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Thread: Mastitis - without obvious signs in breast.

  1. #1
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    Sep 2015
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    Default Mastitis - without obvious signs in breast.

    I feel like I got hit by a Mack truck. Fever, headache, chills fatigue. I don't imagine i caught the flu - have not left the house much and haven't been around sick people. No one else is sick. I'm 5 weeks postpartum. I have a large milk storage capacity (like 15 ounces per side) and have a bad oversupply issue. That said, my breasts feel fine. My nipples are sore but they were this way with my first. My doctor said to take the antibiotics anyway, which I will. But I'm really confused as to why I'd have mastitis with no breast symptoms. Is this something that can happen? Infection with no breast pain/ hard or red/sore areas that are obvious?

  2. #2
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    Default Re: Mastitis - without obvious signs in breast.

    I feel like I got hit by a Mack truck.
    Say no more. That sounds exactly like mastitis. Yes it can happen with no obvious breast symptoms.

    Here is the thing. A person like you who is making a huge amount of milk with an enormous breast storage capacity is going to have a super difficult time moving enough milk out of the breasts frequently enough to prevent milk stasis. So what may be happening is milk stasis deep in the breasts causing the problem. I would strongly suggest go see a lactation consultant- not because of the current mastitis, but for advice on how to handle such extreme hyperlactation without continuing to get mastitis.

    Personally I have never been able to beat mastitis without taking abs, and when I tried, I just got sicker. However some moms do manage to get better without abs. However since you sound so sick and your doctor ordered abs I am not recommending trying that. You can continue to nurse while taking abs. Whether you take abs or not, it is also vital that baby nurse very frequently and you rest. I mean, get horizontal and stay that way. Mastitis is tricky so be careful if you suddenly start feeling better to not jump up thinking you are cured!

    More on mastitis: https://www.llli.org/faq/mastitis.html

  3. #3
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    Default Re: Mastitis - without obvious signs in breast.

    Thank you. I had a hard time finding anything about mastisis that didn't include pain in the breast itself. And I hate the idea of taking abx, but will to avoid a bigger problem. With my first, I never had an issue. I think the problem is long stretches overnight without his getting up to eat. We had been waking him every 3 hours, but we let him go, and he'll go up to 6 hours without waking to eat. Because my first had such a horrible first 3 months, and because I now know how massive my supply is, and that it will not regulate for another 7 weeks or so, I am pumping frequently to bottle feed as well as offering a very soft breast 1-2x per day (which STILL overwhelms him). I just can't pump to the point of having an empty breast, and he could block feed on one side for 24 hours and not empty it. But I admit I haven't been the best overnight about pumping, especially when he sleeps. I hope to ramp up the breastfeeding when my supply falls.

  4. #4
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    Default Re: Mastitis - without obvious signs in breast.

    I would agree that the overnight stretches are most likely the problem. I also have a history of OP and that was certainly part of the problem with my third child- she was the only one I had mastitis with, and I ended up having it three times! (But luckily only once in those early weeks.)

    As I am sure you know, normally pumping and bottles would not be the best choice in an OP situation (pumping increases milk production, may not take milk out of a good variety of the milk sinuses as well as baby, plus baby having bottles increases length of time between nursing sessions) Plus there is the very real risk that bottle feeding a baby this young will cause breast refusal.

    However I understand your situation is a bit extreme and unique so you are trying an alternate route. I would still suggest see IBCLC if you can.

    Also while I get it that your older child had a rough time and you want to be proactive about that, I always make the point that OP tends to be much more of a potentially serious problem for the lactating mom than for baby. My oldest had a very rough time with my OP, but second and third babies basically handled it ok even though it was worse than the first time as is common.

    Also I am not sure you would even want to pump to totally empty the breast...after all the risk there is again this tells the body to make more milk. What seemed to work best for me was getting baby to nurse super often night and day (I put my phone with alarm on under my pillow at night) and then I also hand expressed as needed.

    Also it occurred to me that another possibility is that you have some OTHER type of infection. Especially since you are only 5 weeks post partum you might want to ask your doctor about that possibility. Given your milk production situation I doubt that is it but just trying to cover all bases.
    Last edited by @llli*maddieb; August 12th, 2017 at 08:11 PM.

  5. #5
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    Default Re: Mastitis - without obvious signs in breast.

    Thanks! I think i may have found the problem area...a slightly harder area of one breast, closer to my armpit. That said, is it likely I'll face breast refusal if I'm able to have 1 successful session at the breast each day? The decision to bottle feed was not taken lightly...I was quite a hysterical mess about it for a couple of days. And I still struggle with the decision. We tried for one week, and it was just so incredibly stressful for both of us. But I know my hormones are in overdrive and nothing I tried (and I tried everything) cut my supply.
    Last edited by @llli*goli79; August 13th, 2017 at 08:01 AM.

