by Ashley Georgakopoulos | Oct 11, 2023 | Health Conditions, Infant Care and Breastfeeding
“The breasts are not an empty cavity to be filled with milk, but contain a network filled with alveoli that can be found even in the uppermost part of the breast tissues leading into the armpits. The ducts leading from these, channel the milk to meet behind the nipple inside the areola area, and release.”
Milk flow obstruction often results from milk not fully draining from the breast, causing inflammation and tenderness. If left unaddressed, clogged ducts can develop into more severe issues like mastitis, underscoring the importance of prompt and effective resolution.
Clogged, blocked, and plugged ducts. There are many terms for the same problem. Restricted milk flow, or “milk stasis”, leading from the milk-storing alveoli (those grape-like clusters in the breasts), may lead to a fatty blockage that soon becomes painful, and even infectious mastitis, if not treated quickly enough. These clogs can very well lead to other problems and occurrences, including lower supply thresholds, nerve pain in the breast tissue, lessened pumping output and bruising sensations.
The breasts are not an empty cavity to be filled with milk, but contain a network filled with alveoli that can be found even in the uppermost part of the breast tissues leading into the armpits. The ducts leading from these, channel the milk to meet behind the nipple inside the areola area, and release. Too much compression without proper release, be it due to improper bra fitting or tight, shallow latching, can cause buildup to occur. Poor suction from latching or pumping can also prevent proper drainage which leaves behind the fattier part of the milk and may lead to the same problem.
This “network” is also designed to be tapped into frequently. If milk is allowed to sit and settle for too long, say during block feeding versus feeding frequently and on demand, the risk for blockage to occur drastically increases.
Causes of Clogged Milk Ducts
Some of the most common reasons behind clogs are:
- Poor latching – shallow, weak, uncomfortable
- Restrictive clothing and bras
- Block feeding/feeding schedules
- Incorrect flange fit or pumping technique, if pumping
- Nipple damage/blebs- secondary issues from poor latching
- Abrupt weaning
- Long stretches in between pumping, 4+ hours
- Fibroids in the breast tissue pushing on ducts/channels
- Lowered immune system
- High stress
- Thrush or bacterial infections
Symptoms of Clogged Milk Ducts
Most women can feel the backed-up milk occurring with a clog. Clogs can be anything from a tender knot in the deep tissue to a blocked outlet on the nipple, also known as a bleb. Pain may also occur while hand expressing or having a letdown, as other channels push up against it. While a small fever may occur due to localized inflammation, clogged ducts are mostly a nuisance and a pain more than anything else. Symptoms beyond these are more in line with mastitis, which is an infection of the breast tissue, and need immediate attention. Expressed milk may show strings or a grainy appearance. While this may look unappetizing, it’s completely safe to give to your baby.
Treatment for Clogged Milk Ducts
Treating clogged milk ducts involves a combination of strategies to alleviate discomfort and restore milk flow. Effective methods include frequent nursing or pumping sessions to empty the breast, using warm compresses before feeding to encourage milk flow, gentle massage towards the nipple during feeds, and ensuring proper latch and positioning. Rest, hydration, and over-the-counter pain relievers can aid in reducing inflammation. If symptoms persist or worsen, seeking guidance from a healthcare professional is recommended to prevent complications like Mastitis.
The most common forms of treatment involve warm compression, massage and nursing through it while massaging the area during the feed, however, other methods have also been shown to be effective:
- Epsom soaks – dangling the breasts in a tub of warm water with epsom salt can encourage release of the clog.
- Dangle feeding – lying baby down on a safe surface and dangling over to feed.
- Vibration and gently shaking the breast are both ways to break up a clog.
- Lecithin – a fat constituent found in foods and supplement form, such as sunflower and soy, known to help emulsify fatty milk for easier release.
- Pump – if the baby does not feed well or has already fed, pump immediately after a feed to encourage more thorough emptying and clog removal.
- Stay hydrated – this is important in flushing out potential infectious tendencies.
