In order to prevent plugged ducts you must understand their cause, which is simply anything that interrupts the normal flow of milk. Your breasts were designed to “know” exactly how much your baby needs. The more milk you take out (by nursing, pumping, or hand-expressing), the more your body will make. The less you take out, the less your body will make. Unfortunately, there is a limit to this magical flexibility of your mammary glands. If you nurse a lot every day and suddenly nurse very little one day due to a schedule change, you will find that your breasts probably did not get the memo. Especially if you have a large milk supply, the extra milk may pool and back up, resulting in problems for you. For this reason, it is usually recommended that you don’t wean any faster than dropping one feeding every three to four days or so.
If you know a schedule change is imminent because of an upcoming transition such as returning to work, it is important to drop feedings gradually. Though you may be planning to pump, be aware that a breast pump cannot empty a breast as fully as a baby can. Also, make sure you are well-versed in pumping before your first day at the office. Feeding the pump is an acquired skill, but a valuable one to possess in case of unexpected events.
Interruption of normal milk flow can also be caused by anything that compresses mammary tissue, such as an overly tight bra or constrictive shirt, pressure from carrying a heavy purse or bag, use of nipple shields, previous breast surgery or injury, wearing a baby carrier that presses heavily on your chest, sleeping on your stomach, or pressure from lying on a bunched-up shirt while breastfeeding. Some women believe erroneously that the breast tissue under their babies’ noses must be pressed down during breastfeeding to prevent suffocation. Actually, a baby’s nose is specially designed to breathe while at the breast, and this compression may just backfire and cause a plugged duct.
Mothers may be more prone to plugged ducts immediately postpartum due to problems with their baby’s latch (mouth position on the nipple). If the baby’s latch prevents him from nursing effectively, in addition to Mom getting a plugged duct, Baby might not be getting the milk he needs, so it is important to take up any problems with latch with a professional lactation consultant as soon as possible.
Some mothers find that other less obvious factors predispose them to plugged ducts, including exercise of the upper arms, and high levels of stress. Plugged ducts are also more likely to occur during winter months, perhaps because of holiday stresses and schedule alterations.
Some risk factors for plugged ducts are not within your control, but you can still take measures to prevent problems. For example, your baby might refuse to nurse. He might be overly sleepy, less hungry due to illness, less interested in the breast during certain phases of development, or on a “nursing strike” for some other reason. He may suddenly begin sleeping through the night instead of taking his 2 a.m. feeding, and you may find yourself awake and engorged. In these situations, you should pump or hand-express just enough milk to make you comfortable again. (If this doesn’t work, be aware that most babies will nurse during their sleep. You can wait until he is asleep, then offer the breast again.) If your baby no longer needs that feeding, your supply will gradually decrease with your baby’s decreased demand, and soon this extra effort on your part will not be necessary. On the other hand, if he later needs more milk, he will increase his consumption, and your supply will increase again.