On Plugged Milk Ducts

Owie! Ok, so I'm not sure if every nursing mom experiences this at one point or another, but I thought I had escaped. That was until today.

It is pretty common knowledge the effects of plugged milk ducts left untreated. If for some reason you don't know, a plugged duct feels like a hard knot on your breast. If left untreated or not emptied, you run the risk of your breast tissue becoming infected and getting mastitis. This can be painful, lead to abscess, fever, etc. No fun. The good news is, mastitis typically affects the tissue around the milk duct and has no effect on the milk itself meaning you can still nurse, in fact, it will help you heal. The bad news is that nursing on an infected breast is super painful. So, to avoid issues, if you have a plugged duct, get it empty!

I'm guessing I caused myself to get a plugged duct, but it is a complicated sort of round about way and I really don't know if it could have been avoided. The good news is that I was able to empty it out. This is what happened:

My teething baby at nine months feels like he's got a mouthful of teeth. He has eight and that is plenty. For some reason, his latch has been off and oddly enough, it is only on one side that it doesn't seem quite right. I find myself having to detach him and let him latch on again multiple times. Unfortunately, he still seems to revert to a closed mouth, nipple only latch even when I readjust him. So, needless to say, my right side is rather sore and I'm back to using lanolin. I'm not giving up though, I'm going to continue to try to correct his latch on that side.

In any case, starting last night, my right side was particularly painful, so I decided I'd nurse only on the left side and pump off the right side. I did this several days ago and it worked well and gave my right side a bit of a break. This morning, however, after I pumped off the right side, I noticed a knot on the top inside of my right side. This was not the little knot that they demonstrated in my breastfeeding class. It felt as if I had a knot about the size of my baby's fist.

I went through the list of recommended solutions:

First, I tried to massage the area. It was a bit difficult and it just seemed to make it more sore. Before it was mildly tight, massaging it made it actually hurt.

Second, I nursed the baby, despite the pain, with his chin towards the plugged duct. Given the position, it wasn't the easiest. I did this by laying on the floor on my back. I placed the baby on his belly with his feet over my left shoulder (remember, the plugged duct was on the top inside of my right breast). He was positioned kinda upside down. He managed to latch ok with minimal pain (since his teeth were in a different spot than usual, after all, I don't typically nurse him upside down) but this didn't seem to help a ton. I did try massaging the duct as he nursed, but I'm not sure it had much effect. The baby wasn't all that hungry so he tried to crawl away after a few minutes.

Third, I tried to apply a warm compress. I heated a small towel in the microwave for about 30 seconds and applied it with light pressure. This kinda made it hurt more and the heat dissipated from the towel pretty rapidly. I tried to heat the towel for longer and that made it too hot. I applied the warm towel until it cooled about three times (I noticed the plugged duct in the morning and the three applications were an hour or so apart).

I was at a loss. I didn't know what else to try and it seemed that no matter what I did, I was causing more and more pain to myself. I was also beginning to panic as I do not really know the time period it takes for mastitis to develop if a duct is not emptied. I was about to call and ask my mother-in-law who is a lactation consultant (IBCLC) but she was probably at work at the time.

Finally, frustrated, I decided to try nursing on that side again, normally this time. Since it hurt so badly to nurse in a normal position, I pulled out a nipple shield in hopes that it would block some of the pain caused by his teeth resting on me. He doesn't really bite, it is more just the position his teeth fall and press in while he is suckling. Well, apparently, the silicone of the nipple shield is not the same texture as a real nipple and he bit down. Hard. I screamed, I cried, after all, my nipple was inside the shield! I can not describe the pain it caused. This of course, caused the baby to scream and cry. Luckily, he hadn't broken skin. When I felt brave enough again, I tried one more time (with clenched teeth) - without the shield.

I laid down on my side and laid the baby alongside me. He latched on and while it was a little painful, I did manage to get him positioned, after a couple of tries, in a manner that wasn't tear inducing. As he started to nurse, I massaged the duct towards him. Slowly, I felt the knot get smaller and less tight until I couldn't feel it any more. Success!

