Mastitis, 4th time. I feel so broken.

[@llli*mommal]

Another possibility for the latch issues is a tongue-tie. A bad latch can cause persistent pain, and cracking, and because a poor latch can contribute to plugged ducts and cracks can allow bacteria to enter the breast, all those things can add up to repeat bouts of mastitis. Can you see a lactation consultant, preferably an IBCLC, and have your baby's tongue and latch evaluated?

[@llli*mtmama]

Another possibility for the latch issues is a tongue-tie. A bad latch can cause persistent pain, and cracking, and because a poor latch can contribute to plugged ducts and cracks can allow bacteria to enter the breast, all those things can add up to repeat bouts of mastitis. Can you see a lactation consultant, preferably an IBCLC, and have your baby's tongue and latch evaluated?

good thinking!

[@llli*shortthumbs]

Another possibility for the latch issues is a tongue-tie. A bad latch can cause persistent pain, and cracking, and because a poor latch can contribute to plugged ducts and cracks can allow bacteria to enter the breast, all those things can add up to repeat bouts of mastitis. Can you see a lactation consultant, preferably an IBCLC, and have your baby's tongue and latch evaluated?

Yes, I've seen several IBCLCs and they say no tongue tie and externally latch looks good. Have never had an issue on right side.

Am now attempting to wean on one side. Alternating hot (flax bag in microwave over castor oil compress) and cold (grated potato, cabbage, ice packs) to massage and hand express milk. Am also scheduling a breast ultrasound.

Any reccommendations on successful single-side weaning? Does anybody know if I can aid in drying left side by drinking a "no more milk" tea, then supplementing as right side supply increases? What's the gentlest formula, if it comes to that?

[@llli*aprilsmagic]

Don't mess with the tea. It could decrease your supply so dramatically overall that you'll be in trouble.

What about a different position on the sore side? Like nurse on the good side but don't change baby, move yourself.

The downside of single side feeding. Lopsidedness. I'm a D plus on one side because it makes more milk but a B on the other.

You can tryd treating yourself for thrush too, and Iwould call one of the IBCLCs back and tell her what is going on. Because obviously something is, and whatever it is, it is not typical.

Good idea for the ultrasound.

[@llli*mommal]

Stay away from the no-more-milk tea. I don't think you can expect to totally dry up the bad side, but you can certainly get to a place where that side produces only minimal milk. Of course, that does put you at risk for some lopsidedness, as the PP said... But it sounds like that's not the worst thing you've put up with!

Have you considered getting a really good pump and pumping the bad side? During a bout of mastitis isn't the best time to wean, and removing milk from that breast right now would probably help you feel better faster. Since you've been to the IBCLCs and they say the latch looks good, I wondering if you may have some sort of anatomical difference on that side which holds nipple flat to the skin, and prevents an ideal latch. You can have a great latch on the outside but still have it feel awful and be awful on the inside. And nipple trauma leads to cracks, and cracks lead to mastitis, etc.. So I'm thinking that if you can pump that side for a while you may 1) feel better because removing milk will help beat the mastitis, 2) have your own milk for supplementing purposes, 3) prevent lopsidedness (if that's important to you), 4) potentially draw out that nipple more, eventually enabling a better latch, and 5) maintain production on that side so that when your baby is bigger and has a bigger mouth,you can eventually try nursing on that side again. Does that make sense?

[@llli*joe.s.mom]

I have had to wean off one side temporarily, it can be done. Even for me, and I had oversupply. But I'm really worried that it will just make your mastitis worse! That's the last thing you want to do when you have mastitis!

Get your breast under warm water (I like to add a bunch of kosher salt for antibacterial effect) and really massage the infected area, and let the milk flow. This breaks up clogs and can get things moving, to help clear the infection.

[@llli*shortthumbs]

Stay away from the no-more-milk tea. I don't think you can expect to totally dry up the bad side, but you can certainly get to a place where that side produces only minimal milk. Of course, that does put you at risk for some lopsidedness, as the PP said... But it sounds like that's not the worst thing you've put up with!

Have you considered getting a really good pump and pumping the bad side? During a bout of mastitis isn't the best time to wean, and removing milk from that breast right now would probably help you feel better faster. Since you've been to the IBCLCs and they say the latch looks good, I wondering if you may have some sort of anatomical difference on that side which holds nipple flat to the skin, and prevents an ideal latch. You can have a great latch on the outside but still have it feel awful and be awful on the inside. And nipple trauma leads to cracks, and cracks lead to mastitis, etc.. So I'm thinking that if you can pump that side for a while you may 1) feel better because removing milk will help beat the mastitis, 2) have your own milk for supplementing purposes, 3) prevent lopsidedness (if that's important to you), 4) potentially draw out that nipple more, eventually enabling a better latch, and 5) maintain production on that side so that when your baby is bigger and has a bigger mouth,you can eventually try nursing on that side again. Does that make sense?

I do have a Medela hand pump (Harmony?) and I have had some issues with pumping that side. The first time I tried it I got blood out, and that was way back a few iterations ago, so I will try again. Not sure I have the correct nipple shield size though. The nipple itself is so swollen, like, the base of the nipple where it meets the areola is more like a angled flat-topped pyramid, with puffiness and extreme tenderness, so when I try to draw it into the pump its very painful. Not as painful as nursing on that side, but close. But I will try again this time and see if anything has changed.

