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Updated protocols for ductal narrowing (plugged ducts)





One Friday morning I woke up with a hardened painful area on the outer quadrant of my right breast. At first, I thought it was just excess breast milk I needed to pump because my 7-month-old is sick and had not been nursing well. However, after a single pumping session, the swelling did not go away and by midday, my symptoms were worse. I put into play the newest protocol for ductal narrowing (reduce pumping + ice every 3-4 hours after feedings + rest + NSAIDs). 30 hours later almost all my symptoms were resolved now. Of course, this is not medical advice for anyone experiencing something similar (consult trained care providers first y'all) - but it was cool to put my knowledge and training to use on my own body.


The lactation community's understanding of "plugged ducts", nipple blebs & mastitis is shifting as we incorporate the latest research.


The Academy of Breastfeeding Medicine's 2022 protocol #36 details these changes if you want to nerd out on the science (https://www.bfmed.org/assets/ABM%20Protocol%20%2336.pdf).

TLDR: What we thought of a single duct getting plugged up is really an area of ducts becoming narrowed due to inflammation. The updated treatment recommendations center around decreasing that inflammation using ice and limiting/careful use of pumping/massage etc. Granted these situations are never cut & paste - that's why Lactation professionals (who make sure to stay current on the latest research) are essential.


Have you ever experienced plugged ducts/ductal narrowing before???


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