When to start antibiotics for mastitis?

[@llli*3kidsmama]

I have my fourth case of mastitis since December. Usually I pretty quickly go from a painful, inflamed area to fever, aches, flu-ish symptoms so I've taken antibiotics the past three times. This time, however, I began having a painful spot in my breast Friday afternoon and haven't yet progressed into a fever, so I'm wanting to hold off on antibiotics if I can. I've been doing heat, nursing first on that side, massaging, etc. The pain doesn't seem to be getting any better and I can still feel the clog. I don't want to risk it abscessing. Do I need antibiotics? Thanks!

[@llli*mommal]

I think that you hold off until you see fever, aches and pain, malaise, or red streaks/patches on the skin of the breast. Until that sets in, you don't have mastitis- just a nasty plugged duct. If you can, beat this with frequent breast emptying, massage, warm compresses, etc. no reason to take abx unless you absolutely have to!

[@llli*3kidsmama]

Thanks! I forgot to mention there is done very faint redness. Patchiness - but very mild. Much less than I've seen in the past.

[@llli*mommal]

Okay, then I would consider that to be a plugged duct that is thinking about tipping over into mastitis. I still wouldn't take the antibiotics- but I would pump/nurse like mad! Keep that breast as empty as possible.

[@llli*3kidsmama]

Ok. Thanks. Hopefully I can make some progress with this plug today. Thanks!

[@llli*mommal]

Let us know how it goes!

Do you take a soy lecithin supplement? That's supposed to be helpful for women who are prone to plugs.

[@llli*3kidsmama]

I do take lecithin. 3600 mg per day. I don't understand why I keep getting it, although twice it has coincided with illnesses going through my household. It was as if everyone else got whatever bug that was and I got mastitis. The other two times she was teething...and maybe her latch gets wonky? I always do breast compressions at the end of sessions and she obviously softens my breasts each time (by the end of the day they're floppy and very soft). So I don't know what else to do to prevent it?

[@llli*3kidsmama]

Also, those two times when it happened right when others were sick - I never felt a plug. Just woke up overnight with severe pain and redness and had a fever and aches by the next day.

[@llli*lllmeg]

I understand not wanting to take ab again, and theoretically it should be ok to hold off if all you are dealing with at this point is a painful spot or plug. (see this tip sheet) http://www.llli.org/docs/00000000000...atcanyoudo.pdf
But so much depends on you and your body. I suggest keep monitoring how you feel very closely, and if you start feeling worse, take action.

Meanwhile it is important to keep "emptying" the breasts by nursing (or otherwise extracting milk) very frequently and RESTING. This means sleeping or laying down.

I would also suggest maybe calling in for a prescription just so you have it on hand (or at the drugstore) so you can start taking them as quickly as possible if you feel worse or develop a fever.

Have you always taken the full course of ab every time? This is imperative and yes I know it's really really hard to do!

If you have always taken a full course I suggest talking to your doctor about if you need a different kind of ab should you need them again.

These things are important because one possible cause of recurrent mastitis is that the body has never fully fought off the previous infection.

When you are feeling better, you can look over this article for the causes of recurrent mastitis.
http://kellymom.com/bf/concerns/moth...rent-mastitis/

[@llli*3kidsmama]

Thanks Meg. I'm feeling much better this evening. I can still feel a small plug, but it's hardly painful at all and I'm able to hand express thickened milk out each time after she nurses. I've also pumped a couple times to empty it as much as possible.

I have finished each round of antibiotics - and the interesting thing is that I've felt 100% better by the second or third dose each time (but I continue through the 10 days). I've been taking keflex. I have a refill available, so I can fill it right away if I need to start. I will speak with my doc, though, if I need them agin and see if I should try something else. Or maybe a longer regimine?