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Thread: Help, I'm considering weaning at 12 months but don't want to

  1. #11
    Join Date
    Aug 2012

    Default Re: Help, I'm considering weaning at 12 months but don't wan

    Hey mamas, I saw a doctor today who was filling in for a breastfeeding expert doctor. The usual doctor is highly recommended and is a member of the Academy of Breastfeeding Medicine; I'm not sure if the doctor filling in is or not. Anyway, I got some advice that I thought was questionable, so I wanted to see what you all thought, and I can't get hold of my LLL leader at the moment.

    She gave me a prescription for antibiotics, 250 mg of Keflex, and said that I should start taking it (3/day) at the first sign of a lump, but that I could try 3, 2, even just 1 day of taking it instead of the usual 5-10 days recommended, to see if that kicks it. I asked if that isn't normally not recommended because not enough time on abx will just encourage the bugs to become resistant to them, but she seemed to feel it was ok to "listen to my body" and if I felt totally better, to see if that does it in order to minimize the antibiotix exposure, because anyway they "wouldn't become resistant right away."

    She also prescribed Fucidin antibiotic cream to put right on the nipple 1-2 times per day (or up to 5 if I kept having to wipe it off to feed baby), as my nipple does invert in on itself when baby's not sucking, so it's pretty much a breeding ground for bugs as well. And she recommended that I do that all the time, every day, not just when I feel a plugged duct coming on.

    Also, she talked about the fact that a sick baby will keep infecting me, like when baby has a cold or something. I was under the impression that mastitis was caused by bacteria, not viruses - can it be viruses getting into the breast as well?

    Thanks for your time! I'm a bit confused by all this. It doesn't sound right but I don't know, I'm pretty desperate. Maybe I could just do a full 5 days of the abx (she gave me 50 tabs). I know that antibiotics are particularly hard on my body so I have tried really hard to avoid them, but maybe one full course of them would kick this recurring thing? I don't know! Any insight is welcome.

  2. #12
    Join Date
    Oct 2012

    Default Re: Help, I'm considering weaning at 12 months but don't wan

    Well... we're not supposed to give medical advice on the forum. So I'm going to resist the temptation to agree or disagree with specific advice you were given (though I will say that I agree that mastitis is caused by bacteria, not viruses, so baby having a cold should not make a difference - unless it leads to a nursing strike and less emptying of the breast!). But if you are feeling uncomfortable with the advice you were given (and I would be, too), perhaps it is best to seek a second opinion - when is the doctor who is a member of the Academy of Breastfeeding Medicine coming back? I would not assume that the person covering has the same expertise.

  3. #13
    Join Date
    Aug 2012

    Default Re: Help, I'm considering weaning at 12 months but don't wan

    Hi satin.mama--Agree with PP who says we aren't supposed to give medical advice. I can, though, tell you what my personal experience has been with mastitis.

    What my Dr had me take when I had mastitis and a very painful lump that was probably an abscess but didn't need to be surgically drained: The kind of bacteria I get, staph, when I have mastitis is resistant to Keflex, so I have to take clindamycin (it's a strong antibiotic so many drs are hesitant to give it out unless obviously needed, which in the case of staph it is, that and I'm allergic to other good antibiotics like amoxicillin). I took 7 days of clindamycin and the mastitis cleared, but it took another week for the painful lump, probably a plugged duct that was slightly abscessed, to go away; this was confirmed by an ultrasound about a week after I finished the meds. In the same breast, I have a little crack that often opens and never really heals (whether it's a latch issue or something else, I don't know; have seen several specialists and the general thought is that it probably won't heal until I totally wean, so I deal) and I have to be very careful to wash hands before touching, keep clean bra or nursing pads on even though I don't leak, and always apply APNO in a very small amount to the spot to prevent any bacteria from finding its way in. I would think that the antibiotic cream the Dr prescribed you would be find for the prevention of a bacterial infection, but as it does not have an anti-yeast component like APNO, you would want to be careful that you aren't encouraging yeast, which would love a warm dark area, to grow. You might ask the regular Dr about APNO when s/he returns to the office, as it has been very helpful and non-irritating to me and my baby.

    As for the recommendation on taking some Keflex rather than all: I'm not a medical doctor, but my doctors and pharmacists always tell me to take all of the medicine to indefinitely kill the bugs causing the infection; otherwise, you are just suppressing it for awhile and it can return, sometimes resistant to that medicine. I would agree with your hesitation on this point. I think it would be a good idea to get a breast milk culture the next time you have mastitis or a painful lump--that way you and your dr will know exactly what it is and how to treat it. That's what I have my Dr do so we know how to treat my infections.

    Also agree with PP that mastitis is caused by bacteria, not viruses, so unless you baby has a nasty sinus infection you are probably in the clear for nursing. If you are worried about possible germs in baby's mouth/saliva, you can always rinse the nipple with a warm salt water solution to kill any potential bugs after nursing--it's something like 1 tsp of salt per 1 cup of water, I think. I have taken a short glass, filled with the saline solution, then lean over and dip the breast in for about 90 seconds, then let air dry.

    Sorry you are having problems and the substitute dr did not fully answer your questions. Definitely follow up with the specialist once s/he returns.

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