Birth control to treat recurring mastitis

[@llli*m11612]

I wasn't sure where to post this, but I'm looking for some advice.
I am currently breastfeeding my 2 yo son throughout the day and night and my 5 yo daughter just before bed. Ever since my son was born I have had issues with plugged ducts and mastitis. It has effected both breasts and in different areas of each breast. I have read everything I can find, spoken with multiple IBCLCs, doctors and LLL leaders. I have tried every suggested form of prevention and treatment. I am able to clear the plugs eventually (sometimes requiring antibiotics), but I get a new one every month (or more frequently). I've been working with a doctor to try to find a root cause because I don't want to keep having to deal with this. I almost always get very run down and have fevers with each occurrence. I can't parent effectively while I feel this way. Based on everything I've tried and all the tests done it seems the cause has been narrowed down to hormones. Which brings me to my question. What would you do? I don't want to risk drying up my milk by taking BCP, but I am not sure what else to do. Thoughts, advice and experiences are greatly appreciated.

Additionally, the doctor said that the mini pill would not be a good option for me.

[@llli*maddieb]

Based on everything I've tried and all the tests done it seems the cause has been narrowed down to hormones.

Can you explain in what way your current hormone levels are causing plugs and how the hormones in BC would help prevent plugs?

I don't want to risk drying up my milk by taking BCP, but I am not sure what else to do.

Estrogen containing BC in known to decrease milk production, and it could be dramatic. Unless I am missing something, I suspect this is how the BC would 'cure" the plugs supposedly. By telling your body to make less milk. Now a mom with overproduction and who thinks that is the root of her plugs might want to decrease her production. That makes sense. But if it were me, I would want to be sure I had tried every other method for decreasing production first. When you say you have seen all these people and tried everything, I have no idea if this means you have tried everything to decrease your production or tried every method for preventing/treating plugs.

So I guess am asking, is overproducing the problem, or is there something else going on hormonally that might be causing plugs?

Since you say you have tried everything, I am not sure what else to suggest. However I will take a stab, sorry if these are things you have already tried.

Plugs or no plugs, reoccurring infection (such as mastitis) is often related to the mom's overall health and wellness. Moms struggle so much anyway with getting adequate sleep and being properly nourished and healthily active, and being frequently ill does not help. But taking care of yourself in these areas may decrease your chances of being frequently ill, even if you still get plugs.

Reoccurring mastitis is often actually unresolved infection that "lies low" and then flares. You have been treated with ABs repeatedly it sounds like, but did you always take the full course? Is it possible you need a different AB?

Have you met recently with an IBCLC in person so she could look at you and your child and how he nurses? Plugs are usually caused by milk not being removed frequently enough from the breasts or effectively enough from the breasts. So how your child nurses may be playing a part.

[@llli*m11612]

Thanks for your response.
The idea my doctor suggested is that my breast tissue may be swelling as a premenstrual symptom. She is wondering if the swelling is causing the plugs.
I did have overproduction in the beginning but my supply has regulated and I don't have feelings of fullness or even leaking like I used to. So, I don't think a decrease in supply is needed.
We did rule out unresolved infection. I always took the complete course of antibiotics each time it was prescribed. I can't remember which I have been prescribed. I know I checked on breastfeeding Inc to be sure it was one of the recommended types each time. Also, the plugs are in different areas of my breasts each time.
I have been to a lengthy appointment with an ibclc.

[@llli*maddieb]

The idea my doctor suggested is that my breast tissue may be swelling as a premenstrual symptom. She is wondering if the swelling is causing the plugs.

So, do the plugs tend to happen shortly before or during your period?

If it were me, these are questions I would ask the doctor: is taking BC something that is used to reduce pre-menstrual inflammation? Is there clinical evidence that BC helps reduce inflammation? Why would the mini-pill (progesterone only) not help?

This is just speculation, but I think it does make sense that unusual amounts of inflammation in the breast tissues would possibly lead to plugs. But again if it were me I would be wondering why I might be having such severe inflammation. Plugs and mastitis are fairly rare among nursing moms who are nursing kids this age, so something seems out of the norm here. Anyway, if the issue is inflammation, I wonder if you can ask your doctor if taking a course of an anti-inflammatory aimed specifically at reducing inflammation might help? That or using cold compresses, but it would be hard to use cold as a preventative... Also, there are many "anti-inflammatory" diets you could look into if you wanted.

I guess you could always try the BC and see what happens. But since you are not wanting to reduce milk production, you should be aware that milk production reducing is a pretty good possibility. So, I think you would only want to take something in a once a day pill form that you could stop taking immediately if you are finding it is harming your milk production or just not helping take care of the plugs. Also I would always suggest do your own research on whatever BC your doctor is suggesting, as there are more possible issues with taking hormones than only what might happen to your milk production.

I have been to a lengthy appointment with an ibclc.

Was this fairly recently? She had no suggestions that helped?

[@llli*mommal]

This sounds super fishy to me. I have never heard of contraception being used to treat mastitis. To reduce milk supply, sure. But a treatment for inflammation or infection? Nope. That's where you reach for antiinflammatory drugs or antibiotics.

Are you 100% sure that you have been treated with the right antibiotics? I have known women who have had repeat cases of mastitis that resolved only when they too different, stronger antibiotics, because they were infected with antibiotic-resistant bacteria.