Happy Mothers Breastfed Babies
Results 1 to 5 of 5

Thread: Oversupply after misdiagnosed mastitis

  1. #1

    Default Oversupply after misdiagnosed mastitis

    Hello! Long story here so please bear with me...

    My son is almost two months old. I had mastitis on the right breast just a couple weeks after he was born and that healed within a couple days with antibiotics. A couple of weeks later, I started getting redness in the triangle/wedge shape on the left side. I wasn't sure if it was mastitis or not since I didn't have a fever like the first time and it looked and felt different (wedge instead of streaks like first time, pain going up into armpit during/after feedings). It was hot to the touch when full.. I also never had one obvious hard lump with either case, just small ones occasionally that were easily massaged out. It looked more like stretch marks, but in the wedge shape. Because I wasn't sure I let it go longer than I should have and didn't contact my doctor about it for almost a week. When I did, she (a different doctor than the first one above) prescribed a new round of a different antibiotic.

    Ten days later I had my 6 week postpartum appt and my breast looked the same. My doctor who prescribed the second round of antibiotics said it should have cleared up by now and prescribed another different antibiotic. She also said that I need to completely drain the breast at every feeding and told me to pump to emptiness after every feed.

    One week after that it still looked the same. I became more concerned so I called into my doctor's office and they had me come in the next day (last Friday) to see the doctor I spoke to with my very first case of mastitis on the right. She comes in, looks at me, and says "your breast looks totally fine right now." I explained that it looked like that at my appointment with the other doctor and she prescribed more antibiotics. This doctor however said that my breast just looked stretched and since I didn't have a fever and it wasn't bright/shiny red and very hot to the touch and there wasn't a big hard lump that the most it could be is a yeast infection (because of the pains in my armpit) and told me to put Lotrimin on it for a week after every feeding.

    So, whether or not I had mastitis at all on the left, ever since my doctor told me to pump on the left after every feeding I have been dealing with engorgement and oversupply. It sprays out milk, my son chokes on it occasionally, he has watery and explosive poops (though not every time he poops). He latches really well in spite of it - in fact his latch has been worse on the right lately. My breast fills up very fast and when I offer that breast first he does drain it pretty well but I know there is more in there.

    Additionally, my breast does still look basically the same, with the red wedge shape. It isn't quite as red as it was though, and the pain going up into my armpit during/after feeds has gone away since I started the Lotrimin. I am VERY lopsided though (1-1.5 cup sizes larger) and it is really wearing on my self confidence.

    Any advice on how I can lower my supply on the left without drying myself up? As well as how to even myself out? The past few days I have tried alternating feedings and only pumping to comfort on the left as well as giving the right first for two feedings in a row and then the left while only pumping to comfort in between. So far I haven't seen any improvement. Also, any thoughts on whether this actually was mastitis or not? It's seeming like not, but the wedge shape is what troubles me since I've read that is very typical of mastitis.. ?

    Thank you so much for your help!
    Last edited by @llli*kcoat711; October 11th, 2016 at 10:32 AM.

  2. #2
    Join Date
    Jun 2009
    Posts
    10,004

    Default Re: Oversupply after misdiagnosed mastitis

    Good grief.

    This is why doctors should REALLY stay out of the breastfeeding management business, or learn something about breastfeeding.

    I will get to you question about OP in a minute, but first just for any folks out there who are scratching their heads, let me take a moment to address a couple things:

    First, if you had no fever and did not feel ill, it was probably not mastitis that time. It may be a plug, or it may be a "breast lump' that sometimes occurs after mastitis and eventually goes away, but should be investigated further to be sure it is not something else, unrelated to lactation. There is lots of info out there on plugs, but as far as I know only Jack Newman has stuff on lumps, I will link an article if I can find it.

    Also, draining the breast each time baby nurses (or ever) is NOT typically required in cases of mastitis. Frequent milk removal is what is suggested, and that is very different than "draining" the breast.