- Rest- really prioritize rest and recovery.
- Pain relievers can be used, just check with your care provider and utilize resources, like LactMed, for safety while breastfeeding.
- Antibiotics are NOT needed unless it progresses into mastitis.
Another important note – while massage is a primary go-to for dealing with clogs, it’s crucial to realize that the clog is in FRONT of the backed-up milk, which is the knot most feel. Massaging in front of the knot will release the clog faster, while pushing behind it may be adding to the milk back-up.
Prevention
While clogs may happen regardless of effort, there are ways to help prevent them.
- Avoid block feeding or strict schedule regimens that space out expression opportunities more than 4 hours apart
- Don’t pressure “sleeping through the night,” neither mom’s supply or the baby is designed for that
- Ensure proper latching, so as to tap into all of the milk stores
Preventing clogged milk ducts involves maintaining a consistent breastfeeding or pumping routine, ensuring proper latch and positioning to facilitate efficient milk drainage, and avoiding tight-fitting clothing that might impede milk flow. Adequate hydration and proper self-care, including managing stress levels, also play crucial roles in preventing duct blockages. Being attuned to your body and seeking assistance from a lactation consultant if issues arise can further help in proactively preventing clogged milk ducts. Addressing latching issues as quickly as possible will not only help with frequently-occurring clogs, but help prevent them from happening again. If clogged ducts are a common occurrence, rule out latching and mechanical feeding problems.
If pumping, take time to learn proper handling and technique, and just as important, flange-sizing. Just like with a shallow latch or too much compression, a flange that is too big or too small will cause the same problems. Adjust strength settings to a comfortable level to avoid compression of the ducts.
Ashley Georgakopoulos is the Lactation Director at Motif Medical and an IBCLC. Her focus is in the clinical management of breastfeeding and pumping. Ashley is also a mother who has dealt with the obstacles and joys of breastfeeding. She educates families, connects them to resources, and helps the next generation be as healthy as possible: nutritionally and sustainably.
www.motifmedical.com
by Sarah Goldberg | Sep 20, 2023 | Family and Relationships, Health Conditions, Mental Health, Parenting and Child Development
“I was so happy with the way I was handling the new addition that my following depression blew me out of the water. My husband was away on a trip, and I got a new car. Sounds like a good thing, but somehow I found driving a new car with its new buttons and pockets in different places to be overwhelming. To be fair, it was also a nine-seater. I’ll let you sit with that.”
I am a mother of eight. My youngest is 16 months old and my oldest is expecting my first grandchild at 22 years of age. I am extremely blessed. I am also a woman who has experienced multiple episodes of Postpartum Depression (PPD.)
I’m told I’m predisposed to anxiety, which resonates with me. As far as I know, I didn’t experience PPD with my first two births. For what it’s worth, all of them were normal, healthy births. After my third, a lot of things irritated me. A lot! I found my fists clenched all of the time and it took a bit before I realized that wasn’t normal. I wanted to enjoy my baby, husband and other kids but everything set me off. I got a psychiatrist referral from my doctor who promptly prescribed psychotropic meds. I started getting debilitating headaches and was concerned that they were a side effect of the meds. My kids were making a lot of noise when I reached out to the psychiatrist by phone and had my concerns dismissed. He surmised that if he had as many kids as me, and it was so noisy around him, he too would have a headache and hung up. Imagine what he’d say about the five more kids I have now!
Needless to say, I deleted his contact, and told my OB to take him off of his referral list. When a person is in a vulnerable state, she needs understanding and empathy; not cruelty and sarcasm.
Then came baby number five. I had a bit of a bumpy ride leading up to the birth because my parents had divorced a year earlier and my dad was getting remarried. It was a bit dysregulating, (read: one of the hardest experiences of my life emotionally). I mention this because at that time I may have already been in a high stress situation and standing at the edge of the cliff. Maybe, who knows? I had the best time with my baby for four weeks. I was present, my other kids were excited, and they were in camp during the day so I had some time alone with the baby. I even had my dad and stepmom over for the first time. The higher you are, the harder you fall.
