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Thread: Supply after Mastitis or Plugged Duct

  1. #1

    Default Supply after Mastitis or Plugged Duct

    The first time I posted here I was having a latch issue. Since then, and for the past month and a half my little one has really improved his latch. I haven't seen lipstick nipple really since about when I posted! And, as a result, he nurses much quicker. It concerned me for a while, because I was thinking that he couldn't possibly be getting enough. But he seemed happy enough, and appears to be gaining weight. Lots of poopy and wet diapers, so that's always a good sign. And an overall great disposition.
    Just as everything was going swimmingly, and we were getting into a good groove with sleep as well, I felt a few lumps in my breast on Sunday night. In the middle of the night on Sunday I woke up in a lot of pain and had to pump before my little guy had woken up (I wanted to enjoy that good sleep he was getting too!). When I woke up in the morning on Monday, the lumps were bigger and I had 100.1 fever. This indicated to me either severe case of plugged ducts or mild mastitis. I've never had an oversupply issue, and my baby's latch is great. The only cause I can think of is probably his sleeping 6 hr stretches a night. In any case, I attacked the problem with advil, hot compress, hot shower, comb trick from kellymom, lots and lots of nursing, and by this morning I felt pretty good. If I still had a fever today I would have gone to doctor to get antibiotics, but I see no need. Haven't had a fever since yesterday morning. I worked the remaining lumps out in the shower this morning. The breast still feels a little firmer than usual, and definitely sore. But the pain is not what it was on Sunday night into Monday morning. And I don't feel lumps.
    So, now I'm very very concerned about supply. My usually very cheerful baby has not been so cheerful today. My babe hardly ever cries unless we are trying to put him to sleep. He has been crying while nursing. I've been offering the affected breast first. He'll take it for a few minutes and then pulls off. When I put him back on he'll suck a few times and pull off. This isn't totally new behavior. He used to do this on my other breast sometimes, the one I believed to have a bit of a slower flow. Now he's relatively content on that breast. In any case, his first feed this morning was fine. But all feedings since then he hasn't appeared satisfied. I've been nursing as much as I can, but I also had to supplement with some of the milk I pumped out in the middle of the night. (I'm setting an alarm now to pump so I don't go 6 hours, even if he's sleeping). I can't FORCE him to stay on that boob, because he'll just pop off and cry. I got him to suck on it for a while this afternoon, when we were lying in bed and he was falling asleep. Does that even count in terms of sending a message to my body to produce more?
    When I pumped in the middle of the night last night, I only pumped 1.5 oz from the affected breast, when I would normally get around 2-2.5, so I'm pretty sure supply is a bit lower. I realize that my supply will likely be affected for a little while because of this. But I had supply issues at the beginning, so I'm just so bummed to have to be dealing with this again. I finally felt like I was producing the right amount for my little guy, but not with ounces to spare!
    Has anyone else dealt with this issue? If so, how long did it take to get supply up to normal? I am doing the things I did early on to get supply up: Nursing followed by pumping, when I can. Oatmeal. More milk plus pills. Water. Rest.
    Also, assuming I continue to feel fine and am able to work out these lumps, is there any reason to go on antibiotics?
    Thanks in advance for any tips!

  2. #2
    Join Date
    May 2006
    Posts
    24,023

    Default Re: Supply after Mastitis or Plugged Duct

    Don't worry too much about supply. Trust your baby to bring it up to where he needs it to be, simply by nursing. There should be no great need for pumping, except as a replacement for the nursing your baby isn't doing and as a treatment for any residual lumps. And you definitely want to avoid supplementing, provided the baby's diaper output stays normal (keep a careful eye on that for now). Supplementing just allows your baby to go longer without nursing, forces you to rely on the pump, and teaches your baby that acting fussy and refusing to nurse is going to be rewarded with a bottle- all of which are bad for supply and for breastfeeding in general.

    It's totally normal for a baby to be extremely fussy during/after a bout of mastitis. First of all, the flow speed may suddenly be less than he likes, and second, when milk sits in the breast for a long time it tends to get salty and a lot of babies don't like the taste. But don't give him the option to avoid nursing by using the bottle, right?

    If this were me, I would:
    - Nurse as much as possible, always offering the affected breast first and also at the conclusion of a feeding
    - Pump if the baby is refusing the affected breast or if you still have lots of lumps to work out
    - Get lots of rest
    - Do breast massage, warm soaks, and cool compresses on the affected side
    - Keep an eye on diaper output- if that is normal, no need to supplement!
    - Call your doctor. It is definitely possible to resolve mastitis without antibiotics, and it sounds like you are well on your way to doing that. But it's always a good idea to let your doc know what is going on, and if you don't feel all better by tomorrow (Thursday), it might be a very good idea to go in and get a prescription. You don't have to fill it if you continue to improve, but it's a good idea to have it in hand just in case the mastitis suddenly gets worse on the weekend, when your doc isn't in the office.

  3. #3

    Default Re: Supply after Mastitis or Plugged Duct

    Thanks for the tips! Yesterday after I wrote he outright refused the affected breast, so I had to nurse the other and pump the affected. After he finished the good side, he wasn't actually crying for more, so we were able to save what I pumped. And by his next feed when he was a little calmer/sleepier, he nursed very well on both. And he has since been nursing the affected breast very well, and seems satisfied. His output his been normal. But we probably supplemented about 3-4 oz total yesterday. Not a huge amount, but I will avoid supplementing today and see what happens.
    I pumped almost 2oz from that breast in the middle of the night, which is a little more than the night before, so I'm feeling positive. Any advice about setting an alarm to pump? My baby is sleeping a 6-7 hrs stretch, so the past two nights I've set an alarm 3.5 hrs after he's gone to bed to pump. This is just so I can avoid the pain I experienced that first night. Am I just making it so that I could possibly have this issue again? Should I try to let my body adjust to his sleeping longer by not pumping? I would eventually like to NOT wake to pump, obviously.

