sleeping position.
You noted baby sleeps with her "like velcro". She may not be changing
position enough at night to prevent pressure to the breasts, causing
irritation and then plugging. Is baby "latched" most of the night or
just next to her?  I've heard moms describe sleeping with baby
"attached" nearly all night---if hers is one of those, could she use a
pacifier instead, so she has more room to move? Just a thought.
Rowena Tucker, IBCLC

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