title: Six-Step Recanalization Manual Therapy: A Novel Method for Treating Plugged Ducts in Lactating Women.
abstract: BACKGROUND
  Plugged ducts are a common, painful condition in lactating women, but no standard treatment is currently available.
  
  
  OBJECTIVE
  This study aimed to evaluate the clinical efficacy of a newly established 6-step recanalization manual therapy (SSRMT) for treating plugged ducts.
  
  
  METHODS
  This observational study included 3497 lactating women with plugged ducts. The SSRMT comprised the following well-defined steps: (1) preparation, (2) clearing the plugged duct outlets, (3) nipple manipulation, (4) pushing and pressing the areola, (5) pushing and kneading the breast, and (6) checking for residual milk stasis. The response to the treatment was graded as I (complete resolution), II (marked improvement), III (improvement), or IV (no response).
  
  
  RESULTS
  Of the 3497 patients, the mean age was 26.7 years and 3284 (93.9%) patients were primiparas. Fever was present in 1231 (35.2%) patients. After a single SSRMT treatment, 3189 (91.2%), 173 (4.9%), and 83 (2.4%) patients achieved grade I, II, and III responses, respectively, with only 52 (1.5%) showing unresponsiveness. For the 308 (8.8% of total) non-grade I patients, a second SSRMT given 3 days later resulted in grade I, II, and III responses in 267 (7.6% of total), 28 (0.8% of total), and 13 (0.4% of total) patients, respectively, and none were absolutely unresponsive. No complications with clinical significance were observed.
  
  
  CONCLUSIONS
  Based on this large-scale clinical observation, SSRMT appears to be a useful, safe, low-cost treatment for postpartum plugged milk ducts.
authors.affiliation: Department of Breast Surgery, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, PR China cyzhao59@163.com.
authors.forename: Chunying
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Department of Breast Surgery, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, PR China.
authors.forename: Rui
authors.initials: R
authors.lastname: Tang
authors.affiliation: Department of Breast Surgery, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, PR China.
authors.forename: Jiandong
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, PR China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Guan
authors.affiliation: Department of Breast Surgery, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, PR China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Department of Breast Surgery, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, PR China.
authors.forename: Junyan
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Breast Surgery, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, PR China.
authors.forename: Gaowu
authors.initials: G
authors.lastname: Hu
authors.affiliation: Department of Breast Surgery, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, PR China.
authors.forename: Cong
authors.initials: C
authors.lastname: Song
keywords: breastfeeding; manual therapy; massage; mastitis; plugged ducts