I had my first kid last year, and I have been able to breastfeed her which is a blessing. It's also extremely, chronically painful. Something I did not know beforehand - it seems very little research has gone into improving breastfeed, namely in the clogged ducts department. Like, they say massage and heat and hope for the best. It's ridiculous.
I've struggled with clogged ducts since my daughter was born. Many mothers do not get them, or only get them once or twice. I have been getting them nearly weekly, sometimes more, every once in a while less. But through my struggles, many have reached out with advice and I would like to catalog what has helped me here. Obviously everyone is different, all of us are on our own journeys, but I'm writing this down in the hope that it can help someone.
When my friend heard that I was getting clogs, she recommended Sunflower Lecithin (this supplement), which is a rather big pill (I'm not great with those) but I think it has been a game changer with getting my clogs to move out quicker. Before I started taking this twice daily, my clogs would linger for days on end - after starting it (and taking more on days with clogs), my clogs usually move on after a day or two. UPDATE: It comes in liquid format! It's super thick but I think it's easier to get down than the big pill version.
But that's still a day or two of pain, so my mom sent me a list of things that could be helpful and on it (#12) was Happy Ducts Lactation Support (this supplement). [The supplement mentioned in the previous point is #13 on this list.] I put a few droppers of it into like a shot of water (it doesn't taste the best, kind of just herby, but I think it's worse to mix it into a drink) when I have a clog and this has really helped to move out clogs in usually the same day they start.
When I feel a duct clogging (hardening lump, feels very obvious), I warm the area with a heating pad my friend made for me - it's basically a beanbag filled with rice. I microwave it for about 15 seconds and place it on the painfilled area. The heat helps sooth the tender area and can help the clog move. I don't have a link for this one, since mine was home-made for me, but I'm sure there are plenty of options out there. You can look in the sports area of a CVS-type store and they should have ice/hot pads - I've heard that cooling the area can be helpful but I have not found that to be true for me. Or you could just fill a clean sock with rice, microwave it, and work with that.
I alternate between warming the area and massaging the area. Now you can massage with your hand, I did that for the first few months, but dang the area hurts and I kinda feel like I'm hurting myself by messing with it. So my amazing husband found this little massager and it's great. That brand has several types - I have found success with this one so I haven't tried the others. It was a game-changer. It feels nice (the silicone is very smooth and does not catch on my skin or irritate it) and works well to break up the clog so it can be pulled out by either my pump or my baby. It's also water-proof so I can use it in the shower or tub, which means I can have hot water on the area while massaging which is helpful in moving the clog out.
UPDATE from 2023: So when I wrote this back in 2021, above was the best practice. But now I've been told that you should use cold and not work the area, just treat it like a sore muscle instead? So I've tried doing that and it seems to help? Minimal massaging and using cold rather than hot. What do I use for cold? The packs that come with this very helpful C-section recovery band. The packs can go hot or cold, and when cold they are still flexible. The band itself was way more comfortable than the hospital-provided binders (my hospital seems to only have S or XL and I'm neither). I wore the band when going for walks in the month or so after my surgery - the band helps keep the surgery site stable and protected from clothes rubbing against it. The hot/cold packs fit nicely inside the band and help relieve the pain on the surgery site.
UPDATE: I found out about these nipple shields and they seem to be helping immensely! I very rarely clog with my second adventure in breastfeeding and I started using them a week before I gave birth (like the instructions say) and it's a fairly simple change with seemingly great results (or maybe my second time nursing is just going way better? It's hard to know).
Dangle feeding is another thing mentioned in that list above and also mentioned by my lactation consultant (my baby's pediatrician's office employs several - check if yours has any!) but I have not noticed success with that.
If you notice inflammation or get a fever, please call your doctor since that could be mastitis and you should get that checked out.
Hopefully you won't need this advice, but if you're reading this post then you probably do need it, so I hope something here is helpful for you! Reach out to moms you know - mine pray fervently for me as they know the misery that plagues me, and their prayers are an encouragement to me. You are not alone in this! I know the book of Psalms was written by guys, but some of the passages are quite applicable when struggling with this pain.
One last thought, be mindful of your mental health. I know I get depressed when my chronic pain flairs up, and reaching out to friends for prayers and also reading the Bible help keep my spirits from getting too low. Find what works for you and remember to do it! Stay away from negative sources like the news or people who bring you down - find something that relaxes you to remove excess stress since nobody needs extra stress, especially when you're in pain and have a very needy baby!
Postscript: How to finish nursing your baby? It was a big question for me because I have had plenty of supply for my whole journey. I started spacing out my baby's feedings as I could and kept spacing them out until I was just feeding her when she got up and when she went to bed. Dropping to just one feeding wasn't too bad, and after a week or so I dropped the lone feeding of the day and my baby was fine with it! But I was not fine with it - I slowly engorged over the next week until the pain was just too much and I had to express it. I then slowly engorged again and had to repeat - I think this happened three times, each time took about a week to get painfully full. I applied peppermint essential oil topically to help with the pain (and it might have reduced my milk supply), and it was not a bad thing. I did stop taking my sunflower supplement since that can increase milk supply and I did not want that. After about a month, I was good to go! No more leaking, no more engorging, the milk supply is gone!