Though I’ve now had clogged ducts more times than I can count, I have (knock on wood) so far avoided mastitis.   Here are some suggestions for basic clogged ducts.  First, read Kellymom’s page about clogged ducts and mastitis.  The following is my protocol for handling a clogged duct.  I find that immediate attention makes a big difference in preventing a painful clogged duct. 

• Hot shower.  As soon as I notice a hard area in one of my breasts, I get in the shower and direct a stream of hot water at the affected breast.  After a few minutes, I gently begin to press on the clogged duct with the palm of my hand, starting out on the chest wall and working my way inward toward the nipple.   If I’m lucky, I will soon see a stream of milk ejecting itself from the breast, which means I’ve gotten it unplugged.  I continue the firm, steady pressure until the milk stops squirting out and the clogged area feels almost the same as the rest of the breast; be sure to stand so that your nipple isn’t in the way of the shower water so that you can tell when the squirting stops.  I then nurse as soon as possible after the shower to keep things flowing.
  
  
• Applied heat.  Another pain-relieving and flow-inducing strategy is using a heating pad.  I use a buckwheat-filled Bucky bag or gel pads like BustBuddies.  Both can be heated in the microwave.
  
  
• Ibuprofen.  If the clogged duct is painful, it is considered safe to take ibuprofen, an anti-inflammatory.
  
  
• Opening a milk blister.  Sometimes I see a milk blister when I have a clogged duct.  In my case, unless I carefully open up the blister with a sterilized needle (and then hop in the shower and express the milk from the duct), the duct will often remain clogged.  Kellymom has instructions for opening a milk blister but recommends asking a health provider to do it so the risk of infection is minimized.  Keep in mind that after you open a milk blister, you have an open wound on your nipple that will need extra TLC to heal.

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