Prone to mastitis - How much milk should I express?

I had a baby nine days ago and already have mastitis. It started during my engorgement. I was told to rent a pump to get out what my baby wasn't getting since he was jaundiced he had to be woken up to eat. I was also told I was on this fine line to pump milk to help the mastitis but also an overprodution of milk I had to be careful not to pump too much. I really don't know where that line is ????

My mastitis is going away with antibiotics but my breasts are still tender due to fullness. Am I supposed to pump after every feeding if he does not eat for 15 minutes on each side? Even at night when he nurses for shorter periods of time may be 5 to 10 minutes on one side?

I had this problem with my last child. I got mastitis 5 times in my first three months. I really could use some help with overprodution and mastitis. The information I get from the lactation consultants seems too vague and not very specific to my problem. I would really appreciate the help so I can continue breastfeeding and not give up so quickly.


Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

Mastitis is most common in the early weeks of breastfeeding. Unresolved engorgement definitely plays a role in it's development, as does fatigue and stress (which are also very common during this early postpartum period!)

Women with a very abundant milk supply may be more prone to developing mastitis. As you were told, there is a fine line between expressing enough milk for comfort, and expressing too much which will further increase an already bountiful milk supply. You're right, this can be difficult advice for any Mom to follow.

The reason you don't want to express a large quantity of milk following each feed is because your body will get the message that your baby needs more milk, and will generously comply. It could become a vicious cycle of always needing to express the excess milk. You don't want to make breastfeeding into a difficult production. That can become very discouraging.

Start now by only expressing enough milk for comfort following a feed. It may only be a few drops, or in the beginning, it may be more. You don't need to use a pump, if you learn hand-expression. It can be much more convenient if you need to just express a few drops (into a handy towel or diaper) following a nighttime feed, or when you're out during the day running errands. Do not make it a practice to express your milk following each feed. Listen to your body! Only express milk if you feel uncomfortable.

Many moms with oversupply are able to reduce their milk supply to a more manageable level by simply changing their baby's feeding pattern. Allow you baby to nurse at one breast per feed. During the first 3 to 4 days, as your supply is adjusting to this new way of feeding, you will very likely need to express milk from the other side, but you should quickly see this need decreasing if you are expressing only when needed. Since you are prone to mastitis, it is very important to get in the habit of paying attention to your comfort level, and expressing just enough of your milk for relief.

Probably the most important thing to remember since you are one of those Moms who seems to be prone to mastitis, is to get some rest! I do know it's difficult, especially when you have more than one child, but it can be done, and you need to do it for your health. Rest with your new baby when he rests. Your older child might also want to nap with you. If not, babyproof your bedroom and have some special toys and books available for your older child to enjoy while you rest. Offer him a little snack and drink. Even if you aren't able to sleep, you will be getting some much needed rest during the day. A little quiet time is important for everyone, and can leave you feeling refreshed. Give it a try! Wishing you good health, and a long and happy nursing relationship!

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