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I wouldn't just take the medicine. I'd talk to the doctor/midwife and a lactation consultant. There could be something more effective available now and perhaps they would have ideas of early, early signs to watch for so you know when to start taking the medication right away and head off problems. I am super prone to blocked ducts, which can easily turn into abcesses and mastitis, so at the first sign of one -- a little localized achy feeling -- I hop in the shower and let the hot water hit the area and massage the milk out to head it off, and I managed to avoid anything horrible and we've been nursing for 20 months now. If yours start that way, you could try that, and you could also reduce your saturated fat intake and take lecithin (there is more information at the La Leche League website on that). I'd also see if my latch is OK -- since you get infected easily, you want to make sure you aren't causing little breaks in the skin where bacteria can enter from an incorrect latch. Good for you for nursing for nearly a year!!

With my third child, she was the only one i could b/f. My 2 boys just seemed to be eating more than I could provide. I really wanted to b/f my daughter and my doctor suggested taking medication to help me lactate better. It's actual use is for gas reflux but the side effects are producing milk or lactation. There are no other side effects and it is proven safe for nursing mothers. It helped me to continue nursing my daughter with no problems with mastitis or soreness. You can eventually wean yourself off once your milk is established. The medication is called Domperidone. I don't know if this will help your situation but maybe it will help provide an abbundance and keep your ducts flowing more to prevent blockage. Also, when i did try to nurse the boys i had problems with engorgement and blockage too. Maybe its worth a try. Is that the medication you were on?