I'm not sure if this last thing was all I needed to do or if everything I tried throughout the day helped to loosen it up even though I didn't notice a change. All I know is that it worked and now everything feels normal again. The one thing additional thing I've heard suggested for plugged ducts that I did not try was taking a hot shower and massaging it. I'm just happy it worked out. If you find yourself in a similar situation, try it all until it works. That's the best advice I can give. If you are lucky, you won't ever have to worry about it, I hope you don't!

On Diaper Rash

Ah, the joys of motherhood extend all the way to caring for red irritated bums! Unfortunately, this is something that we probably all have experienced and anyone with babies on the way (or in our futures) will experience it at some point.

There seem to be a number of tales that people tell when it comes to diaper rash. Some people tell you that breastfed babies are less likely to experience it. Some say that cloth diapers make them more likely to get it. Some babies will get a rash based on what they eat when they are introduced to certain new foods that don't agree with them. Either way, none of this really matters (with the exception of the food thing because then you can either avoid that or put off future exposure until later). In the end (on the end, rear end that is) babies get rashes.

Diaper rashes can be mild red bumps to the more severe bleeding cracked skin. My baby has experienced both. (He's breastfed, cloth diapered, and exposure to new food didn't line up - just to throw that in there.) The cause can be simple irritation, constant moisture on the skin, allergic reaction, or infection. There are many creams, salves, and powders out there that you can use, but most importantly, when it is encountered, changing the diaper often and keeping the baby as dry as possible is the across the board recommendation.

My topical treatment of choice is Desitin creamy. It started because I received some tubes in gift sets at my baby showers, but I have found that it works really well and so I've continued to use it. Desitin is also what my pediatrician mentioned to use, though I don't know if that was a brand recommendation or a random name thrown out there like we use Kleenex or Coke. Either way, I have found that sufficient lathering with it has healed even the worst of his diaper rashes.

Other moms that I've spoken with have used various other products that they would swear by or recommend. My sister-in-law hails Budreaux's Butt Paste and wouldn't use anything else. This product from what I can tell has a fairly big following. Some of the other moms I talk to like to use natural products like Motherlove Diaper Rash & Thrush salve or California Baby Diaper Rash Cream. These products also get great reviews for effectiveness, though I don't have a ton of experience with them.

A few moms that I talk to also use cloth diapers and depending on which ones you use, certain diaper creams seem to be contraindicated. The creams or salves can prevent the diaper from absorbing the moisture and therefore, it decreases the effectiveness of the diapers. If you use cloth diapers, make sure to read the instructions when it comes to which products you should or should not use. I have not had issues with my terry diapers and the Desitin Creamy, but that may not be the case with everyone.

One more note: Baby powder is commonly found in many gift sets and whatnot for babies. The intention of such a product is to help absorb moisture in the diaper and keep the baby's skin dry and free from irritation of moisture and other diaper deposits. From what I've heard, it is not recommended for use especially with very young babies because it can become airborne and can be inhaled. Use with caution if you choose to use it.

Hope this helps!

On Laundry

Before my baby was born, a small bottle of Baby All appeared on the shelf in my laundry room. I think it was a gift from my in-laws, but I'm not really sure. What I do know is that it was used to wash all of the baby clothes before he arrived and gave them that fantastic baby smell that we all love. It did make me think though, is it really necessary?

A friend of mine had a baby about a year older than mine and I remember him telling me about the added cost of the expensive baby detergent. He said it was necessary because it is gentler on the skin. Advertisements for different baby specific detergents advertise fewer dyes and fragrances. My mom never used any special detergent, but then, they weren't available when I was a baby. So, I was a bit confused.

Another friend gave me the best advice, in my opinion. See if your baby is sensitive to the regular stuff first, then if you notice he is, buy the more expensive baby detergent. This worked out for me.

I use Tide, though I did hear from another fellow mom, that this is one of the milder ones out there. I haven't had any issues with breaking out with its use. I do make sure all of my laundry goes through and extra rinse cycle though. I'm not sure if this has any impact or not, but I do it anyway.

