Mastitis -- clog not clearing... Help, please!

iVillage Member
Registered: 08-13-2007
Mastitis -- clog not clearing... Help, please!
7
Wed, 02-20-2013 - 12:03pm

Hi-

I have not been on this board in awhile, but it helped me nurse DS for 3 years, so hoping someone can help again!

I have been EBF DD (almost 5 months) with no problems... in fact I had extra milk (a switch from not having enough with my first! :)) Unfortunately, I developed a clog in one breast that I could not clear despite all of the usual things (pumping, hot compress, shower, massage, lecithin). It developed into mastitis (fever, chills, redness and general yucky feeling). I got antibiotics and I am on day 3 of them, and the clog is still not clearing! I am starting to get really concerned. the Rx helped my fever symptons right away, but this clog is persistent!

Every other time this has happened I have been able to clear, or if I had to start the rx because of fever, etc.. it cleared within a day or 2 at most.

To top it off, my supply is completely tanking in the process. I am pumping less than 1/3 of what I normally pump when she skips feedings (I work from home so try to nurse but there are generally at least 2 sessions/ day where I need to have the nanny give her a bottle).

If anyone has any other suggestions I am all ears! I really want this clog to go away so I can resume a normal BFing pattern with DD. She is only 5 months and I am in this for the long haul!  I am starting to get nervous because i have seen that these can turn into absesses that have to be drained surgically, and that sometimes means you have to quit nursing. I really don't want to do that! I have enough pumped milk to last for a little while, but I prefer to have her at the breast as much as possible

Any insight or advice is welcome, and much appreciated!

THANK YOU!!

 

-Kara (mom to a crazy almost-5 year old boy, and his sweet little "cupcake" of 4 months :))

Photobucket

iVillage Member
Registered: 12-21-2009
Wed, 02-20-2013 - 7:56pm

I’m so sorry. Try the ‘dunk and dangle’ method. Dunk the breast in a hot bowl of water. Make the water like hot bath water, but of course not so hot it burns you. Massage the breast deeply as you ‘dangle’ into the bowl. Sometimes gravity helps. Then breastfeed or pump right after. Try to massage as you breastfeed or pump.

Some plugs are pretty stubborn. I tell moms if it’s not getting smaller after two days of working on it you may need to call your doctor again. I have heard that some stubborn plugs respond to therapeutic ultrasound. I’ve never worked with a mom who has had ultrasound for a plug but you can ask the doctor about it. Some chiropractors and some physical therapists do therapeutic ultrasound.

Don’t worry about the drop in pump volumes. It can be pretty normal to see that decline in pump volumes as a baby gets older anyway. Don’t forget what the baby gets is more than what the pump gets anyway. So if your baby is happily breastfeeding and gaining and growing well then you have enough milk and should continue to have enough. It would be ultra-rare for a baby to breastfeed well without restriction and for mom not to suddenly “dry up”.

It’s also pretty common when a mom has oversupply that she will actually pump way more than the ‘average’ mom in the earlier months. Then as the supply adjusts to normal amounts she will see her pump volumes dip to more ‘average’ amounts which will seem low to her. FYI typical pump volumes are about ½ to 3oz per pump session total.

If you do get an abscess it doesn’t mean you can’t breastfeed. Yes, they often need to be drained but depending where they are located you can still breastfeed. If it’s within the area where the baby’s mouth goes you may need to stop breastfeeding until it heals on that side but you’ll still need to drain the milk, otherwise it won’t heal. Also, it’s possible to breastfeed on just one side if that is needed. I have known several moms who have breastfed from just one breast.

If you’ve already been working on the plug for a few days, maybe give one more day and call the doctor again. Or call the doctor if you run a fever. If the tender area is getting worse, call right away.

Keep us posted. Hope you feel better soon.

Warmly,

Kathy Kuhn IBCLC

iVillage lactation consultant

and Grammy to Brennan, Elias, Elianna, Tahlia, Makenna, Maura, Silas and Charlotte    

Kathy Kuhn IBCLC ivillage lactation consultant Grammy to Brennan, Elias, Elianna, Tahlia, Makenna, Maura, Silas, and Charlotte

iVillage Member
Registered: 08-13-2007
Thu, 02-21-2013 - 5:23pm

Thank you so much, Kathy!!

I ended up talking to the dr yesterday and they changed the Rx. I think I managed to get that first one out (or the different drug did!), but now I have one in the other breast (I guess when it rains it pours!. This one just developed so I am going thru the motions of getting it out.

I guess I was not expecting such a rapid decline in what I was able to pump out -- it literally dropped overnight. I think last time it was more gradual. This time I literally went from 7 + oz in a missed session to barely 3 total in one day. I have a ton of freezer supply (in fact I just donated a cooler to the mothers milk bank) so I have plenty... and she seems to be eating fine and weight gain is definitely not a problem (she is close to 17 lbs and not even 5 months -- 99th percentile. Heavy baby :))

My mom suggested I start her on rice cereal to supplement, but I think that would mean she would take less milk, right, so that would not solve the problem?  I didn't start anything until after 6 months with my first.

Thanks for all of your help! I am back to all of your tricks to get the other one out now! (at least I am already on the drugs so it won;t give me the flu-like symptoms this time... :))

 

-Kara

 

Photobucket

iVillage Member
Registered: 12-21-2009

Glad you’re feeling a bit better. I know you said you are using lethicin but another thing to consider is if you are compressing your breasts in the area where the plugs are forming. Is your bra too tight, are you sleeping on those areas of the breast?