I have hugenormous breasts and that is even post-reduction. Ever since my breast reduction I have had some additional lumpy tissue in the affected breast, so I know there's got to be something going on. I am not sure, though, where to draw the line between plugged duct and full-on mastitis; it happens so quickly and that breast always feels like a bag of gravel anyway. Even with massaging. I'll start to feel sore in my armpit and feel that nipple pain, and within maybe 4 hours or less, there's the redness and hot skin and the stripes running up the breast. And the fever.

My nipples don't really stick out though they are not flat. When he nurses on the right side (the good side) he comes off with the very lipstick-shaped nipple every time, which I know can be a sign of bad latching. He also grabs and pinches/pulls at the breast skin the whole time, which is annoying, and bites and rears his head back. I worry that I am not making enough for him right now. Last night I expressed milk instead of nursing on the affected side, and then tried again in the morning and it felt better. But this amount of hassle just makes me want to quit; my desire to do this doesn't trump my son's base need to eat something, you know?

[@llli*mommal]

Oh right- I forgot that you are post-reduction! . Maybe what's going on is that the surgery messed up your ducts, making them difficult to drain and therefore leading to increased incidence of plugs (ergo the "bag of gravel" feeling) and mastitis. Just a thought- I know it has to be frustrating to hear all there possible explanations without us zeroing in on the one right explanation!

I can totally understand your concern about providing enough for the baby. If he's having enough wet and dirty diapers and is gaining weight, you can rest assured that things are going okay on that score.

I know you've seen the LCs and it sounds like they haven't helped you as much as one might hope, but one more trip might be a good idea. A L should be able to hook you up (no pun intended) with a really good pump and correctly sized shields. A hand pump is really unlikely to do much for you- hand pumps are the bottom of the line in terms of effectiveness. They're good for a mom who wants to pump once in a great while, and who responds well to a cheap pump and has a good supply. They are not good for a mom who needs to treat a problem like mastitis or who is contemplating doing a lot of pumping.

[@llli*shortthumbs]

Oh right- I forgot that you are post-reduction! . Maybe what's going on is that the surgery messed up your ducts, making them difficult to drain and therefore leading to increased incidence of plugs (ergo the "bag of gravel" feeling) and mastitis. Just a thought- I know it has to be frustrating to hear all there possible explanations without us zeroing in on the one right explanation!

Yes, no worries! I understand that this is a very hands-on issue and I appreciate your out-of-sight (literally!) help and advice. Sometimes it's good to just kick around all possible scenarios. The previous LC said that eventually the unused ducts *should* atrophy, but of course there's no way to tell when that will happen.

I can totally understand your concern about providing enough for the baby. If he's having enough wet and dirty diapers and is gaining weight, you can rest assured that things are going okay on that score.

Yes, I've been tracking the input and output for that reason. In the last six days (since I started really tracking more fastidiously) he's had an average of 8 diapers total per day (cloth) with one or two small poos a day. But I do use very absorbant cloth diapers and so I think that would be comprable to disposables. He's always been an insistent, frequent nurser and probably goes 45 minutes to an hour between feeds. Lately he has been very, very gassy, hiccuppy, and even poots while he is nursing. SO I have no idea what the heck is going on there. It seems like my supply dips every time I go on antibiotics, which is frustrating because even on my good side he is so fierce a nurser I get lipstick nips every time and the areola is frequently bruised.

I know you've seen the LCs and it sounds like they haven't helped you as much as one might hope, but one more trip might be a good idea. A L should be able to hook you up (no pun intended) with a really good pump and correctly sized shields. A hand pump is really unlikely to do much for you- hand pumps are the bottom of the line in terms of effectiveness. They're good for a mom who wants to pump once in a great while, and who responds well to a cheap pump and has a good supply. They are not good for a mom who needs to treat a problem like mastitis or who is contemplating doing a lot of pumping.

The hand pump has been Ok so far... of course I've only used it on the right side but when I do I get 2 ounces or so, overnight. Last night of course he was up every hour so that was rough on me. I will investigate at least getting the shields sized because I know those aren't right.

Thanks again for your help.

[@llli*kmanih]

Hi Mama,

Just wanted to know how you're doing. I hope it's gotten better. Just two more things that occurred to me:
- A manual pump isn't the best when you're dealing with a problem such as mastitis or clogs. In this situation you're much better off with a hospital-grade (you can rent). And yes, you want to make sure you have the right flange size. This made all the difference to me when I had a bad clogged duct. My Harmony wasn't doing anything except hurt! I rented a hospital-grade and the LC gave me a larger flange (b/c my nipple was swollen) and it was much more effective and comfortable.
- Just wanted to second what mommal said about the baby growing and the latch improving. My baby had a tiny mouth so even though her latch was good, it still hurt for the first couple of months, and I got the "lipstick" shape. When her mouth got big enough, it felt amazingly better. At that point the baby won't hurt your nipple so much, and will be better at draining the breast, all of which will help preclude further bouts.

I hope you heal soon, a happy & healthy mama is very important!!!