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Overcoming a Blocked Duct
My dinner party guests were gathered and expectant for their meal. I went off into the bedroom to give my seven-month-old baby a feed before bed, and felt big, ropy lumps in my left breast. I knew immediately what it was; a blocked duct! The architecture of the breast was clearly engorged in a line between my armpit and nipple, the way it is all around my breasts in the mornings when they are over-full after a feed-free night. In the evening they’re invariably empty and soft. I’d feared getting mastitis even before I was pregnant since a friend of mine had a breast abscess following mastitis. Plus my midwife had told me if I didn’t attend to a blockage straight away and it led to mastitis that I’d be screaming for narcotics! This was from a woman who led me through a drug-free labour. But there was no pain, and no fever. So I soldiered on with the dinner party, periodically disappearing from the group to pump the breast and massage it as best I knew how. The next day the lumps were reduced, but there was some pain, which I hoped was from over-zealous massaging. The following day a white spot appeared on the nipple, and the nipple hurt like mad when my baby suckled. I massaged the breast in the shower occasionally, but I didn’t really know how to massage it. Stroke it? Squeeze it? How hard, and for how long? Most of all I wished it away. On the third night I was up in the early hours of the morning, pumping my full breast to relieve the pain. I rang Le Leche League the next day. The spot, the woman said, was probably a bleb – the end of a long thread-like blockage that needed to come out if I was to get relief. She said I might need to use a sterilised needle remove the blister-like covering of the spot in order to allow it to come out, and if I found that too painful I should go to my GP to ask her to do it. Aaaaaagh!, I thought. On the same day a Karitane nurse advised I get some antibiotics from my GP. But I just knew that a GP would do nothing but charge me $50 and give me a prescription for antibiotics – and I knew there must be a better solution. My body had built this perfect baby and nourished him for this long – it wouldn’t fail me now. I needed to talk to someone that really knew about breastfeeding. So I rang Barbara Fletcher, lactation consultant extraordinaire. Someone had given me her phone number while I was pregnant. Barbara was knocking on my door about an hour later. She showed me how to press firmly behind the lump as my baby suckled, moving the pressure gradually closer to my nipple as the lump moved in that direction. I fed him in the football hold so that his chin – the most powerful suckling part – was positioned over the lump, and put him on the affected side first. He was my most powerful ally, she said, because his suck is stronger than a breast pump. However, he ‘went off’ that side somewhat, possibly because the taste of the milk changed as a result of the old milk clogging the duct, or maybe due to the reduced flow, so I pumped from the side as well. I had to be careful though – too much pumping would result in increased milk supply on that side, and then there would be even more milk to bank up in the duct. |
Barbara also guided me very gently through the dreaded needle operation – I passed a needle through a flame and then used it to pick the top off the white spot. Easy. She also showed me how to put hot flannels on my nipple just before feeding, because wet heat softens up the congealed old milk that’s causing the problem. I longed to see a big stringy thing emerge out of my nipple, and to feel the relief that would give me from the ongoing pain. Barbara said some women do see such a phenomenon – but I didn’t. Because I could see drops of milk appearing on the white spot on my nipple when I pumped, I didn’t have so much a blocked duct, but a narrowed one, explained Barbara. While the other nipple pores (exits from the ducts) sprayed out clear jets of milk, the affected one could only let through a slow leakage. Barbara likened it to a clogged up heart artery – the gunky coating on the inside of the artery lets a trickle of blood through, but not the strong flow of a healthy artery. Only once the gunk builds up sufficiently to cause a full blockage does a heart attack occur – and as long as I kept forcing milk through my gunked-up duct, I wouldn’t get mastitis. In the end, a full five days after onset, Barbara rang me and suggested I do some nipple rolling. So I put a hot flannel on my breast, and pulled and turned the nipple in an effort to dislodge the gunk. Then I fed my baby – and during the feed I felt a sharp pain that rose above the background pain. A couple of hours later I realised that the pain and lumpiness was all gone. Bliss! In the two months since this happened, I’ve had two repeat occurrences. There was no white spot or painful suckling, and both times I was very tired after out of character nighttime feeds. The night feeds started when my baby fed less during the day due to his nosiness and excitement at the world in general, which meant that in addition he wasn’t draining the breasts properly during the day. The combination of backed-up milk and tiredness is bad news for my left breast! However, both occurrences cleared easily with a bit of pressure behind the lump during feeding and a good night’s sleep. It’s not all bad news though. I’ve learnt more about my milk production, and I don’t take my healthy lactating breasts for granted anymore. Our bodies are absolute marvels! |