Therapeutic Breast Ultrasound: A Targeted Treatment for Clogged Ducts
Clogged ducts are a common problem for breastfeeding mothers— it is estimated up to 2/3 of mothers will experience a clogged duct at some point during their breastfeeding journey. And as someone whose seen many patients with them and had them myself, I can confidently say— they HURT.
So what is a clogged duct? We used to think that clogged ducts were a literal clog of milk stuck in the milk duct of the breast. So we’d recommend heat, massage, and pumping to “get the clog out.” But, now we know better!
In 2022, the Academy of Breastfeeding Medicine updated their Mastitis Spectrum Protocol, which included new information that a “clogged duct” is not actually a clog — it’s inflammation. Inflammation of the breast tissue causes narrowing of the milk duct (kind of like a kink in a hose), making it hard for milk to pass through. This causes an area of breast swelling, firmness, and pain. It can also cause a dip in milk supply. If it persists, it can lead to mastitis (which is also typically due to inflammation, but can be infectious in some cases).
The mainstay of treatment is aimed at decreasing inflammation in the breast. Your breast needs to chill out— literally. Cool compress or icing the area, taking anti-inflammatory medication, gentle lymphatic massage, breast gymnastics, and continuing to empty the breast as you normally would are all the first-line therapies we look to for management. Typically, this resolves the “clog” within 24 hours. But, other times the clog is more persistent. That’s where therapeutic ultrasound
What is therapeutic ultrasound?
Therapeutic ultrasound is a non-invasive treatment that uses sound waves to penetrate deep into breast tissue. It is safe for breastfeeding mothers and has no impact on milk quality. Therapeutic ultrasound is also gentle and well-tolerated; most patients describe the treatment as warm and soothing, and can be followed by either nursing or pumping to encourage milk flow and duct clearance.
How does therapeutic ultrasound work?
According to the Academy of Breastfeeding Medicine, therapeutic ultrasound’s thermal energy reduces inflammation and relieves edema (swelling).
When should therapeutic ultrasound be used?
If at-home methods for managing inflammation (described above) have not been successful at relieving the “clog” after 24-48 hours, therapeutic ultrasound can be a helpful next step. Therapeutic ultrasound can also be helpful if “clogs” are recurring and the inflammation cycle needs to be broken.
If inflammation has progressed and there are concerns for infectious mastitis or abscess, treatment of the infection would need to happen first. As a Breastfeeding Medicine PA, I always do an evaluation before beginning ultrasound treatment, and can diagnose and provide medical treatment if infection is present.
How many sessions of therapeutic ultrasound are recommended?
According to one study, the average number of sessions needed to resolve a “clog” was, on average, 3.3 sessions. In general, I recommend 2 sessions on consecutive days, with an additional session added on the following day if needed.
What should I expect during my therapeutic ultrasound session?
Your session will start with a consultation during which I will evaluate and diagnose what’s going on. You will then have your first treatment session with ultrasound, if indicated. This typically lasts 5-15 minutes, depending on how many areas require attention. The entire visit will last about 30 minutes. You then return to clinic the following day for your second treatment, after which you should be feeling significant, if not full, improvement.
As a Breastfeeding Medicine PA, I’m passionate about helping women navigate the ups and downs of their breastfeeding journey with evidence-based care. Therapeutic ultrasound is one of the many tools I use to support breast health and help you meet your breastfeeding goals.
If you’re dealing with a clogged duct that won’t budge— or just want expert guidance and relief—schedule an appointment with me today. Submit a contact form and I’ll reach out that same day to get you scheduled. If you’re a local IBCLC or other postpartum care provider and have a patient who needs this service, send me an email to sara@madetomotherlactation.com or text me at 919-480-1935 and I’ll make sure they get the treatment they need.
You’re not in this alone!
x
Sara
