Ultrasound for persistent mastitis and plugged ducts

I have been dealing with mastitis and plugged ducts for the past 10 weeks and my son is only 12 weeks old. I do everything by the book, but NOTHING helps. Now I am experiencing sharp pains in my breasts -- mainly the left one. I went for a mammogram and everything was fine. I am afraid to wean. Is there anything else I can try?

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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

I'm really sorry to hear you are experiencing such difficulties with your breasts. I can imagine how painful and worrisome this must be for you.

You didn't mention if your mastitis has been treated with antibiotics. If not, it is really important that you pay another visit to your Health Care Provider (HCP). If mastitis is suspected, it is important that your HCP culture your milk and your baby's throat to determine the particular pathogen involved. Even if you were given a 10 day course of an appropriate antibiotic, if your mastitis promptly returned, it is very likely that it is a recurrence. Again, a culture of your milk, and baby's throat is appropriate to assure proper treatment.

Using ultrasound to clear persistent plugged ducts is another possibility. Dr. Jack Newman, founder and director of the Breastfeeding Clinic at the Hospital for Sick Children in Toronto, states,

"When blocked ducts recur frequently in the same place, it is often useful to treat with ultrasound. I have used this for some years now, after hearing of its use in Australia. Therapeutic ultrasound can be obtained in sports medicine clinics or physiotherapy offices. (The physiotherapist will probably never have heard of this use, so here is the dose: two watts/cm sq., continuous, for five minutes to the affected area, once daily.) One dose will usually settle the blocked duct; if not, a second dose will usually do it the next day. If not, reevaluate -- do not continue with the ultrasound. This procedure usually settles a blocked duct that does not resolve in the usual 24 to 48 hours, but interestingly, if the blocked ducts usually occur in the same area, seems to prevent them from returning. If you would like your physician to contact me. I can be reached at newman@globalserve.net."

Ductal yeast could also be playing a part, and causing deep breast pain -- particularly if you have already had several courses of antibiotics. Talk with your Health Care Provider about this possibility. He might want to try a systemic antifungal, such as Diflucan.

Use a hot compress or a salt-water soak on the affected area of your breast immediately prior to nursing your baby, or expressing your milk with a hospital-grade electric breastpump. Firmly massage the area, and place your baby at your breast, trying to find a position where his jaw is positioned under the plugged area.

If you do decide to wean, and your problems have been centered in one breast, you might want to consider weaning your little one from only the affected breast. It is still very important (to your health) to wean slowly. Drop no more than one feed every four days or so. Go by your personal comfort level. My very best wishes!

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