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Thread: Recurring Mastitis- 4 Times in 5 Months

  1. #1

    Default Recurring Mastitis- 4 Times in 5 Months

    Hello! I am the mom to a 5 month old. Breastfeeding has been a challenge from the beginning- my baby was 2 months early, was in the NICU with feeding tube and then formula for 2 weeks, and had severe tongue and lip ties that were not diagnosed until he was two months old. Many medical professionals told me breastfeeding wouldn't happen for us. I even went to a LLL meeting and after listening to them tell mother after mother that bottles and pacifiers would derail breastfeeding completely, I left feeling like it might never happen. I kept pumping and supplementing one feeding a day with formula. We kept at it, changed lactation consultants, and I've been exclusively breastfeeding for nearly three months.

    Despite my enthusiasm for finally succeeding with breastfeeding, I have had mastitis four times in the five months my son has been alive. It pretty much presents on a monthly basis. It mostly comes out of nowhere in that I notice a plugged duct, work it out a bit, and with 30 minutes or so feel feverish, flu-like symptoms, sometimes vomit, and notice the classic triangular redness. I've had it in my left breast, two times on the right, and currently on the left again. I'm allergic to penicillin, so I've taken Ceftin.

    To prevent mastitis, I've regularly taken evening primrose oil and for the past few weeks have been taking lecithin in accordance with the dosing on KellyMom. I feed forever in various positions and try to pump after most feedings. I use a heating pad often and massage the heck out of my breasts, particularly in the shower.

    I've been lucky in that I am a doctoral candidate and have a somewhat flexible schedule. That being said, I'd been hoping to be back to work on my dissertation by now and will be adding part-time paid work in mid-February. I am at a point where I need to reestablish some of the routines in my life and feel like I am unable to do this if I am always sick and constantly doing the breastfeeding/pumping combo. I am a runner, but haven't gotten back out there because I am supposed to be taking it easy. Furthermore, I fear that the mastitis has really reduced my supply- I am pumping less and some feedings have me going back and forth from breast to breast for hours. The other day my son would not latch after a 2 hour long back and forth, so I gave him a feeding of formula (I have a very small stock of frozen milk, but we were away from home). I felt a bit defeated, but he seemed very content for the first time all day.

    I'd gotten through the early days of breastfeeding difficulty with a lovely vision of breastfeeding in the morning and in the evening for as long as we both enjoyed it. I'm now trying to figure out if that is even possible with my constant mastitis; I don't see how my body will naturally regulate itself to that sort of routine while also avoiding mastitis. I feel very little sensation in my breasts- I rarely feel the discomfort of full breasts, I do not experience the feeling of let-down, and I rarely notice plugged ducts until they bring on the mastitis. My breasts do not leak very much or very often.

    My son has approximately 7 wet diapers per day and lately has had 1 dirty diaper every couple of days (he used to have many more). He's always been small and long- at his 4 month visit he weighed 11 lbs 15 ounces and was 25 inches long.

    One thing that I've read on the forum that I've not heard is offering one breast per feeding. What are the merits of this?

    I would love to hear your thoughts on how to make this better and / or how to phase out or reduce breastfeeding after 6 months without developing intense mastitis in the process. Please let me know if there is any further information I could provide that would be helpful. Thank you!

  2. #2
    Join Date
    Jun 2009
    Posts
    10,754

    Default Re: Recurring Mastitis- 4 Times in 5 Months

    Have you ever had breastfeeding assessed by a lactation consultant? If you keep getting reoccurring plugs with baby nursing so much, I wonder if there is some issue with baby's ability to transfer milk.

    Any chance the infection is simply never being dealt with properly with the abs and you need something stronger or a longer course? Kellymom discusses this and much more in her article about reoccurring mastitis which I assume you are using as a guide?

    Also I suggest the kellymom article on low milk production. http://kellymom.com/hot-topics/low-supply/ Most of what you describe is normal and not an indicator of low milk production. Production may be lower than it was before, but that is not the same thing as too low.

    One thing that I've read on the forum that I've not heard is offering one breast per feeding. What are the merits of this?
    If a mom has too high a milk production, this is a gentle method of reducing milk production. Also some babies simply prefer to nurse this way, and that is fine if baby is gaining well and milk production is in good shape. I am not sure why you would want to do this, unless you mean as a weaning technique?

    When weaning, if your primary concern is not getting mastitis again, you very slowly and gradually reduce the frequency and totality of milk removal from the breasts. That basically means reducing the frequency of nursing sessions (and/or pumping) while also (possibly) slowly starting to limit the length of pump or nursing sessions. The key is to do this very, very slowly and gradually, paying close attention to your body.

    If you want to continue to nurse your child after returning to work, I am sure you will get many ideas in the working and pumping section. I also suggest the book The Womanly Art of Breastfeeding (8th edition.) They devote two chapters to handling separations and pumping, and also cover weaning in detail.

    Parenthood rarely resembles what we pictured ahead of time. Mothering is a truly full time job. This is true no matter how a baby is fed.That does not mean you cannot do other things, of course. Every mother does do other things. But perhaps not exactly the way or to the extent or with the ease she envisioned before becoming a mother. Obviously it makes sense to stop being repeatedly seriously ill with mastitis, but is the only way to stop being ill to stop nursing? It should not be. What if you could figure out the reoccurring mastitis and make that stop- would you want to continue to nurse? I suggest think about that and be very sure about your decision before weaning.

  3. #3
    Join Date
    May 2006
    Posts
    24,794

    Default Re: Recurring Mastitis- 4 Times in 5 Months

    with the PP. I, too, am suspicious that what you have is some sort of antibiotic-resistant strain of bacteria that has never been properly treated. I have a friend who had that experience- she would get mastitis, take antibiotics, get better, and then come down with mastitis again. The recurrent mastitis went on for months, and then she finally drove an hour to our closest level 1 hospital and saw someone who prescribed her the right antibiotic, and that was the last breastfeeding problem she had.

    I'm sorry you had a dispiriting experience at the LLL meeting you attended. I'd encourage you to go back, because you never know who is going to show up on different nights, and how who is present is going to effect the discussion. It may be that you went on a night when there were a lot of moms who wanted to inappropriately introduce bottles, and the anti-bottle information you heard was directed at them, and not at you.

    Don't worry about not feeling a lot of sensation related to breastfeeding. That means absolutely nothing- there are plenty of moms who don't feel letdowns, don't leak, and don't really notice plugs. You're not weird in that respect.

  4. #4

    Default Re: Recurring Mastitis- 4 Times in 5 Months

    Thank you both for your advice. I really appreciate it.

    Kellymom has a number of very interesting insights both on mastitis and on milk production in general.

    I've contacted my PCP to discuss other treatments for the mastitis that might rid me of it for good. I'm also headed back to a LLL meeting this week, as I am really struggling to hang in there this time with the mastitis and a baby who never seems to be satiated after this most recent round of of mastitis.

  5. #5
    Join Date
    May 2006
    Posts
    24,794

    Default Re: Recurring Mastitis- 4 Times in 5 Months

    I hope this next meeting is more to your liking! Sometimes just hearing from other moms, knowing you're not the only one who is struggling- that can make you feel better.

    Just a thought- would you consider trying a different bra? Sometimes a poorly-fitted bra can put pressure on a duct and cause a plug. Even seat-belts and purse straps have been known to cause problems with plugs, which in susceptible moms can turn into mastitis. It's just something to try while you work on getting this situation figured out!

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