    This doctor however said that my breast just looked stretched and since I didn't have a fever and it wasn't bright/shiny red and very hot to the touch and there wasn't a big hard lump that the most it could be is a yeast infection (because of the pains in my armpit) and told me to put Lotrimin on it for a week after every feeding.
    Where do I start? Yeast overgrowth (thrush) is not anything like mastitis - It has nothing to do with it, it is not in any way some lesser cousin to mastitis. Thrush is not even properly called an "infection," although everyone persists in calling it that. Thrush does not respond to antibiotics and in fact can be CAUSED from taking antibiotics in some cases. So if that last doctor you saw thought the issue was thrush, why in the world were you given more abs? Ai yi yi.

    Anyway, since you continue to have breast pain and a red area, which sounds to me like it may be an unresolved plug or lump but of course I cannot be sure, I would suggest see an experienced and recommended by local LLL or other breastfeeding support group (if possible) board certified lactation consultant (IBCLC) in the hopes of either confirming that this is a breastfeeding thing or NOT. While of course it is most likely either normal or related to breastfeeding, you want to be sure. If it is a breastfeeding thing, the IBCLC should be able to help you fix whatever it going on or reassure you it will go away on its own.

    Ok, overproduction/lopsidedness. If you see an IBCLC, which I strongly suggest, she can help you figure out a safe strategy for reducing your milk production. Here are some suggestions:

    Your baby is two months old and that means your milk production is probably well established. It is also important that baby is gaining very well. The weight gain is important to note. If baby is not gaining at least 8 ounces per week or more, then you might not want to do anything to reduce production, at least not yet. But if baby has been gaining at least that rapidly, it is probably safe to block nurse that one side in order to reduce milk production. I am going to link two articles on block nursing and I suggest read them both very, very carefully.

    Block feeding on one side will tell your body to reduce milk production in that one side. At the same time, you could be encouraging baby to nurse more on the lower producing side, or even pump that side here and there if you like, in order to bring that side "up" while you bring the other "down." This last part may not be needed and of course you do not want to cause OP in that side as well, BUT, on the other hand, if lopsidedness is getting you down, that would be a method to get less lopsided faster. Just to reassure you, lopsidedness is common and almost always entirely goes away once mom stops lactating after baby weans.

    For fast letdown issues, encourage baby to nurse frequently. Of course if you are blocking one side, every few to several hours when he nurses on that side he will get that big shot of milk. But if he is nursing frequently otherwise, that will help overall. Nursing positioning changes may also help with fast flow, I will attach an article. Don't overly worry about explosive poops, green poops, etc. All that is common at this age and not typically a problem. Severe OP is usually much more problematic for mom than baby.

    Emptying the breast tells the body to make more milk So, stop worrying about draining the overproducing breast, unless you deem that needed to get the plug out (if there is a plug.) Even then, "draining" the breast is not always required to get rid of plugs. I will attach an article with several plug strategies.

    Try to Be patient! It took time to create the OP and it usually takes even longer to reduce it. I know you are frustrated but trust me, you want to take reducing your production slowly, because you do not want to risk another bout of mastitis (or to get it in the first place.)


    Jack Newman mastitis, plugs, breast lumps: http://www.breastfeedinginc.ca/conte...ename=doc-BD-M

    Block feeding: http://www.nancymohrbacher.com/artic...=Block+Feeding
    and http://cwgenna.com/blockfeeding.html

    Fast milk flow: http://www.nancymohrbacher.com/artic...Fast+Milk+Flow

    Plugs: https://www.llli.org/docs/0000000000...plugsblebs.pdf
    Last edited by @llli*maddieb; October 11th, 2016 at 10:50 PM.

  3. #3
    Join Date
    May 2006
    Posts
    24,860

    Default Re: Oversupply after misdiagnosed mastitis

    with MaddieB's EXCELLENT post above!

  4. #4

    Default Re: Oversupply after misdiagnosed mastitis

    Thank you so much for your advice!

    Quote Originally Posted by @llli*maddieb View Post
    Where do I start? Yeast overgrowth (thrush) is not anything like mastitis - It has nothing to do with it, it is not in any way some lesser cousin to mastitis. Thrush is not even properly called an "infection," although everyone persists in calling it that. Thrush does not respond to antibiotics and in fact can be CAUSED from taking antibiotics in some cases. So if that last doctor you saw thought the issue was thrush, why in the world were you given more abs? Ai yi yi.

