The Dreaded Plugged Duct

As my faithful readers know, I did a lot of reading on breastfeeding while pregnant. I feel it's something important for both my baby's and my own health. So honestly, the latching problem Em and I are (still) having took me by surprise. I had been feeling discouraged - it seemed silly for me to be so often literally pumping and feeding her from a tube at the same time.

Last Wednesday night, DH had been feeding her or playing with her in the living room as I was getting ready for bed. For some reason, out of the blue, he brought her to me in bed and asked me to try a different position to get her to latch (I say for some reason but I think it's because as much as he enjoys feeding Em, he has seen how discouraged I have been by the problem we've been having, and he wants to help fix it). It was a goofy one, not one of the Four Positions From Which One Breastfeeds, and she didn't latch. But I sat up and tried the cradle hold, and for the first time in ages, she really latched on and sucked for awhile without the nipple shield - a few minutes at any rate.

I only mention this in my post on my plugged duct, because this brief bit of success made what happened the next day - well, I went through a bunch of words, tolerable, less discouraging, a few others - and really, the pain wasn't tolerable, I was still very discouraged - at any rate, I think the success, small as it was, sustained me.

Thursday morning around 3 am, I was having a dream where I was a passenger in a small car being driven by someone else - I can't remember who it was. Em was in the back seat and it had snowed heavily. We were leaving someone's house and the driver backed out of a parking spot onto a very steep and snow covered driveway. They braked hard and we skidded, though the driver more or less maintained control of the car. I clutched my chest, at first in fear of an accident - I remember the driver making fun of me for doing so - but then I realized I was having intense pain in my breasts. I started to explain this to the driver, and then I woke up, and realized the pain was real.

I got up and started pumping. My right breast quickly deflated and started feeling normal again. My left breast, however, continued to ache and when I massaged it a bit, I noticed I had dense area in the top half which was warmer than normal, very painful and swollen. I thought oh, I've read about this! It's a plugged duct.

I searched the Interwebs for confirmation and found great information on the Kellymom web site. Sure enough, that's what it sounded like I had going on. I chose to treat it with:

• rest
• ibuprofen
• massage (ouch! can we get a bugger that hurts!)
• warm compress
• frequent draining of the breasts through nursing and pumping
• more rest

Really. I don't think I've ever napped so much in my life. It was awesome, actually.

I called the lactation consultant I'd been helped by before to confirm my self diagnosis and she agreed with me. She also suggested cold compresses after nursing/pumping to both help reduce the pain and the flow of fluids to the area, which I inferred then might loosen the plug. I didn't do that, but it sounded like a good idea.

By 3 pm Thursday, the lump was smaller and less painful. By 7 pm, the lump was gone and the left breast was still sensitive but not achingly don't even think about touching me painful. I'm surprised at how quickly it went away, since the pain was so intense - I was expecting it to drag on for some reason.

Because I'm mostly pumping, I can get pretty quantitative about how much milk each breast is producing. My left breast was producing much less than my right breast before the plugged duct, and continues to be the slacker boob now. Hoping it picks up...

I've read that some women take a plugged duct as a sign that they're over-extended and they need to rest or cut back on what they're doing. I'm a little worried about what that means for me when I go back to work, but I hope I can find a balance that will work for Em, me and our ducts...

Book Review: Understanding Your Moods When You're Expecting

I'm a big reader and enjoy sharing books with friends, and I was thinking I'd write here about a few of the books that I've read about pregnancy and parenting. I've signed up to be an Amazon Associate, which means that if you use the link provided to the book reviewed, I will make a tiny commission. I was setting this up just as the delisting of queer content shitstorm happened. I went back and forth on whether I'd go ahead with putting up the Amazon links along with the book reviews, and decided I would, though I'm quite unhappy with them these days. Wow, that makes me sound like I'm a total mercenary, or something, eh?

At any rate, my doula loaned me a pile of books which I should really return to her, so I'm going to go through those first. The first is Understanding Your Moods When You're Expecting by Dr Lucy Puryear. 

When I found this in the pile of books, I was skeptical of its value. I wondered how you fill up a whole book with you're pregnant, so you're going to be cranky and weepy, have fun! I decided I'd give it a try anyway.

Dr Puryear is a psychiatrist specializing in female reproductive mental health - a field it hadn't occurred to me exists until I read her book! Like so many pregnancy books, this one is largely divided into temporal phases: first, second, third trimester and post-partum. Throughout, Puryear presents how a lot of the emotions pregnant women experience are hormone related, and she also touches on how women already in psychiatric care for depression or other issues and taking medication, may experience pregnancy.

The first trimester section has some invaluable bits, including a nice section called The Conspiracy of Silence, which addresses in a very sensitive way, how problematic it is that we are so ashamed to hide miscarriages, and not talk about being pregnant until later in the pregnancy. (There is an article I really like on Babble.com by Christine Chitnis that looks at this issue as well.) Puryear talks a lot about trusting your instincts and your trust of information sources, because of the boundless quantity of conflicting information out there on pregnancy. 

I found that for me personally, the second trimester chapters didn't really capture my experience. I think this is because Puryear talks a lot about husbands feeling disconnected and nervous about the coming baby, whereas in my case, it's me that's the nervous newbie and he's more confident about parenthood than me; and anxiety about weight gain is another big topic, and for me my main weight gain worry was the week I lost five pounds. I think that it's probably really good content for a lot of women though. 

The third trimester section is great, covering what I imagine are common anxieties and concerns with the impending birth. Something I really like is that throughout, she presents examples of clients and their family situations (Western traditional nuclear or not), and the complexities of their dynamics, like the woman who didn't want to ask her mother for help after the baby comes, because the new grandmother would take it as a confirmation of her daughter's incompetence. Stuff like that is so real! Puryear gives some good ideas about how to handle the family craziness and also get the support you need.

For me, the real value in this book is the last few sections looking at the emotional impact  of birth and post-partum. I've not yet blogged about this and I'm not sure I will, but I'm pretty sure my mother had pretty bad undiagnosed post-partum depression after the birth of my little sister and probably after me too. 

PPD is so common - according to Puryear, up to 1 in 10 women experience it after giving birth. Puryear presents examples of clients with varying degrees of PPD and how she or other practitioners helped them through it. She also advocates breastfeeding newborns as much as possible, though for some women, she allows that it's more stress and pressure than it is worth. Puryear provides some useful warning signs of PPD which are also available on her website so I won't reproduce them here, but I encourage anyone who is pregnant or knows someone who is pregnant to go check them out.

I was surprised at how valuable I found this book to be and I'm glad it came my way. If what I've written interests you, I encourage you to get your hands on a copy. It's a quick read (199 pages in the edition I have)  and written in a very accessible style.