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Expert Q&A

	By Ann Calandro BSN, RNC, IBCLC Lactation Consultant

I'm an extended nursing mother. I have never used bottles. During this – my third – pregnancy at 12 weeks gestation, my colostrum came in. A few weeks later, I noticed what I thought were plugged ducts in each breast. I notified my OB, and he advised me to leave them alone.

My baby now is 10 weeks old, and I have had mastitis in one or the other breast since soon after delivery. The plugged ducts that I had during pregnancy have formed hard masses. No heat or massage will alleviate these hard masses. A surgeon has even done a needle biopsy that came back as inflammation cells. The masses are not painful unless fever accompanies them. I have been on three rounds of antibiotics and have seen one OB, one pediatrician and three surgeons. They all say that if I wean, the infection will go away.

Why am I having these complications this time? I am staying as drained as possible and am doing all the right things. I feel there has to be another answer. Even my La Leche League leaders don't know what to do. Please help!"

My goodness! You have certainly been going through a difficult time with plugged ducts. The routine advice is to nurse frequently, rotate positions during feeding, watch that your clothing or baby carrier or sling does not put pressure on your milk ducts and be sure your baby is latching on correctly. If you have already done all these, I will share some anecdotal information from other lactation consultants.

I understand that many mothers have found relief from this problem by taking lecithin. This is made from soy and helps to ""break up"" the fat and help it move through the milk ducts. It comes from health food stores and comes in liquid, capsules or granules. Ruth Lawrence's book, Brea stfeeding: A Guide for the Medical Profession (Mosby, 1998), recommends that you take 1 tablespoon of the liquid a day and also cut back on polyunsaturated fats in your diet. Some lactation consultants have said that some mothers need more than that amount of lecithin to find relief from the plugs. Two lactation consultants who had a similar problem found relief by taking a calcium/magnesium supplement and adding 3 tablespoons of flax seed to their diet daily along with taking the lecithin.

As I am not a doctor, I cannot prescribe any of these supplements but I can tell you about them. Certainly you should talk to your own physician about this. I hope that you soon find an answer and will be breastfeeding without problems."

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