Mastitis, Thrush and Pumping, Oh My!
This is my first post. I am currently nursing my second child born on 5/31 and who is now 10 weeks old. I was treated for two rounds of mastitis, on 7/11 & 7/24, with the second course requiring admission to the hospital for IV antibiotics. I feel like I've finally got that under control and have been been off the antibiotics since 8/5. I returned to work full time on 8/6 and have been pumping twice a day at work from each breast. I was already pumping following our 3-4 am feeding to decrease the chances of recurrent mastitis since my son has been inconsistent with his sleep patterns. Some nights he'll go four hours between feedings but he occasionally goes 5-6 hours between feedings. I think the start of the prolonged sleep sessions is what led to my first round of mastitis. This past weekend, I noticed superficial pain with nursing, increased fussiness of my son while nursing and what appeared to be white patches on the inside of his lips. I took him to his doctor today who confirmed thrush and prescribed nystatin drops. I then called my doctor's office and the nurse advised that I can use nystatin cream on myself several times a day. Both my son's doctor and my doctor's nurse said I don't have to take any precautions with bottles, pacifiers, burp cloths, etc. I did call the lactation support center here and they advised boiling anything (bottles, pacifiers, toys, etc) that comes into contact with my son's mouth daily and to wash sheets, towels, bras, etc in hot water. The lactation consultant also advised I could be experiencing pain because of the increased frequency of pumping. She said if I don't see a decrease in pain after treatment, I could try going up a size for the phlanges since I'm currently using the smallest ones and they rarely recommend using that size due to many of their clients expressing pain with that size.
So, my questions are:
1. Do I follow the adivse of the doctors to not treat our environment or do I listen to the lactation consultant and get busy with disinfecting?
2. I realize the disinfecting process also extends to pump parts. I use a Medela PISA. Can I boil/microsteam the tubes or should I buy new tubes?
3. I read that I need to replace nipples and pacifiers weekly until treatment is complete. Is this necessary and do I also need to replace the pump parts weekly until treatment is complete?
I am committed to continue breastfeeding. I would love to make it to a year if not longer. I am thrilled I have come this far with nursing my son since I only nursed my daughter for a month. I was very niave with what all occurs in a healthy breastfeeding relationship when nursing my daughter as well resuming a full college courseload a week after having her via c-section. I had my son via c-section as well. He was 8 lbs and 5 oz when born and weighed 13 lbs 13.5 oz at today's appointment. I am super-proud that I am the source of his cute chunkiness! My boss is super-supportive and gracious in allowing me time to deal with these issues as they arise, but I do want to get this resolved as quickly and thouroughly as possible to prevent casting any doubt on my dependability at work. I also want to ensure I'm taking all necessary precautions to prevent further discomfort in my son and myself that may hamper our nursing relationship.
Any advice and support is greatly appreciated. Thanks in advance!
Mom of Audrey, born 8/2000, and Liam, born 5/31/12