DEALING WITH CLOGS AND MASTITIS PLUS SOME GREEN FAMILY UPDATES

After a December and January filled with illness, it seems like the Green family has finally returned to our normal routine, if you can call it that. Avi is back at daycare regularly and Jared and I are finding our rhythm as a married couple who also work from home together every day. It’s both super fun and a major distraction, but I think we’re finding our groove. We each have our own space - Jared has an office on the main floor and I’ve converted our guest bedroom on the second floor into an office. The other thing that keeps us separated is the fact that our house has high ceilings and is expensive to heat. We leave the heat off during the day and use personal space heaters, which keeps us chained to our own spots!

This past weekend was a nice mix of relaxing and activity. We had new friends over for dinner on Friday night. They live right up the street from us and have an adorable 14-month old girl. She and Avi (sort of) played together until Avi had a fit and we knew we had stretched his bedtime as far as it would go. After all these months, I’m so grateful that Avi is still a good sleeper, but sometimes I wish we could stretch his schedule just a little bit. I’m not complaining - in general I much prefer the structure and the 11-hour overnight stretch - but on the weekends, it would be nice if we could go out later and sleep in a little. We put Avi to bed and the adults enjoyed the rest of the night together, so I guess beggars can’t be choosers.

Saturday I had my Pump Like a Pro! Workshop at Montclair Baby, which is always a ton of fun. Every time I step into Montclair Baby, I feel a sense of calm. It’s like I’m transported back to those early days with Avi, when I looked forward to my Breastfeeding Support Group as the most fun, supportive, and restorative part of my week. One of the things I love about giving this workshop is the opportunity to give back to a community that was there for me when I needed it most. And I’m excited that for our next workshop, we’re going to try a weekday afternoon, so the mamas on maternity leave can join us as they prepare to go back to work. Dates are TBD, so stay tuned.

One of the questions that comes up time and time again with I’m doing my workshop is how to deal with clogged ducts. I’m not sure if there’s data on this, but in my experience, it does seem like clogs occur more when moms are pumping more often. So today, I’m going to spend a little time talking about dealing with clogged ducts and mastitis, how to tell the difference, and when to seek professional help. This information was written with the help of my friend and unofficial mentor Jen Kowal. Jen is an IBCLC and the leader of the Breastfeeding Support Group at Montclair Baby and when you're done reading, you should absolutely head over to her website - www.milkwelllactation.com.

First, what are we talking about? A clogged duct is exactly what it sounds like - a build up of milk obstructing the milk duct. It’s very localized, typically affecting only one side and can appear anywhere on your breast. You’ll feel a lump (they can range in size) and you’ll feel localized tenderness or sometimes pain. Often, a clog will feel worse before pumping and better right after. A clog is not accompanied by a fever (we’ll get to that when we talk about mastitis).

If you notice a clogged duct, you’ll want to take care of it quickly so that it doesn’t get worse or turn into mastitis. Luckily, with proper care, they are usually resolved within 24-48 hours. When I was exclusively pumping, I got a lot of clogs, likely due to my over-supply. These are my tried and true tips, which are also backed Jen, as well -

• Pump (or nurse) often. You need to remove milk to get the clog out. A properly latched baby will be more effective than a pump, so nurse if possible, starting on the clogged side.

• Use heat both before and during your pumping/nursing session. A microwavable heating pad works great for this, but if you’re nursing, remove the heat first.

• Massage the area both before and during your pumping/nursing session, paying attention to massage in a downward motion towards the nipple.

• If nursing, try changing positions so that the baby’s chin points in different positions. If pumping with a non-circular flange (like Pumping Pals), try turning the flange in different directions.

• Hand express in a hot shower.

• Use a vibrating toothbrush (or anything else that vibrates!) around the clog to try to break it up.

Another tip is a sunflower lecithin supplement. While there isn’t any data behind its effectiveness, anecdotally, it seems to help a lot of mothers with milk flow. I won’t list any dosages here, because you should always check with your doctor before taking a supplement and get the correct dosage from them.

If your clog doesn’t resolve itself in 24-48 hours, contact your lactation professional.

Mastitis is an inflammation of the breast most often caused by a clogged duct. Therefore, the symptoms are very similar to a clog, which I listed above, but more intense. If you think you have mastitis, keep an eye out for a tender, hot, swollen area of the breast with a body temperature of 101.3 degrees F or greater and flu-like symptoms. You may also see the appearance of red lines on the breast.

Since mastitis is basically a very severe clog, you want to treat it similarly, so take a look at my list above and pay special attention to the first bullet point - nurse or pump more often. Frequent and effective milk removal is the name of the game here. Jen and I suggest every 2 hours - even if your baby doesn't usually eat that often. You may even want to hand express after nursing or pumping to ensure that you have the best drainage possible. Of course, you always want to try to get rest, adequate fluids, and good nutrition - just like with any other fever.

If the symptoms do not improve within 12 hours or completely go away within 24, it's important that your next step is the doctor. While mastitis is not always caused by an infection, it sometimes is and may require antibiotics. Although mastitis is usually easy to take care of, if left unchecked, it can lead to more complicated medical situations. And of course, it's important to always listen to your body. If something feels off or makes you uncomfortable even before that 12 or 24 hour period, go ahead and call a medical professional sooner.

The good news about both clogged ducts and mastitis is that they are both easily treated and it’s totally safe (and part of the treatment plan!) to continue breastfeeding. There are definitely antibiotic options that are safe for you and your baby.

I hope you found this helpful! It’s a bit more instructional than my usual blogs, but I remember all too well how hard it was to find good, reliable information when I was pumping for Avi. So many moms are searching the internet, hoping that they found the right solution, so I wanted to offer my advice from a mom who’s been there and as a lactation professional!

Looking for more? Head over to www.SandyJGreen.com