  6. #6
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    Default Re: Mastitis - without obvious signs in breast.

    I think the answer is yes. Although...not for the normal reasons. Normally you want the baby to nurse because it's more work than bottlefeeding. In your case I think you risk breast refusal because your baby is not learning to cope with your oversupply. I had OALD and at 1st my baby spend a bunch of time coughing, choking and sputtering. But because we didn't offer anything BUT the breast until the 5 week point he learned to cope with it. He both clicked and popped off. The pop off was what he did (and he started doing it very early) to avoid getting overwhelmed with the initial let down and clicking is how he controlled the milk flow. He got very low on my nipple so that he could block the spray with his tongue. You want your child to learn to cope with the amount of milk that there is to handle. If there is an easier, less stressful way to get milk and they learn that they don't have to cope with your breast, why would they? That is where nipple confusion comes from. When we introduced the bottle at 5 weeks, it was only once a day. So I would switch up the way you are feeding if possible. You could probably pump once in the morning and get enough milk for 2 or 3 feeds right? Allow that to be the goal for how many bottle he has a day. And let him pratice coping at the breast with the OS. And if you find that overwhelming, try to do the breast at least half the time. Twice a day seems worrisome to me in terms of breast rejection as well as you creating a bunch of extra work for yourself that coupled with the exhaustion of Mastitus, seems like it could undermine your breastfeeding relationship entirely.

    Way too lazy for formula

  7. #7
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    Default Re: Mastitis - without obvious signs in breast.

    That said, is it likely I'll face breast refusal if I'm able to have 1 successful session at the breast each day?
    Yes. I am sorry to tell you this, I realize the decision was not made lightly, yes, baby getting mostly bottles is very likely to lead to breast refusal. Now that does not mean bottles are not appropriate in some cases, I am saying that even when appropriate, bottles are a common and direct cause of breast refusal.

    What I have seen over and over again is while everyone has heard of "nipple confusion" (aka, breast refusal) most people do not have a clear understanding about why it happens. They think that if a baby goes "back and forth" from bottle to breast "just fine" at first, that means baby will always do so. But in fact what we know is that the more often, the longer, and the earlier a baby is given bottles, the more likely bottles will lead to breast refusal eventually. Bottles started when your baby is very young and baby is being almost exclusively bottle fed so those both put this situation at a high risk of breast refusal. It could be a few days, a few weeks or a few months, but imo a baby who is only nursing once a day is very likely to refuse to nurse much sooner than later. Of course this does not always happen, some babies really do not care and really do go back to nursing just fine- but that is the exception and not the rule.

    Also pumping instead of nursing, since it is almost impossible to pump as often as a baby nurses, usually puts moms at higher risk of plugs and mastitis.

    I am happy to try to troubleshoot your production issue here and understand what was happening with this baby that caused you to take this step- but I again would encourage seeing an IBCLC about your OP because it unusually severe.

  8. #8
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    Default Re: Mastitis - without obvious signs in breast.

    thank you - i'll try my best. your suggestion is what i did with my first (no bottles for 6 weeks), and she never stopped screaming at me for 3 months whenever she fed at the breast. and my foremilk always triggered a scream filled bowel movement. she loved the bottle when we introduced it. my oald becomes much easier to tolerate after 3 months/when i go back to work so that was my reasoning. but i see what you are saying.

  9. #9
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    Default Re: Mastitis - without obvious signs in breast.

    Yes again I understand your OP is very severe. That is why I am saying it might help to see an IBCLC. I am not sure what you tried last time, but there are effective methods to reduce severe OP, (hyperlactation) - things that may include but also go beyond block nursing. But it is important to do that under the care of someone who knows what they are doing esp. since you are already having a health issue most likely related to the OP.

    I get it things were bad with your older baby, and things were also somehow bad with this baby- but that was just the first week (?) and the first few weeks are almost always really hard for many reasons. Every baby is different and every nursing experience is different.

    Pumping and bottles might indeed be part of your solution...but maybe at this point it might make sense to experiment to see if you can reduce how much they are a part of your solution.

  10. #10
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    Default Re: Mastitis - without obvious signs in breast.

    I breastfed 2x during day and 2x overnight. Since I am going back to a very full time job my ultimate goal is to breastfeed overnight. Lactose overload be damned. I know he isn't taking as much as a bottle, so should I just wake him every three hours?

    Reing... with the mastitis ( which i get the sense can be stubborn) I fear since he will never empty a breast it will be hard to get rid of. Or is treating it more about getting some milk moving regularly? As I mentioned, my daughter did not empty a breast until 3-4 months old.

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