Friday, March 1, 2013

Mastitis

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I was recently looking through my posts and was surprised to see I didn't have a post dedicated to mastitis. So here it is.

I, unfortunately, have plenty of experience with mastitis. Mastitis is an infection in your breast. The first time I had mastitis, Brayden was about 3-4 weeks old. I didn't feel well, but I was coming on several weeks of not sleeping much. My breasts hurt, but breastfeeding had been pretty painful thus far. One day I looked in the mirror to see that my breast was very red. At that point, I had some distant memory come up about what I had read about mastitis. 

I also got it when Kaitlyn was two weeks old, and sometime when McKenna was a young baby. At this point, Brinley is almost 7 months old and I have not gotten it--knock on wood! Here is some basic information on mastitis. I am obviously not a doctor--this is just my understanding and experience. If you think you have mastitis, definitely consult your doctor. Mastitis left untreated can lead to serious problems.

DEFINITION
Mastitis is an infection in the breast. Mastitis can happen at any time (even if you are not breastfeeding, though it is most common when breastfeeding). It most frequently happens early in breastfeeding. You will typically get it in just one breast--so one will be much more painful than the other.

SYMPTOMS
Symptoms include:
  • Fatigue
  • Pain in breast
  • Redness and swelling of breast--it will likely feel hot
  • Flu-like symptoms
  • Fever--101 or higher
TREATMENT
Call your doctor as soon as you know you have mastitis. My first OBGYN was very adament about seeing you immediately if you had mastitis. Mastitis left untreated will most likely lead to a serious problem that requires surgery to relieve the abscess that forms. My OBs sister had this happen. She got so sick it was scary, so he really wanted to prevent it from happening to someone else.

Your OBGYN will likely want to see you physically unless this is not your first time getting mastitis. If mastitis is confirmed, you will be put on oral antibiotics  You can also take a pain reliever to help with the fever and pain. You should feel better really soon--a day or two. I highly recommend you also take some sort of probiotic to help avoid developing thrush (AKA yeast) in your breast.

If you think you have or may be headed toward mastitis, you can work to unclog the duct (see below). If it is mastitis that is simply started by a clogged duct and doesn't have any bacteria (yet), then you might be able to clear it out through clearing the ducts. You can also try natural remedies (just google mastitis natural remedies and you will find plenty) If you have had symptoms for more than a day, though, or if your fever is above 101, I strongly suggest you go to the doctor.

IMPLICATIONS
You can absolutely continue breastfeeding your baby when you have mastitis. It is wise to start each feeding on the infected breast until the clog is gone.

CAUSES
Mastitis is caused by a clogged duct and/or bacteria. If you get a clogged duct and don't resolve it, it will likely lead to mastitis. I always get clogged ducts early in the breastfeeding process. Work really hard to get those ducts unclogged. It can really hurt, but it is much better than letting it lead to mastitis (and for me, the almost inevitable yeast infection that follows the antibiotics).

Mastitis can also be caused by bacteria--often from your baby's mouth entering through a crack in your nipple. 

You can see why mastitis is often an early breastfeeding issue--this is when you have an overabundance of milk and your nipples are building callouses. 

PREVENTION
"They" say that you are either the type to get mastitis or to not get it. I had accepted this, but with Brinley, I had a change of fate. When I was in the hospital the day after she was born, a different OB came to see me in the morning (mine was off work). She mentioned something about mastitis and I causally commented that I always get mastitis. She suggested that I take Newman's Nipple Cream. This was the first time I entertained the idea that I could possibly avoid mastitis. Here are some ways to prevent:
  • Wear a loose enough bra so your milk ducts are not compressed--this can lead to clogged ducts. Do this especially in your first few weeks of breastfeeding while your body figures out how much milk to make.
  • Drink plenty of fluids.
  • Prep your nipples before childbirth. I had great success with regularly applying lanolin during my third trimester. I didn't crack when I started breastfeeding because I wasn't so incredibly dry.
  • Heal your nipples. This is one great thing about Newman's Nipple Cream (this requires a prescription). It has a steroid in it, so it helps your cracked nipples heal faster. You can also use a nipple shield if you would like to while you have cracked nipples. This will help protect against bacteria. Newman's Nipple Cream also has antibacterial agent in it, so it will help fight against bacteria getting in.
  • Keep ducts clear. There are many ways to go about this. If you get a clogged duct, start each feeding on that side.