I was so happy with the way I was handling the new addition that my following depression blew me out of the water. My husband was away on a trip, and I got a new car. Sounds like a good thing, but somehow I found driving a new car with its new buttons and pockets in different places to be overwhelming. To be fair, it was also a nine-seater. I’ll let you sit with that. When my husband called that evening, I told him I couldn’t breathe because that’s how I felt. I hadn’t realized at the time that I was having a panic attack. I actually think I only figured it out recently.
When he returned home, and I was clear that something was horribly wrong, I tried to find a psychiatrist that I could trust but they all had a minimum two week wait. At this point I was getting desperate. I asked to be hospitalized and was turned down because I wasn’t a danger to myself or anyone else. I did not feel like I could be left at home. All I knew is that I needed to be “fixed” ASAP.
My OB prescribed Xanax to tide me over until a psych appointment. I took one pill and slept for 17 hours straight. When I awoke, I couldn’t follow anything with my eyes. That’s when it all started to fall apart. I couldn’t sleep, even for a minute. You’d think having a one month old would’ve made me tired but I physically could not close my eyes. I couldn’t eat, never mind drink, and I’m usually a stress eater not a starver. My closet seemed too overwhelming for me to choose an outfit so I stayed in pajamas. I couldn’t go near the baby and then I couldn’t even leave my room. Everything seemed so frightening. I felt like the walls were going to cave in, literally. If I hadn’t experienced it myself, I wouldn’t believe it. Now I feel like it’s just a movie I once watched. I was afraid to do things I had been doing for decades because they all seemed overwhelming. The future seemed scary and bleak. Does this mean I can’t have any more kids? Will I ever be able to take care of the baby? Leave the house? Get dressed?? What will my other kids do? It was a dizzying spiral. And then, a friend of mine brought over her friend who had PPD with her first child.
I knew this woman. She had a full life, a normal life. She had a second child after her episode and it all went well. We spoke and she gave me hope, even if it was the tiniest bit. I had some old meds (I do not recommend trying this at home) so I took one. And the world was different. It was so different. I don’t think it’s common for people to turn around as quickly as I did, but I’m grateful. I felt like I could see a way out, and once things were a bit more stable, I was able to wait for my doctor appointment with more ease. I met my superstar psychiatrist, Dr. Jennifer Yashari. She focuses only on the woman’s cycle, so things like PPD, infertility, pregnancy, adoption, menopause etc. She wanted me to get more out of the medication so she made me a cocktail that I’ve been taking ever since.
When the baby was 15 months old, I found myself with a surprise twin pregnancy, yes I know how that sounds. It scared the living daylights out of me. Dr. Yashari reminded me that this time was different. I had knowledge, I was prepared, I had her, my meds, and we were watching. I stayed on the meds throughout the pregnancy, as research has not concluded that it’s dangerous, but unstable mental health definitely is. As far as I know, one of the babies was a bit sleepy for a day and that was the extent of the effects my meds had on the pregnancy. When my life was at its most hectic, with three kids aged two and under, plus another four above them, I was at my most stable.
Eight years later, we went for one more, just for fun. It was the most amazing pregnancy and an awesome postpartum experience. Since then we have also married off a child, are expecting a grandchild and I have been open and honest about my challenges with my kids. My pregnant daughter finds comfort in knowing that I am looking out for her and will do everything to keep her safe. PPD should not be stigmatized; it’s not a guarantee, and it’s treatable. We need to educate our partners and family members to keep their eyes out for anything that seems unusual and have them bring it up in the most gentle of ways. If you or anyone you know is questioning their mental health after giving birth to a baby, reach out to a professional and get evaluated. You are not alone and you won’t be like this forever.
***
This post is written in memory of my superstar OB, Dr. Jay Goldberg. Like many of his patients, I considered him a cherished friend. His days were too few, his accomplishments many, and his loss devastating to those who knew him. He helped bring my lights into this world all the while emanating his own bright light and he is missed by many, every single day.