I'll typically wash the baby clothing, blankets, spit rags, etc. together on the hand wash cycle. Given that they are made for short periods of wear, I'm not sure how sturdy they stand up to heavier wash cycles, call me paranoid. I tend not to separate them out by color like I would with my own, but I haven't had issues with too many colors running. I have noticed sometimes that spit-up doesn't always rinse out the first time and occasionally I throw those items in for a second wash. I then dry on low. I wash all of my diapers separately (the details are in my "On Cloth Diapering" blog entry) on casual setting, they are terry cloth so they seem sturdier than some of the other fabrics. Occasionally they go through a second wash if they need to be treated with Clorox 2 (spot treat and let sit at least 5 minutes before washing), after which I do a second extra rinse cycle to make sure everything is rinsed out of them. The diapers I dry on medium.

Along with the Tide, I use a splash of vinegar in my wash cycles as it is great for odors and, so I've heard, helps protect colors and keep them from bleeding. For stains, including those on my cloth diapers, I use Clorox 2, quite liberally might I add. I typically avoid fabric softener on the baby laundry, mostly because the instructions on the diapers say not to (I think it affects absorbency) and I've heard it can be detrimental to fire resistancy they put on some children's clothing, like pajamas.

I have had no issues with rashes or irritated skin with this combination of products. I don't know if it is because of the products I have chosen to use or if it has more to do with my baby individually. Either way, it works, so I'm passing it along!

On Baby-wearing (updated December 2010)

Baby-wearing can be associated with several different mothering styles. Some may consider it "crunchy" or "granola" others may associate it with attachment parenting. No matter how you look at it, I call it convenient.

If you don't know, baby-wearing is basically a way of carrying around your baby in a type of carrier, typically made of fabric, that holds the baby in a hands-free manner against your body. It's kind of the modern papoose. I'm not sure if you can call it popular, but I think that the idea is gaining popularity among modern mamas.

I have a sling that I wear my baby in. He has done great in it, but I can probably attribute that to starting him in it when he was quite young. My sling, which is a Hot Sling, a type of pouch sling, provides variety in ways a baby can be carried based on age and level of development. When my baby was young, I held him in the cradle hold, basically, he was laying down in the sling. In this position, it was actually quite convenient to nurse him in the sling allowing me to work around the house, prepare meals, or do whatever. The sling works great to hold him securely against my body, which is ideal for newborns. Now, I carry my baby in the hip position, which he's been in since he was strong enough to hold his head up well and sit supported, and it is great because it provides him the security of being next to his mama, he's contained and usually calm, and he can still look around and "interact" with people. When we are out and about, it is great because I am completely hands free so I can shop or do whatever without having to juggle holding him and doing something else.

One situation which I didn't anticipate the benefit of the sling is actually in a gathering type setting. Let's say for example, you are at a social gathering of some sort where you may or may not know the people there very well. This is likely in situations like weddings or showers. It is nice to be able to carry your baby around but your arms may get tired. The sling, or other baby-wearing carrier, comes in handy in these situations. But the best benefit in these situations is that people can see and talk to or interact with your baby, but they are less likely to try to hold them than if you were simply carrying them. This way, you can stay a little protective of your baby without feeling like you are being mean or rude to those you are interacting or conversing with. To me, it is a great advantage.

I get tons of compliments and questions about my sling. I can't think of a time I've gone to the store or craft fair or social gathering without at least one person making a comment about liking the sling or asking if the baby likes it or asking if it saves my back. It is very apparent to me that it is easy to see the benefits that slings provide.

Baby-wearing provides many benefits to mama (or papa) and the baby. First and foremost, the baby is next to his or her parent. This is where babies are meant to be. Baby-wearing allows the baby to be close but still be able to interact with or observe the world around while feeling safe and secure and protected. Baby-wearing allows for hands-free baby carrying. No more worrying about the carrier. No need to fear leaving your baby on the shopping cart to grab some veggies (which can also run the risk of the carrier sliding off or falling off of the cart if it is not secured or locked into place). A baby-wearing shopper can also opt for the hand basket if only a few small items are being purchased because his or her hands are available to hold the basket in one hand and grab items with the other. Baby-wearing allows a fussy baby to move with his or her parent while chores are completed around the house. Many mamas can nurse their baby while baby-wearing very comfortably. Baby-wearing is less bulky and lighter than carrying a baby in a traditional carrier (no more waddling or constant shifting) allowing for longer trips/walks. And again, as I've mentioned previously, baby-wearing allows strangers to say, "Hi" and interact with the baby but are less likely to ask to hold the baby keeping the parent from having to make the decision about whether or not they want to pass of their baby to someone they don't know well or risk appearing rude.