    You can also vary nursing positions to help drain different portions of the breast.

    You can also do some pumping between feedings to relieve pressure. I didn't do this with my first three children because I wanted my body to get used to how much milk really was needed. However, I found with Brinley I could pump a little bit and take the edge off and then just slowly cut down on how much I pumped. Pumping can be annoying, but I assure you that it is far less annoying than mastitis.

    As your baby eats, gently massage the clogged duct. I apply pressure and press toward the nipple. This hurts like crazy, but if you work the clog out, it will feel better in a couple of hours. It will, however, still be tender.

    You can also apply warm compresses or run warm water over the affected breast. Again, rub the clog out and toward the nipple. I found this the most helpful in relieving clogs. I just continued massaging until the clog was gone.

10 comments:

landonsmom said...

I know this all too well. I was very prone to clogged ducts (partly b/c I have a tendency to sleep on my stomach) and had flown blown mastitis (fever, aches, pains) when my son was probably 4 months old. By far the best way to get rid of clogged ducts was nursing so that my son's lower jaw was running in the direction of the clogged duct. (lower jaw supposedly has the strongest suck) I had one distinct memory of my husband helping me to situate my son so that he was on his tummy over my left shoulder and I was laying flat on my back. It worked perfectly! What a relief. I highly recommend nursing with your baby's lower jaw against the duct.

Katie {My Paisley Apron} said...

This is a great post, and I'm also surprised it's your first post dedicated to mastitis, given your experience with it.

I totally second the looser bra recommendation. I have found that both sports bras and running (too much bouncing!) are not possible for me while breastfeeding.

I would say too, pumping might help (like for you) or be worse (for me). I wonder if it just depends on your body and your pump. I only have a hand pump, and that thing often seemed to cause me to develop clogged ducts. I have never officially had mastitis that needed to be treated but I've had engorgement, clogged ducts, and once got a fever in conjunction with these (after running and wearing a sports bra). But maybe if you use a "real" pump it's more helpful!

Jessica said...

It's funny that you posted this because two days ago I was searching your website for any posts as I felt like I was coming down with mastitis. I did not have any problems with mastitis with my first born but with my second I had my first bought with it two weeks after he was born. I have had it at least 6 times or more now 6 months in. I live overseas so I'm having trouble finding something to help fight it off...I've been on antibiotics every time and it has cleared it up but I still would like to avoid it all together.

Valerie Plowman said...

Thank you landonsmom!

Valerie Plowman said...

Katie, before Brayden was born, I bought a few nursing bras with underwire....I don't know, maybe some people like those, but they caused MAJOR clogging issues for me!

That is interesting about the pump. My pump is actually just a hand pump.

Valerie Plowman said...

Oh Jessica! No fun! I hope you can prevent it from coming again.

Sandee Doss said...

When I had Mastitis for the first time, it came on so fast! Was feeling yucky one hour, and the next, massive fever, hallucinations and feeling like the only thing that could possibly happen next was dying. Mastitis is no joke. Looked into Newman's- not covered by insurance, so a little tube was $70!!! Baby is 2 months already so maybe I will avoid it this time. Hope you will too, Valerie!

lwicks said...

I have awful trouble w/mastitis - is the nipple cream supposed to be used when you have cracks, or is it supposed to work even if your nipples are fine, but still dealing w/mastitis issues?

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Jessica Wekke said...

My first did not latch until he was 2 months (I had to use a shield), then because he had been on antibiotics and because I wasn't faithful with sterilizing the shield like I should have, I developed what I'm convinced was thrush on one side. Shooting pains, constant plugged ducts, you name it, it was horrible. I was on antifungals and saw my OB as well as my family doctor. I even at one point got an ultrasound b/c I had a lump on that side that just wouldn't go away and I was worried. The thing that ended up working best for me? Castor oil packs. I used them every day for a while and it went away and I never again had issues. Oh and I also sent on a probiotic for several months. ThreeLac. It's wonderful stuff. Just wanted to offer my input.

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