***
Resources for Postpartum Depression:
The Mayo Clinic – Postpartum Depression
Mental Health America – Postpartum Depression Test (New & Expecting Parents)
NIH, National Library of Medicine – Use of Prescribed Psychotropics during Pregnancy: A Systematic Review of Pregnancy, Neonatal, and Childhood Outcomes
Recurrence Rates and Risk Factors in Perinatal Mood Disorders
Sarah Goldberg is a licensed life coach in private practice. She is on sabbatical while she immerses herself in the joys of raising a toddler and a family of 10. She lives in Los Angeles, where she can be found at a different public playground every day!
She welcomes any questions or opinions on pregnancy, labor, or child raising and can be reached through sarahlgoldberg@gmail.com.
by Dr. Sarah Dirks | Aug 30, 2023 | Health Conditions, Infant Care and Breastfeeding, Parenting and Child Development
“The pressure used during therapy is less than the weight of a nickel and most of the movements are so slight that they are often missed by the parents as the practitioner moves through the treatment. “
It’s 2:00 in the morning and your one month old newborn has been screaming since midnight. You and your partner have tried everything… nursing/bottle, diaper change, warm bath, rocking, bouncing, white noise, singing, a walk outside… but the screaming seems endless. This continues for several days and you both decide to call the pediatrician. You are told that your baby is perfectly healthy, the screaming is normal, and there is nothing to worry about. Now what? Do you just grit and handle the screams every night? What other options do you have? You still feel like something is off and that your baby is in some pain or discomfort. You and your partner may even feel lost as to what to do next.
Navigating the first year of a baby’s life can be extremely challenging for any parent. Pediatrician, night nurse, lactation consultant, physical therapist, chiropractor, occupational therapist, myofunctional therapist, pediatric dentist… Sometimes it feels like there is an overwhelmingly endless list of people to help your child. Let’s take a deeper look into the option of craniosacral therapy to help you decide if it is the best option to help your child.
What is Craniosacral Therapy?
Craniosacral therapy is a very gentle manual technique used to assess and enhance the function of the structures surrounding the brain and spinal cord. Alleviating tension in these structures can promote improved functioning in the nervous system and subsequently the other bodily systems, which allows the body to respond better to the stressors of life. Craniosacral therapy facilitates the body’s natural healing process and can therefore be used to increase the body’s resistance to disease.
What Can Craniosacral Therapy Help With?
Craniosacral therapy can help infants who struggle with many different ailments. Some of the most common are difficulty gaining weight, latching issues, colic, reflux, gassiness, difficulty sleeping, mouth breathing, torticollis and/or muscle tension (clenching fists constantly or straightening legs/arching back during diaper changes.)
Is Craniosacral Therapy Safe?
The pressure used during therapy is less than the weight of a nickel and most of the movements are so slight that they are often missed by the parents as the practitioner moves through the treatment. With this small amount of pressure it is safe to use on most infants and newborns, however it should not be used in conditions in which a slight change in intracranial pressure would cause instability.
What to Expect During Craniosacral Therapy.
Craniosacral therapy is typically performed in a quiet, calm, dimly lit room with the infant lying comfortably on a massage table. The practitioner will first identify the craniosacral rhythm by placing their hands gently on the baby. They will then feel the baby’s head, neck, torso, and spine while assessing and alleviating tension in the craniosacral system. Many of the movements are so subtle that they can be imperceivable except for the calming effect and relief seen in the child.
What If My Baby Cries Constantly or Doesn’t Sit Still?
Don’t stress if your child is fussy or has the wiggles during an appointment. Some treatments occur while infants are breastfeeding or even with them laying on top of a parent. A skilled therapist has encountered a wide array of baby obstacles and has many options to help calm them. Typically by the end of the session the baby is relaxed, quiet, and/or sleeping.