    Anyway, since you continue to have breast pain and a red area, which sounds to me like it may be an unresolved plug or lump but of course I cannot be sure, I would suggest see an experienced and recommended by local LLL or other breastfeeding support group (if possible) board certified lactation consultant (IBCLC) in the hopes of either confirming that this is a breastfeeding thing or NOT. While of course it is most likely either normal or related to breastfeeding, you want to be sure. If it is a breastfeeding thing, the IBCLC should be able to help you fix whatever it going on or reassure you it will go away on its own.
    The last doctor I saw was the one who recommended the lotrimin actually - my original post may not have been clear about that. Here is how it went:

    Doctor 1: Prescribed antibiotics for mastitis on the right 2 weeks postpartum (I did have a fever that time - we only spoke on the phone)
    Doctor 2: Prescribed antibiotics for mastitis on the left about 4 weeks postpartum (spoke on phone only)
    Doctor 2: Prescribed different antibiotics for mastitis on the left at 6 weeks postpartum appointment (saw my breast in person and didn't say that it could be something other than mastitis even though she knew I didn't ever have a fever...)
    Doctor 1: At seven weeks I had an appointment because my breast looked the same as it did at my last appointment and this doctor said it probably isn't mastitis and could at most be a yeast infection and to put lotrimin on it for a week after each feeding and call if I get a fever

    I was just reading this page and it actually does sound like what I have been dealing with - pain, itching, shiny appearance, sometimes purple-red nipple, more erect than usual nipple, and sensitive to clothing. No symptoms in my son except for him seeming a little bit gassier but it says they might not have symptoms. That article says that baby should be treated alongside mom though...

    "If the mother and baby are under the care of separate doctors, the mother will need to ensure that she and her baby are simultaneously treated. Even if only the mother or baby shows symptoms of yeast, it is vital that both be treated."

    My doctor didn't say anything about this when I saw her. Should I be contacting my pediatrician about this? He has his two month appointment next week. The pain has mostly disappeared now, and the redness does seem to be fading, however slowly. It looks more like stretch marks now to be honest. What I notice more now is just itchiness, which I had originally attributed to the stretching from my breast growing (my nipple isn't itchy, the rest of my breast is). I am planning on going by the breastfeeding support group here in town as soon as I can though.

    Quote Originally Posted by @llli*maddieb View Post
    Your baby is two months old and that means your milk production is probably well established. It is also important that baby is gaining very well. The weight gain is important to note. If baby is not gaining at least 8 ounces per week or more, then you might not want to do anything to reduce production, at least not yet. But if baby has been gaining at least that rapidly, it is probably safe to block nurse that one side in order to reduce milk production. I am going to link two articles on block nursing and I suggest read them both very, very carefully.

    Block feeding on one side will tell your body to reduce milk production in that one side. At the same time, you could be encouraging baby to nurse more on the lower producing side, or even pump that side here and there if you like, in order to bring that side "up" while you bring the other "down."
    He was gaining very well the first month and if I can get in to the breastfeeding support group before his appointment next week he will get weighed then also. I have been trying to encourage him to nurse more on the lower producing side since yesterday and offering the other second - have not attempted any block feeding yet. My engorgement seemed like it was getting a bit better yesterday but after a couple of 3-4 hour stretches of sleep last night it came right back... which I suppose can't be avoided unless I get up sooner to feed him. (That has been a challenge lately as my husband and I have slept straight through any and all alarms lately... the only thing that wakes us up is our son starting to fuss.) After a few nursing sessions this morning the engorgement had gone back down somewhat.. have only had to pump to comfort a couple of times thankfully. Hopefully it is starting to resolve itself!
    Last edited by @llli*kcoat711; October 13th, 2016 at 06:29 PM.

  5. #5
    Join Date
    Jun 2009
    Posts
    10,004

    Default Re: Oversupply after misdiagnosed mastitis

    Sorry I was not around for a while and missed your reply. How are things going now?

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •