Plugged Ducts, Mastitis & Low Breastmilk Production ....

Effective Natural Remedies for these Issues and More

By Pam Caldwell
Herbalist
Pregnancy/Lactation Specialist

Many women can breastfeed easily and problem-free. This is the vision and expectation that all new mothers have. We assume that breastfeeding will come easily and naturally and be a beautiful experience, and for some, it is. For others, however, breastfeeding can be difficult, painful and emotionally devastating. We feel inadequate, frustrated, and more than anything, scared that we're starving our babies. We never imagined how difficult, painful or hard it could be. But there is help available. There are many safe and extremely effective remedies available to solve many of the most common breastfeeding problems.

Low Breastmilk Production

Breastmilk production is affected by many things. The new mother's stress level, nutrition, fluid intake, adequate nipple stimulation and baby's sucking technique all play a part in how much milk will be produced. Returning to work or starting the baby on solids can also affect milk supply. In these cases, there is a decrease in the frequency and number of nursings, which in turn decreases the level and frequency of nipple stimulation necessary for milk production. This, for some people, can result in a decrease in milk supply. There are other factors as well, such as breast issues, abuse or previous breast surgeries. It has also been noticed that mothers who undergo cesarean section may experience a higher level of breastfeeding problems than mothers who have a vaginal, or even better, a natural childbirth. With c-sections, stress, including major abdominal surgery and the separation of mother and baby at birth, even for a short time, and particularly for an extended period of time, can have an effect on milk production. This is one argument of many against elective c-sections. In many cases, however, a cesarean section is necessary to ensure the safety of mother or baby or both. In these cases, cesarean section is absolutely the best course of action to take. Another consideration with c-sections, the body will put a lot of energy into repairing itself and into recuperation (it is major abdominal surgery after all).  For some women, this can result in low milk production.  Once the body has recovered however, it can then put that energy in to milk production.  So don't think that all is lost - give yourself some time for recovery, use the herbs mentioned below (especially the Nursing Tea or Tincture which is highly nutritious and has health-building herbs that can help speed recovery).   

The following suggestions have been proven helpful in increasing milk production. Some or all of them may be helpful to you.

•  Good nutrition, including plenty of protein, vegetables, fruits and grains. You actually need more calories as a breastfeeding mother than you did when you were pregnant. Remember to drink lots of water or herbal tea (which count toward your 8 glasses a day)!

•  Rest, as much as you can. Sleep when the baby sleeps. Arrange for someone to cook, clean and do errands for you. Your job right now is to take care of yourself and your baby.

•  The following herbs have proven to help increase breastmilk production (known as galactagogue herbs): Goat's Rue, Fennel, Raspberry Leaf, Alfalfa, Nettle (all of which are in Herb Lore's Nursing Tea), Fenugreek and Blessed Thistle (which are not in the Nursing Tea).

     - Goat's Rue is one of the most effective herbs for increasing milk production, and some say that it has worked better for them than Fenugreek.  (They work differently - more on both herbs below.) 

     - Fennel Seed not only helps to increase breastmilk production, but also helps to expel gas and help soothe indigestion and colic.

     - Raspberry Leaf is high in vitamins and minerals and will also help the uterus to recover and regain its size and shape quickly and aid with postpartum recovery.

     - Alfalfa and Nettle are loaded with vitamins and minerals, including iron, calcium, and Vitamin K (the blood coagulant vitamin).

     - Blessed Thistle is wonderful for helping increase breastmilk production.  It is also used as a digestive bitter and is extremely healthy for the liver.

Two herbs that I do not recommend are Borage and Hops.  Borage is an effective galactagogue, but isn't an herb that one would want to use for longer than a week at a time, as it contains an alkaloid that may be harmful to the liver. It is a great herb for cooling fevers and balancing the adrenals, but again I would recommend using it for only a short period of time. Hops has been used to increase mother's milk (which is why they say to drink beer while nursing), but can cause depression when used over an extended period of time. It may also make you sleepy! The beer in other countries contains Hops that are helpful for milk production, but the beer in the United States doesn't seem to have the same content or quality. 

•  Fenugreek ( ORDER NOW ). This is one of the best and strongest herbs for increasing breastmilk production. It works by promoting body secretions - breastmilk being one of them.  Because of this, you will notice a maple syrup-type smell from your perspiration.  It's an indication that the Fenugreek is active in your system.  Its strength is not needed by everyone, however – it's kind of the “big guns” of the galactagogue herbs. Fenugreek also works on the digestive system, but may cause gas in some individuals, including babies. (If this occurs, Herb Lore's Nursing Tea ( ORDER NOW ), Tummy Tea ( ORDER NOW ), or Fennel Caps can help to alleviate the problem while working to increase milk production.) This herb, along with other therapies, has even been used successfully by non-birth mothers to help them produce breastmilk for their adopted babies.  Another important note:  Avoid products with Fenugreek as one of it's many ingredients.  Fenugreek intake must be regulated and consistent, and it is very difficult to accomplish this when it's in a multi-ingredient product.  It's nearly impossible to regulate how much Fenugreek one is getting per dose when it's in a mixture (especially if it's in a tea), which could result in up-and-down Fenugreek intake, which then could result in an up-and-down milk supply.  Click here for more information on Fenugreek and how to use it correctly for best results.  Insulin-dependent diabetics should use the herb with caution or not at all, as it may affect their blood sugar readings and insulin needs.  Fenugreek is a member of the legume family.  People with allergies or sensitivities to legumes should also avoid Fenugreek.

•  Goat's Rue (ORDER NOW)  Goat's Rue is another powerful herb for stimulating the production and flow of breastmilk. It has a direct effect on the mammary glands themselves, and is a good choice for women who experience problems with their production from the beginning.  It has been shown to increase milk production by up to 50% in many cases, and may also even stimulate the development of the mammary glands.  It is an extremely effective herb for increasing breastmilk production, and is one of the main ingredients in Herb Lore's Nursing Tea and Nursing Tincture.  It can be used along with the Nursing Tea or Tincture for increased support, and along with Fenugreek as well if necessary.  It is very easy to use, with no reported side effects.  Dosing would be similar to that of Nursing Tincture, beginning with two droppersful three times a day and adjusting up or down, according to results.

•  Pumping. It is important to give the nipples adequate stimulation to promote milk production. Nurse the baby first, when he's hungriest and will provide the most vigorous stimulation, and nurse him until he fusses to tell you that there's no more milk. If possible, hand him off to a helper to give the rest of his feeding by bottle (so that he doesn't associate you with a bottle), while you pump. If you have no helper, feed your baby the rest of his feeding, and then you pump.  Above all, adequate stimulation either from a pump or from putting your baby to the breast is the most important factor to maintaining a good milk supply. 

Plugged Ducts

Breastmilk is made up of a large amount of fat, which is necessary for the baby's development and nutrition. In some people, these fats can coagulate, or plug up in the milk duct. It's kind of like a plugged pipe in the breast with milk backing up behind it. It can be very painful and if not attended to, can lead to mastitis (breast infection). Several things can lead to a plugged duct, including missed feedings, incomplete emptying of the breast, or constriction of the breast (such as a tight, ill-fitting or underwire bra).

•  Pump if you miss a feeding or if the breast isn't completely emptied. Try not to let the milk just sit in the breast for long periods of time.

•  Keep nursing! This is so important! It may be painful, but it's necessary to keep that plug moving out so that it doesn't cause infection.

•  Apply heat, especially before pumping or putting your baby to the breast.  Heat will help “melt” the plug or soften it so that it will move out easily with the suction of the pump or the baby's suckling.  Should the plug come out in the baby's mouth, not to worry - it's just thick breastmilk... kinda like baby ice cream!  

•  Massage the breast from behind the plug toward the nipple as the baby sucks to help move the plug out. Again, it is not a problem if the plug comes out in the baby's mouth.  So heat first, then massage as you pump or nurse.

•  Position the baby while nursing so that his chin points to where the plug is. This has the most drawing effect. Get help if you need it to position the baby. It may be breastfeeding acrobatics, but it works!

•  If chronic plugged ducts are a problem, you can take Lecithin on a regular basis. Lecithin is a vitamin/mineral type supplement.  It's very healthy for the brain and liver, and is also a wonderful fat emulsifier, which means that it keeps fats smooth and creamy.  Most chocolate products contain Lecithin because it gives chocolate that smooth, creamy, melt in your mouth quality that we all love so much, and it will do the same for your breastmilk - keeping it smooth and free-flowing so that it doesn't coagulate and plug up in your ducts.  Lecithin is safe for both you and the baby, even in larger doses. It comes in a granule or in a gelcap (like Vitamin E). (I recommend the gelcap as I understand the granules are not very tasty.)  Take the dose that works for you. For me, it was 4 gelcaps in the morning and 4 at night (about 1200 mg twice a day). Once I found the right amount for my body, I never got another plug again and I breastfed my baby until she weaned herself at almost 3 years of age! (I had been getting a plug every 10-14 days resulting in mastitis twice, so this was a miraculous discovery for me.)  Also pay attention to your diet. Don't eliminate fats entirely, just go easy and eat a healthy diet.

•  Take Poke Root ( ORDER NOW ) and/or Echinacea ( ORDER NOW ). Poke Root is a lymph cleanser and will help clear the breast tissue. Echinacea will increase your white blood cell activity (the infection fighters) to prevent and fight infection.
 
•  If your plugged ducts are caused by too much breastmilk production, try some Sage to help curb it. 

•  If your plugged duct causes your milk supply to become low, try some Nursing Tea or Tincture first, then add or try Blessed Thistle, Goat's Rue or Fenugreek if necessary.

•  Do not wear a bra or any other garment that may constrict or block the breast or milk ducts.


Mastitis

Mastitis is caused by several reasons, the most common are plugged ducts that are not resolved, and by over-tired and stressed moms who are not getting enough rest and who are doing too much.

•  Go to bed. Take your baby with you, nurse, and just rest. Get someone to help take care of you, the baby and any household chores that need attending to.