Some moms who have repeated plugs or mastitis are actually battling the same case of mastitis that never totally cleared up. So be sure to stay in touch with the doctor. Some moms need a longer course of antibiotics to really kick the infection.

Don’t forget to take some probiotics while you’re on the antibiotics to lower the risk of diarrhea and yeast problems.

Keep us posted on your progress.

Warmly,

Kathy Kuhn IBCLC

iVillage lactation consultant

and Grammy to Brennan, Elias, Elianna, Tahlia, Makenna, Maura, Silas and Charlotte    

Kathy Kuhn IBCLC ivillage lactation consultant Grammy to Brennan, Elias, Elianna, Tahlia, Makenna, Maura, Silas, and Charlotte

iVillage Member
Registered: 08-13-2007
Fri, 02-22-2013 - 10:56pm

Thank you for the reminder on the probiotics! I would have forgotten probably.

All seems to be back in order. Both clogs are gone and my supply has even picked back up almost to where it was.

I think the problem with the clogs is that I generally have to use a nipple shield -- for her not for me. My nipples are completely and totally flat -- no amount of manipulation brings them out.  I can occasionally get her on (and was eventually able to get my son on without, but not until around 12 months)... I went thru a parade of lactation consultants in the hospital and none of them could help me get her on. They eventually brought the shield. I try not to use it, but she has the hardest time getting on without clamping her jaw on (not exactly fun for me!).  I was doing well this time and went a good 2+ months without any clogs and occasionally getting her on without the shield, but I must have gotten lazy. as she gets older and her mouth gets bigger, I keep trying! I did it finally with my son so fingers crossed I can with her too.

Thanks Kathy!! I really appreciate it! You helped me so much with my first (and he nursed until he was 3!), and I intend to nurse this one for the long haul too. I just leave it to them and go with the flow :)

THANK YOU!!

 

-Kara

Photobucket

iVillage Member
Registered: 12-21-2009

Thanks Kara, you are right the shield can increase the risk for plugs which is of course one reason it’d be great if you could wean off of it.

Of course it’s also important to use it correctly. Do you wet it first and roll the nipple inside out about half way to apply it? Does the baby have his lips up on the ‘brim’ of the shield, not just the nipple part? If the nipple part tends to slide in and out of the baby’s mouth that can indicate the baby isn’t latched deeply enough.

Have you seen this one?

Weaning from a nipple shield:

http://messageboards.ivillage.com/n/mb/message.asp?webtag=iv-ppbreastfeed&msg=6379.1&ctx=4194304

Also, I’m having more success with using the more laid back position when moms have flat nipples. Just recline in the same position you’d be in if you were in a reclining chair. Position the baby so he’s about nipple to nose and allow him to try to latch more on his own. Some babies will sort of dig their chin in to mom’s breast, creating an area to grab onto.

Good luck and get back to share your story with other moms who have used the shield long term and eventually weaned.

Warmly,

iVillage lactation consultant

and Grammy to Brennan, Elias, Elianna, Tahlia, Makenna, Maura, Silas and Charlotte    

Kathy Kuhn IBCLC ivillage lactation consultant Grammy to Brennan, Elias, Elianna, Tahlia, Makenna, Maura, Silas, and Charlotte

iVillage Member
Registered: 08-13-2007
Tue, 03-05-2013 - 4:15pm

Hi KAthy!

Thanks for the link. Yes, I am pretty sure I am using it correctly. I did it with my son too and saw some LCs to confirm.

I am trying to wean her from it too, but with my son it was when he got older and his mouth got a little bigger! For some reason both of them have tiny mouths. I generally would get him started on the shield and then pull him off and put him back on once he had drawn the nipple out a little. The other option was to pump a few minutes first, but with him I did not have enough milk, so by the time it was drawn out enough, the milk did not flow as quickly and he would get furstrated and clamp down more.

This time around I thankfully seem to have plenty of milk, and I can occasionally get her on without, but she tends to clamp down more than he did so I will likely try to get back in to the LC at the local hospital to see if she can make any improvements to positioning/latching.

I love the idea of that position and will give it a shot!

Thanks Kathy!!

 

 

Photobucket

iVillage Member
Registered: 09-18-2013
Wed, 09-18-2013 - 9:32pm

I'm having a similiar problem.  My daughter is 2 months old now I've had a few blebs and clogs that I've gotten out without any problems but not this one.  This is also y second daughter I nursed my first for 15 months and had mastitis and bleb after bleb with her.      So I had  a bleb for over a week that I had managed to keep opening up when all of a sudden on saturday it stopped opening it, finally I did salt water and it softened it up enough for me to get it to open again she took care of the backed up milk and all was good until I woke up sunday with my other breast hurting.  By the end of the day half of the breast was red and I had a fever.  Went to the doc monday got a prescription bc of the infection.  I'm still doing compresses and soaking it and nursing frequently but this thing is not going away.  Plus the other side w the bleb is starting to back up again.  I'm so lost now and frustrated.  It's extra hard when you have a 3 year old in the house and you have to keep telling them to wait bc you are feeding again or getting ready to feed.  Shouldn't the clog being going away even if I wasn't doing everything else since I'm taking the medication