There are several styles of baby-wearing apparatuses. Here are descriptions of a few:

Slings: Slings are worn distributing the baby's weight across the body with the strap on one shoulder. Several varieties are available.

A bag sling provides some structure for a young baby but does not have the versatility that some others may have. The baby is carried in a single cradle position. Be extremely careful with this style though, some of them were part of a recent recall due to infant deaths from positional asphyxiation (suffocation). These types are not usually associated with "baby-wearing" because the baby hangs in a bag rather than being up against the body of the person carrying them and therefore, some or all of the benefits of baby-wearing may be lost.

This is a Hot Sling. This style is called a pouch sling. The sling is a continuous "loop" around the body that is sewn securely. The baby may be held in a cradle position where he is lying down and tucked completely in the sling, a front carry position where he is slightly more upright (shown far right), or a hip carry where the baby is sitting up with the legs hanging out (shown left). The pouch sling is a fixed size and is typically sized for one wearer. A baby can easily be nursed in this type of carrier when in the cradle position.

A ring sling like this one is worn very much like a pouch sling. It is secured by two large durable rings that create tension when the end of the sling is threaded through. It also allows for the variety of positions that a pouch sling has. One additional benefit of a ring sling is that it can be adjusted to change sizes for the baby and the individual using it. This comes especially in handy when dad is much taller or larger than mom. A baby can easily be nursed in this type of carrier in the cradle position.



 

Wrap Carriers: Wrap carriers have less structure than slings. They are typically made with a large long cut of durable fabric with or without  a small amount of stretch. The fabric is wrapped around the baby in a number of configurations from front carry to cradle to back carry and more. Weight distribution is more balanced in this type of carrier which is a benefit if the baby is older or particularly large. This type of carrier can be worn by multiple individuals, as it is retied each time it is worn. A baby can easily be nursed in this type of carrier. Here is a picture of one type of wrap carrier.

Soft Structure Carriers: These carriers provide some structure but they are typically made of durable fabric with or without clasps or buckles to secure them. They are typically easily folded and washed. They are worn either on the front or back of the body. A carrier of this design that ties is called a mei tai. These carriers support the baby's weight over both shoulders and typically have a waist strap and occasionally will have a chest clip to secure the shoulder straps. Some varieties of these carriers (especially those widely available at retail stores) allow the baby to face outward, but use caution with these types of carriers: studies have shown that babies spinal and hip development is better protected when their weight is supported on their rump while they are carried for extended periods of time. If you prefer this style of carrier for your baby-wearing, choose one where the baby is seated on his rump with legs spread wide and knees above the  rump rather than supported in the crotch area. More often than not, you'll find the safest and most comfortable position for your baby is when their body faces yours.


Pack Carriers: Pack carriers have more structure and can be used long term for activities such as hiking, camping, or other outdoor activities. Carriers of this design provide some protection for the baby from falls if terrain is not level, but it will not protect from everything. Babies worn in these carriers are worn primarily on the back and usually are not considered to be "worn". While these carriers do provide some of the benefits of baby-wearing, others are lost. These types of carriers typically provide very good weight distribution to make longer periods of carrying more comfortable.

I hope this enlightens and informs. Make sure to read and follow all safety instructions for proper use and follow your instincts - if the baby doesn't seem safe and secure, he probably isn't. With that in mind, I'd highly suggest baby-wearing to any parents. I enjoy it as does my little one!

Added note: All of these pictures were taken from Google image search results. No copyright infringement was intended. If these pictures are not intended for free use, please contact me and I will gladly replace them. I'd suggest in that situation that the images be better protected and not able to be saved/downloaded to personal computers.