•  Take Poke Root ( ORDER NOW ). Just 2-4 drops in a little water will usually clear a breast infection within 24-48 hours.

•  Take Echinacea ( ORDER NOW ) and Vitamin C. Both will stimulate and strengthen your immune system.

•  Rest, and keep nursing on the affected side. The milk from that breast is still good and will not hurt the baby or make him sick. It is important to keep nursing so that the infection doesn't become worse or so that your production doesn't drop. If it does decline, you will be able to regain it by using the Low Breastmilk Information above once you have the mastitis under control.

•  Do not wear a bra or any garment that will constrict the breasts or milk ducts.
 
•  If your plugged duct causes your milk supply to become low, try some Nursing Tea or Tincture first, then add or try Blessed Thistle, Goat's Rue or Fenugreek if necessary.

•  Are you making too much milk?  Over-production can also cause plugged ducts and mastitis.  Read more below...


Over-Production, Weaning or Needing to Decrease or Stop Milk Production

For weaning purposes or to stop breastmilk production altogether , it is recommended to start with one cup of tea three times a day, or two droppersful of tincture three times daily. (Two droppersful of tincture equal one cup of tea.) Increase the dosage levels as necessary to achieve the desired results. Results should be apparent in a day or two.

Again, everybody's bodies are very different, so notice what results you're getting from the above-mentioned dosage suggestions and make adjustments accordingly.


Thrush

Moms and babies can develop thrush, especially if they were given a round of antibiotics. The mother will experience shooting pains in the breast and pink, shiny nipples. The baby will exhibit white patches that look like milk on the inside of the mouth that won't rub off. It can be quite painful for the mother, but is usually not uncomfortable for the baby.

•  NO SUGAR! This is a yeast organism, and they feed and proliferate off of sugar. You will have a better chance of clearing the yeast from your system and your breasts if you stop feeding them. You may have some intense sugar cravings, but this is the yeast organism dying off. Don't give in – it will pass shortly! You're almost there! It's a good sign that you're making progress! Good job!

•  Take Acidoplilus supplements or eat plain yogurt with live cultures (preferably non-dairy). The Acidophilus supplements need to be a refrigerated variety with an expiration date. This ensures that you have live cultures that will help to repopulate your system. You may swab the inside of the baby's mouth with plain yogurt or liquid acidophilus.  Again, try to get a non-dairy product. With clean hands, spoon a bit of yogurt onto your finger and swab the inside of the baby's mouth, letting him suck it off, or give a 1/2 to 1 tsp. of the liquid directly to the baby (read product label for dosing info). This will help clear his system so that you don't become re-infected.

•  After nursing, rinse your breasts with a solution of 1 cup water with 1 tbsp. apple cider vinegar. It must be apple cider vinegar, and the distilled may make the problem worse. Airdry your nipples and apply a coating of the plain yogurt.

Sore Nipples

•  Food grade lanolin (Lansinoh) can be applied to the nipple. This will help protect and heal. It can be found in any drug store, and is safe for the baby to nurse from.

•  Do not use soap on the nipples. The nipples exude as antibacterial substance that will help keep the nipples clean naturally. Soap will interfere with this and can dry out the nipples, causing further irritation. Rub breastmilk onto nipples for extra anti-bacterial support.

•  Change breastpads often.  Keep nipples clean and dry.  Go topless whenever possible.

Typically, the first six weeks tend to be the hardest. It takes the baby and our breasts a little while to “catch on” to all of the ups and downs and “speed bumps” sometimes associated with breastfeeding, but it can happen. It does get better in most cases! Get support from a qualified Lactation Consultant or call La Leche League (listed in the phone book) for information and support. La Leche League provides one-on-one guidance, group classes or gatherings for mothers to share and get support from the leaders and each other.

Isolation while going through a major life change such as having a baby, laced with difficulties, is a major contributing factor to depression. Reach out and ask for help! We are learning more and more all the time about how important breastfeeding is to us as mothers, and especially to our special little babies. The care and bonding that breastfeeding promotes has an incredible impact on our babies that will last for the rest of their lives. And the nutrition and immunity provided by mother's milk is unparalleled. I find that in every case of someone I've talked to with digestive issues, including Crohn's Disease and Irritable Bowel Syndrome, among others, that these people were not breastfed. Breastfeeding has powerful physical and emotional benefits for both mothers and babies and should be continued until the child is at least 3 years of age. (See www.ttfuture.org for case studies and findings of the benefits of breastfeeding until the child is 2-1/2 to 3 years of age under the Bonding section.) Breastfeeding can be the beautiful, bonding experience that we all envisioned and hoped for!

So hang in there, and pat yourself on the back for the hard work that you're doing! Think of the lifelong gift you're giving your baby, as hard as it may be sometimes. Feel proud that you're doing this hard work, and that any breastmilk you give your baby, however much or little you're able to give, for as long as it's possible is a gift that will last him or her the rest of their life. And for some mothers who aren't able to breastfeed, know that you gave it your best, and that your best is enough. Cuddle and love, touch and caress, sing to and talk to your babies … however you are able to feed them!