Dr. Sarah Dirks is a pediatric and prenatal chiropractor, specializing in craniosacral therapy and Webster Technique. She received her doctorate of chiropractic at Los Angeles College of Chiropractic in 2010. Dr. Dirks is in private practice and collaborates frequently with midwives, lactation specialists and pediatric dentists to provide a comprehensive treatment for all of her patients.
She is a wife and mom to a one year old daughter and a three year old son. In her free time she enjoys spending time with her family, as well as swimming, traveling and going to concerts. After having her son, who was colicky, tense, and struggled to gain weight, she began to dive deeper into craniosacral therapy. The technique gave him so much needed relief.
by Eos Rejuvenation (Sponsor) | Mar 22, 2023 | Fitness & Nutrition, Infant Care and Breastfeeding, Mental Health
“…moms may need to wean their babies or switch to formula before the surgery since both anesthesia and antibiotics can impact breast milk.”
After childbirth, many moms start wondering how they can enhance their physical appearance, allowing them to feel confident in their own skin or extend some of that pregnancy glow.
Women who have given birth can undoubtedly be good candidates for plastic surgery. Still, according to board-certified facial plastic surgeon Dr. Nima Shemirani of Eos Rejuvenation in Beverly Hills, it is essential to wait an appropriate amount of time, ensuring the body is ready for the rigors of surgery.
When To Schedule Your Procedure
All moms are different, and their post-pregnancy recoveries can progress at varied timelines. For most, Dr. Nima recommends waiting three months before having any type of aesthetic surgery.
After cesarean or vaginal birth, it is vital to wait before considering a plastic surgery procedure for several reasons. Most importantly, this time allows the body to regain strength following childbirth and reduce the risk of complications during recovery. Additionally, moms may need to wean their babies or switch to formula before the surgery since both anesthesia and antibiotics can impact breast milk. For these reasons, Dr. Nima recommends that moms wait at least three months before considering a plastic surgery procedure and recommends consulting with their doctor first to determine the best plan of action tailored to their specific case.
The Advantages of Waiting
While it is perfectly natural to feel eager or impatient about transforming your appearance, there are ultimately many advantages to waiting.
One of the main benefits of waiting a year or so before having surgery is that recovery from plastic surgery requires a fair amount of downtime, and most patients will need to rest and heal for a week or more. Peace and quiet may be hard to come by when you have a baby in the house, but not as challenging as juggling your recovery with newborn sleep cycles, breastfeeding, and the like.
But the main reason to delay surgery is for your general health and wellness. Giving birth to a baby is no small thing; it will weaken your body for several weeks or even months.
Talk to Your Doctor
Ultimately, the best way to evaluate your readiness for plastic surgery is to talk to your doctor. Your readiness depends on your unique recovery timeline, which only you and your medical provider can determine. If you’d like more information on plastic surgery after childbirth, contact Dr. Nima of Eos Rejuvenation today to learn how cosmetic procedures may benefit your post-baby transformation journey.
Dr. Nima Shemirani grew up in a family of artists and found himself drawn towards the field of medicine in college when he recognized that biology is an equalizer. “Underneath the microscope, we are all the same: we are merely human without color, race or religion.” This personal revelation spurred a deep passion, and Dr. Nima applied to and excelled at the prestigious Medical School of Wisconsin where he also completed his Otolaryngology (ENT) residency. Dr. Nima then secured a greatly-coveted fellowship with the globally-respected Glasgold Group in New Jersey, where he trained under some of most highly trained plastic surgeons in the world.
With a luxurious office and Medicare-certified (highest certification) surgery center in the heart of Beverly Hills, Dr. Nima offers individualized and artistic results for his patients, specializing in facial plastic surgery (i.e. rhinoplasty, facelifts, brow lifts, earlobe reduction, etc.), ENT (ear, nose and throat procedures) and non-surgical facial enhancements (i.e. lip augmentation, non-surgical rhinoplasty, injectables, etc.).
