I am emailing with a mother who has blockages, but her annoying problem is the most extreme case of stringy milk despite doing what we normally recommend (massage, express, lecithin, etc.) Does anyone have any ideas what would help this mom to PREVENT these episodes? She has given me permission to post from the emails she sent me. I will try to condense it as much as possible, but I find her descriptions very important.
With my first baby, I came home from the hospital with a blockage.I had the book, *The Nursing Mothers Companion* that talked about blockages and how to handle them. I followed the advice in the book. I started getting blockages with regularity when Baby #1 was two or three weeks old. I My husband rented a breast pump to help get the blockages out. When one side cleared, it felt like a water balloon popping, and the milk nearly choked the baby. It soaked her, my shirt and pants. I pumped after she finished nursing and got 4 ounces out.
With Baby #2, the blockages started the first week. I think I got three right off the bat, two in one side, one in the other. I started lecithin capsules, and increased the dosage until I got relief. That worked at first. I went almost two weeks without a blockage. Then they came back with a vengeance. So I started taking lecithin granules by the tablespoon. I took three tablespoons, spaced throughout the day. I still got blockages every couple of days, but they were much easier to clear.
The stringy milk started when Baby #2 was three or four months old. It has never coincided with a major blockage. At six and a half months, I seem to have more stringy-milk episodes than the more traditional blockages. I have two
ducts in each side that seem the most susceptible, in the 6:00 and 11:00 positions. The ducts that produce stringy milk are also not the same ones that typically block.
I've had about 20 cases of stringy milk. There is a difference between a traditional blockage and the stringy milk.
With a blockage, pain comes from the backed up milk. The breast gets very hard where it is blocked, and the skin looks like there are marbles under it. If the blockage is on the outside of the breast, the milk backs up to my armpit. The breast gets hot, and it is very painful to the touch. In fact, it hurts to hold the baby, and it hurts when the baby nurses. When the blockage clears, the milk drains very easily, regardless of how long it has been there (I can often get 4 or 5 ounces out after the baby nurses when I have a blockage). This is true for blockages that clear within a few
hours, to ones that may take three days. The milk is not stringy after this type of blockage. I've had about 60 or so of this type of blockage between both babies.
When I get the stringy milk, the first thing I notice is nipple pain, which comes from the strings in the nipple. Then, as I massage the breast to find out exactly what duct is causing the problem, I may find a spongy lump. It is not nearly as pronounced as the other type of blockage. It is usually comparatively easy to get the strings out by hand expressing. These strings may be up to 0.75 inches long, and when balled up are the size of a BB pellet. I have to massage the milk up from the breast, then squeeze up the nipple, and press on the end to get it to pop out. I can often feel the
milk clot move along inside the nipple. It's best if I can get it started while in the shower. It usually takes most of the day to clear the clotted milk, and the affected section is sore. The soreness differs in intensity and nature from the type of pain I get from backed up milk.
Baby #2 doesn't like to nurse out the stringy milk, because it is quite salty. She'll only take that breast when she's sleepy. Then I compress the breast the whole time she nurses. That often clears most of the stringy milk. I
continue to hand express throughout the day to make sure I get rid of the stuff.
I get stringy milk one to two times a week. I no longer get bad blockages unless I do something really stupid,
like nurse on the same side twice in a row. I used to get them every other day, in either and sometimes both breasts. I take two tablespoons of lecithin a day. More is simply not practical. If I seem to be having a series of blockages, though, I'll take more until the problem corrects itself.
I do not have overly large breasts. The breasts easily double in size when full of milk, but I really don't think I have a tremendous oversupply. I do not have a high-fat diet. In fact, I probably consume less fat than average. There are days when I consume a lot of fat (you know, McDonalds stuff), but they do not seem to coincide with blockages. I also do not have a high sodium diet, and rarely add salt to any food and I drink about 8 oz of water every time I nurse. I also used to think that maybe I had problems from tiny ducts. But, judging from the size of the strings I get out, I doubt that is the culprit,either.
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Sorry for the length of this post, but I'm wondering if anyone has experienced a mother with the stringy milk to this degree and what suggestions can you offer that this mom is not already doing?
Terriann Shell
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