Your Milk Hasn't Come in Yet If you're trying to pump right after giving birth, it's possible that your milk hasn't come to volume yet. According to the CDC, most moms won't see actualbreast milk until 3 days after birth. Itmay take even longer for some moms.
However sometimes engorgement can be so severe that a mother can't seem to get her milk to let-down at all, her breasts will feel hard, lumpy and very painful. The mother may describe them as being “blocked” or that “the milk is stuck” and she just can't express any milk.
In short, you should pump until milk isn't coming out any more. Or, if you're trying to boost your supply, pump a little while longer after the milk stops flowing.
Symptoms of plugged ducts, mastitis
Plugged duct symptoms progress gradually, and can include pain, a hard lump, a warm and painful localized spot or a wedge-shaped area of engorgement on the breast. Mastitis symptoms appear rapidly and include flu-like symptoms such as fever, chills, fatigue and body aches.
Blocked milk duct
Try these tips straight away to ease the problem. Have a warm shower and massage the breast under water to break up the lump. Use a warm compress – wrap a warm (not hot) heat pack in a soft cloth, and hold it to your breast for a few minutes. Gently massage to break up the lump.
Ultrasound treatment delivers deep heat to milk ducts that won't go away with superficial heat treatments you do at home. Ultrasound treatments work very effectively, usually clearing the lump within three sessions.
Firmly massage the affected area toward the nipple during nursing or pumping and alternate with compression around the edges of the clogged milk duct to break it up. Try a warm soak in the bath or shower along with massaging the plugged duct while soaking.
Most clogged ducts resolve within 1–2 days, with or without treatment. Regular, consistent breastfeeding is the fastest way to resolve a clogged duct. It is essential to empty the breast with the clogged duct completely during each breastfeeding session.
Most blocked ducts will be gone within about 48 hours. If your blocked duct has not gone by 48 hours or so, therapeutic ultrasound often works.
“If a plugged milk duct persists [for longer than two days] and there's no relief, there's a chance it can develop into mastitis,” Kramer says. “With mastitis a mother develops a fever (100.4 degrees Fahrenheit), begins to feel fatigued and achy and should seek medical attention immediately.”
You can help to release the clogged area through gentle massage. Before and during a feed, gently swipe your thumb over the lump and toward your nipple. You can repeat this as many times as you like but don't use too much pressure as this can cause damage to your milk ducts.
The signs of a plugged duct may be gradual. A blocked breast duct may appear as a tender lump the size of a pea or larger, and occasionally presents with a small white blister on the nipple.
On the affected side you may notice a temporary decrease in supply and during your let down it may be more painful. After the clogged duct has cleared, usually within a day or two, it is normal for the area to feel bruised for a couple weeks.
Eat Anti-Inflammatory Foods
Your clogged milk duct is painful because it is inflamed. Reduce inflammation with anti-inflammatory foods like fatty fish (think salmon and tuna), nuts, green leafy vegetables, citrus fruits, berries and tomatoes.
Massage it away.
Applying gentle pressure to the plugged duct both before and during a feeding can help loosen the clog. Try a circular motion on the outside of the breast and move in towards the lump. Resist the urge to overdo it, though, since that could lead to overstimulation or bruising.
It is not always easy to tell the difference between a breast infection and a plugged duct. They have similar symptoms, and both can get better within a day or two. But the mastitis may also include other signs, like these: Flu-like symptoms like fever, chills, body aches, nausea, vomiting, or fatigue.
Baby wants a faster milk flow
Even very young babies can be quick to notice that pulling off, kneading the breast, etc. can cause an additional let-down, and can facilitate a faster, easier milk flow. Some babies become impatient with the slower milk flow following the initial fast flow at let-down.
Each time baby begins to nurse the nerves in your breast send signals that release the milk in your milk ducts. This let down reflex usually happens after your baby has been sucking the breast for about two minutes. Some women feel this let-down reflex as a tingling or a warmth.
During this time, before you letdown, you might see milk dribbling out your nipple, and just a few drops going into the bottles. When you have a letdown, you will see milk start to spray into the flange and flow more quickly into your bottles.
Oxytocin. The oxytocin reflex is also sometimes called the “letdown reflex” or the “milk ejection reflex”. Oxytocin is produced more quickly than prolactin. It makes the milk that is already in the breast flow for the current feed, and helps the baby to get the milk easily.
Feeling stressed or anxious
Stress is the No. 1 killer of breastmilk supply, especially in the first few weeks after delivery. Between lack of sleep and adjusting to the baby's schedule, rising levels of certain hormones such as cortisol can dramatically reduce your milk supply.
Pump no longer than 15 minutes.
Pumping frequently for short pumping sessions is better than pumping long. Pump every 2-3 hours during early postpartum; this can be adapted as your milk production stabilizes. Some women can pump much less frequently, and some require continued frequent pumping.
Why it happens: Low milk supply can be the result of not pumping enough, pumping too soon after a feeding or not nursing between sessions. You may also have a low supply if you're not pumping long enough, if you're using the wrong type of pump or you're not drinking enough liquids.