  4. #4
    Join Date
    Mar 2014
    Location
    Sweden
    Posts
    21

    Default Re: Supply after Mastitis or Plugged Duct

    Hi Momma,

    So sorry you came down with mastitis, I had it 3 times . The first time it got cleared out without antibiotics, the second and the third time I hade to take them. Flukoxacillin didn't help so I got Clindamycin. Even though I eventually recovered I do not recommend it, LO was gassy and now we treat her for C. Difficile. All three times I noticed reduced supply and LO refused to nurse on that side. I tasted my milk and it was salty. I felt worse after 3 days, got fever over 100, they took my CRP blood levels, it was elevated so I got antibiotics. It's best to have your milk tested if you are worried. My milk was positive for S. Aureus twice, but it doesn't mean you have it too. I had lumps for about 10 days even during the AB treatment, it got cleared out by nursing on the affected side first and then switching to the other, if LO wants to.

    This is what I did and never got mastitis again - I put a wet towel in the micro, use it as a warm compress (re-heat towel if neccessary, but don't use too hot), nurse or pump if LO doesn't want to. Then I hand express until I see the last drop but breast is never fully empty. I guess this helps promote the lactation on the affected side so you get your supply back sooner, I got it back to original levels after about one week. Then I soak the towel in some tap water (room temperature) and wrap the breast for a minute or longer if you are comfortable with it, but it's not neccessary. I used to take a warm shower after nursing and hand expressed there. I now have more milk on that side than on the healthy breast so keeping the affected breast as empty as possible was good both for supply and recovery in my case. I did this for about a month after my last bout, it was stressful and took a lot of dedication but it helped. Mastitis is horrible and stressful so I hope you will get better soon *hugs*!

  5. #5
    Join Date
    Jun 2009
    Posts
    9,051

    Default Re: Supply after Mastitis or Plugged Duct

    Nurse lots, rest, and don't worry about how much you can pump. I am serious about the resting, mastitis has a tendency to reoccur especially if not treated with anti-biotics I have learned the hard way! This is not to say that you need antibiotics! Certainly It can clear up without them in some cases. Just saying, take care of yourself. An old LLL saying is that mastitis is a reminder to mom that she is trying to do too much.

    I pumped almost 2oz from that breast in the middle of the night, which is a little more than the night before, so I'm feeling positive. Any advice about setting an alarm to pump? My baby is sleeping a 6-7 hrs stretch, so the past two nights I've set an alarm 3.5 hrs after he's gone to bed to pump. This is just so I can avoid the pain I experienced that first night. Am I just making it so that I could possibly have this issue again? Should I try to let my body adjust to his sleeping longer by not pumping? I would eventually like to NOT wake to pump, obviously.
    Will baby nurse instead so you do not need to pump? Yes I am suggesting waking your baby up to nurse, or bringing baby to you while asleep to see if baby will nurse in sleep as they often will. This would not cause a problem with encouraging overproduction (as pumping might) because rather than pumping EXTRA milk you are just letting/encouraging baby to nurse more often.

    If you are feeling uncomfortably full overnight, your body is probably not quite ready for that long a time without any milk extraction. So if baby will not nurse, I suggest hand expressing just to comfort, and if hand expressing does not work for you, pump. IN both cases, go by the way you feel and not the amount of milk that is expressed. Express the milk until your breast feels reasonably comfortable, and do not worry about how much came out!

  6. #6

    Default Re: Supply after Mastitis or Plugged Duct

    Thanks again for all the tips. I haven't been pumping and I haven't felt painfully full either, which is good. He has been nursing off both breasts now, and there aren't anymore lumps in my right breast. I think the flow tends to slow down, actually on both, after about 5 minutes of good nursing, so I end up doing a lot of massaging and compressing to keep him nursing. If I don't he'll pop off and on, and I can't tell if he's done or frustrated. I suppose he could be done in 5 minutes...he's 3.5 months old. This is actually a problem we were having before the clogged duct, but the problem was on the other breast. Anyway, now he will get fussy on both and pull off. Then he'll go back on. I'm doing a lot of switch nursing. But if we take a minute and stop nursing, his fussiness will turn into smiles and contentment. My husband says I should stop worrying, but I can't help but always wonder if he's getting enough when he does this. Anyway, that's unrelated. But part of he bigger picture! I love breastfeeding, but the unknown of what he's getting/not getting makes it really hard for me sometimes!

  7. #7
    Join Date
    Jun 2009
    Posts
    9,051

    Default Re: Supply after Mastitis or Plugged Duct

    Yes he could be done after 5 minutes! It is also pretty normal for baby to change nursing patterns around this age, nurse more often, nurse less often, nurse shorter, pull off, go from being a 'one-sider' to a '2 sider' and just on general; nurse 'weird.' No harm in gently encouraging baby to nurse longer if you wish, but I suggest don't stress overmuch about it.

  8. #8
    Join Date
    Jan 2014
    Location
    NY
    Posts
    707

    Default Re: Supply after Mastitis or Plugged Duct

    Hi! When my baby did what you describe your baby doing, I would attempt to relatch him 3 times. If he still popped off or showed he wasn't interested, I'd leave it at that and catch him at a later time. If he was truly hungry, he'd come back for more. My baby is 6 months old now and he'll just push both his hands into my chest to move his body back, as if to say, "enough is enough!"

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