she has had
>clogged milk ducts and specifically painful ones on the nipple (3 to be
>exact). The baby is now 6 months old.   The clogged ducts in her breast
>come and go, but the ones on her nipple are constantly there - sometimes
>they feel better than other times.  She has been doing warm compresses,
>gentle massage and pumping.  She also reports that her breast hurts most
>after emptying it!

I think this could be a yeast infection.  The nipple plugs could be the
blebs that sometimes accompany such an infection.  The sentence that really
caught my attention was that last one: "She also reports that her breast
hurts most
>after emptying it!"

If it were "simple" plugged milk ducts, I think that the breast would feel
better after emptying.

I recommend trying Gentian Violet on her nipples to see if the nipple plugs
are relieved.  I had one mom with yeast overgrowth who found that GV was
the only thing that brought relief for those blebs. And it can sometimes
help in the intraductal yeast; but with the stress she is under and having
had this problem for so long, I would recommend that she go the Diflucan
route--200mg on day 1, and 100 for 14 days. This is in addition to the GV,
which she can use until the bleb is healed.

That dosage is still a minimal one if this has been long term, but it will,
hopefully, resolve the problem. Of course, she will need to take the other
steps for resolving yeast overgrowth.

I anxiously await other ideas on this case, as I don't want to always see
"yeast."  In fact, I wish that I never saw it at all!

Patricia Gima, IBCLC
Milwaukee, Wisconsin, USA



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