Beyond his impressive credentials, Dr. Nima has developed a compassionate sensitivity to his patients’ needs and fears. He takes the time to really listen to them and collaborates with each one to develop a highly personalized approach that directly addresses not just that patient’s particular issue but also takes into account the individual’s personality, sensitivities and concerns. He creates a warm atmosphere where his patients feel safe, secure and nurtured.
by Hayley Oakes | Mar 15, 2023 | Labor and Delivery
“I like to encourage clients to take note of the cord immediately after the baby is born as one can visually see the cord change from being full of blood and pulsating to white and drained within a few minutes. Also in this time, they will notice their baby start to darken and/or pink in color receiving a healthy amount of oxygen.”
The heart of my work as a midwife (and mother of two) is educating and informing clients about their options surrounding care in pregnancy, labor, birth and postpartum. This runs the gamut of discussing the pros and cons of out-of-hospital birth vs hospital birth to my recommendations for nursing bras.
Once a client is halfway through the third trimester (week 34), we discuss postpartum options and their preferences. Two hot topics surrounding the immediate postpartum period (aka the fourth stage of labor) are cord blood banking and delayed cord clamping.
What is cord blood banking?
Cord blood banking is the process of collecting blood from the umbilical cord immediately after the baby is born for storage and potential future use of umbilical stem cell treatment.
Cord blood banking can be beneficial if an immediate family member has a current health condition in which they could benefit from stem cell treatment. There is ongoing research about the vast treatment opportunities for diseases such as lymphomas, leukemias, Alzheimer’s, diabetes, heart disorders, autism and over 100 more conditions.
However, it’s not completely risk-free. Firstly, collecting and storing cord blood in a private bank is costly. One can expect to pay a few thousand dollars for the initial collection and then an annual fee of a couple hundred dollars. This is a lot of money for a very low likelihood of your child needing to use their cord blood. Secondly, and more importantly, it involves clamping and cutting the cord early — before a baby has received 100% of their oxygen-rich, red blood cells from the placenta.
During the final stage of labor when the baby has descended into the pelvis, they shunt about a third of their blood volume back to the placenta to help fit through the vaginal canal. Once the baby is born, the placenta immediately sends the blood back to the baby via the umbilical cord. This process can take up to 10-15 minutes. Honoring this physiological process is called delayed cord clamping.
Delayed cord clamping is the act of waiting to cut and clamp the cord until the cord has visually stopped pulsating and/or the placenta has been delivered.
The moment a baby is born, their respiratory and cardiac systems are altered in an instant. Waiting to cut the umbilical cord allows the baby to receive oxygen from two sources while undergoing that transition. They are breathing room air utilizing their lungs for the first time and receiving oxygen rich blood cells via the umbilical cord. I like to encourage clients to take note of the cord immediately after the baby is born as one can visually see the cord change from being full of blood and pulsating to white and drained within a few minutes. Also in this time, they will notice their baby start to darken and/or pink in color receiving a healthy amount of oxygen.
Another benefit of delayed cord clamping is decreasing the risk of childhood anemia, which can affect a child’s growth and development.
So, if one is a healthy candidate for cord blood banking (remember: a sibling or immediate family member with a current health condition that could benefit from stem cell treatment), and they would like to do delayed cord clamping, is this an ‘either/or’ situation? Not entirely!
My recommendation is to wait at least 90-120 seconds before the cord is cut. See this incredible TED talk about the benefits of waiting just 90 seconds. Then the remaining blood in the cord can be collected and stored.
There are so many options surrounding the childbearing journey and hopefully some clarification about a couple of these choices can make the decision-making process that much easier.
Hayley Oakes is a licensed midwife based in Los Angeles offering integrative pre- and postpartum care. She has been attending births since 2010 as a doula, midwife assistant, apprentice and midwife, witnessing and supporting birth in all settings: home, birth center and hospital. Hayley is the host and creator of Milk Trails — a podcast dedicated to the out-of-hospital birthing experience. In February 2019, Hayley became a mother herself and welcomed her second child in January 2022. As a midwife, educator and mother, she is committed to supporting childbearing folks in having a safe and satisfying pregnancy, birth and postpartum experience to help grow healthy, happy babies.
