Dear Kellie,

You wrote about a mom with a 3 mos old with oversupply issues and nipple 
blebs and plugged ducts.  There are many previous posts about treatment of all 
these problems in the archives but will give you suggestions for each.  For 
oversupply she could take parsley or sage in addition to using one breast per every 
four or more hours.  She will likely need to express only to comfort the 
unused breast, or risk more severe blocked ducts and maybe mastitis.  She can 
treat the blebs by soaking in salt water (1/4 teas per cup of warm water) and then 
gently abrading the nipple face with a washcloth to open.  Once open, she 
should breastfeed as soon as possible or pump as in my experience the blebs often 
are the cause of the plugs and milk removal will release the plugs as well.  
Then have her get a script for Newman's (Jack, not Paul) All Purpose Nipple 
OIntment and use after feeds.  Use of olive oil or simple homeopathic calendula 
ointment are other alternatives.  I've had moms who are afraid to empty the 
breast well by a bit of additional pumping, but until the blebs and blocked 
ducts are resolved, she runs the risk of mastitis and treating these while 
simultaneously treating for oversupply will eventually bring her supply down to 
what's manageable and likely eliminate recurrent blocked ducts and blebs.

If you have further questions, I'd be glad to help; sorry I don't have the 
dose of parsley or sage in front of me, these would be capsules.  Sage tea, 1-2 
cups for 2-3 days with careful noting by mom of her supply can also be used.  
Another possibility is the use of Sudafed--again dosage not in front of me, 
but all this is in the archives.  Two herbal sites also may be of help; Mechell 
Turner's, birthandbreastfeeding.com  and Kathryn Cox's motherlove.com; both 
have sage, etc in tincutures for reducing supply.

Barbara Latterner, BSN, RN, IBCLC 


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