See doctor or LC?

[@llli*lcmpdx]

My son is 5 weeks old today, and he is my second child. I was able to nurse my first son (now 3 years old) successfully for 15 months.

The issues I am running into are:
- DS does not seem to like the more forceful let-down that I have on my left side. He tends to lose suction, and then upon relatching has a shallow latch. I have trouble getting him to have a nice deep latch on that side as it is due it being the more full side in general.
- Now I have either a plugged duct or beginning of mastitis on that side. Very tender, large red splotch on my breast. There is no lump there, though. I have to work so I'm trying to pump as frequently as I can, and nurse as frequently as I can while at home.

At this point, due to the duct/possible mastitis should I try to see my doctor or a LC first?? I would like to see an LC either way, but I'm wondering if this warrants a trip to the doctor. I have only a low grade fever, under 100.

Thanks for your help!

[@llli*still.here]

If the LC is a nurse practitioner she can write a prescription for you and you don't need to see a doctor. IMO it doesn't warrant a trip to see your doc, but if you have a fever it may be a good idea to get on antibiotics before it gets worse, if he'll call in a script for you.

[@llli*lcmpdx]

Thank you, I will see if I can get in with an LC as soon as possible, unless it gets worse by the end of the day.

[@llli*mommal]

Doctor, first, then LC. You have a fever, a red patch, and tenderness, and that sounds like mastitis even though there's no perceptible lump at this time. Mastitis sometimes resolves without antibiotics, if you can empty that breast thoroughly enough and often enough. So while you may not need antibiotics, it's a very good idea to have a prescription in hand in case things aren't getting better or are getting worse. Especially as we're now midweek. You don't want this getting worse on the weekend, when it may be difficult to get it to see a doc.

The best thing for mastitis is "empty breast, lots of rest". Stay hydrated, do breast massage, nurse baby as much as possible on the affected side, pump it if the baby can't or won't nurse. I hope you feel better soon!

[@llli*lcmpdx]

Thank you, I did put in a call to my advice nurse. Waiting on a call back.

[@llli*usafreat]

You can beat mastitis without antibiotics, in case you'd like to avoid them.

[@llli*eve9]

I'd see a doctor first then LC. Hope she calls you back with good advice.

[@llli*lcmpdx]

Thank you, everyone.

Just to update: Advice nurse called me back and got all my symptoms, then after speaking with my doctor they concluded that I most likely have mastitis and prescribed antibiotics. I don't particularly like taking antibiotics, but I'm not against them. They also gave me the following guidelines:
- Drink at least 16 oz of water with each feeding/pumping session, plus more in between.
- Warm compress before nursing/pumping.
- Massage toward nipple while nursing/pumping.
- Take 2-3 hot showers per day, let hot water run over the breast and massage toward nipple.
- Nurse/pump as frequently as possible, at least every 2-2.5 hours.
- Rest as much as possible
- Take ibuprofen and/or tylenol

I am also going to pick up some probiotics to take in between antibiotic doses, so I can hopefully avoid thrush.