On Sunday, I developed a blocked duct in my right breast and my breast became engorged.  At least I think it was a blocked duct because the last time I had one was when I first started nursing Gavin.  Back then, everything hurt so I guess I was more tolerant of the pain.  When I palpated my nipple, I could feel small lumps in the aveolar area - which are indicative of a block duct or three.  

It all started on Saturday night when I avoided nursing Gavin on the right breast because of a sore nipple (I think it was cracked).  Over the entire night, I kept giving Gavin the left breast - that was my first mistake.  On Sunday morning when I woke up, not only was my right nipple still sore it felt like I had rocks in my right breast. 

Realising the problem, I wasted no time putting Gavin on the right breast but it hurt so much my eyes were smarting from the pain.  It seemed that Gavin wasn’t really interested in the breast either because he kept pulling away, which hurt even more.  So I went through everything I remember from the books about engorgement (I tried to express the milk, I tried hot and cold compresses) and took a warm shower as suggested by my BFF.  They all worked to a limited extent but I would feel the ache coming back again after a while. 

I was feeling desperate enough to take painkillers, but I’m glad I held off.  I waited until I knew Gavin would be eager for a feed before putting him on the breast.  He managed to drain most of the breast except for one lump at the top.  I’m sure he would have drained that one, too, if it weren’t for the Dad who was singing to his daughter in the baby room that I was trying to feed Gavin in.  My keipo (read: nosey) boy kept pulling off to see where the voice was coming from. 

For the rest of the day, I would nurse Gavin twice on the right side for every nursing on the left.  By Sunday night, my right breast was returning to some semblance of normality.  By Monday morning, me, my breasts and I were all hunky dory.

My take-out from this experience:

• If I ever have a cracked or sore nipple again, I will persist with feeding baby.  If I had forgotten how good Bepanthen is fantastic for helping the healing process for cracked/sore nipples, I certainly remember now (and I’m not saying this because I used to work for Roche - Bepanthen is now manufactured by Bayer anyway).

• Nothing beats baby when it comes to resolving a blocked duct and an engorged breast.
• If I am ever in charge of building a shopping mall, I will design a baby room with sound-proof nursing cubicles.

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I’m starting to develop rather uncomfortable breasts engorgement. My left breast was so full even my nipple felt hard. I called ML for some advice on the engorgement and also checked up the LLL International breast feeding book: “The Womanly Art of Breastfeeding”. The suggestions to manage and avoid engorgement are:

1. Feed every two hours (which is hard with Gavin who can be quite hard to wake when he’s determined to continue sleeping)

2. Express a little milk before feeding (which is currently what I’m doing)

3. Have a warm shower before feeding

4. Use a warm compress before feeding

5. Gently massage the breast. Stroke the breast towards the nipple (preferably under a warm shower or over a bowl of warm water, sloshing water over the breast)

6. Wear a cabbage leaf under your bra between feeds. After 2-4 hours the leaf will wilt. Reapply for up to 8 hours. Do not do this for longer than that as it can affect the milk supply.

7. Engorged breasts can flatten the nipple and make it hard for baby to latch on. Applying an ice pack or cold wash cloth can help draw out the nipple.

8. Use a nipple shield just prior to feeding to help draw the nipple out. Alternatively, you can use the nipple shield for a few feeds.

I tried the nipple shield and it worked a treat for a while. Personally, I would discourage doing it because baby doesn’t learn to suck properly and you end up at the beginning of the learning curve all over again. The other problem I had with the nipple shield was that it had a habit of drawing out my milk which made Gavin choke. And if you have an aggressive feeder, baby tends to pull the nipple shield off. In my opinion, it’s better to just work with baby and encourage baby to feed directly from the nipple.

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