Weaning due to repeated mastitis

I have been nursing for eight months. I have been diagnosed with mastitis twice, once in January and once in April. I had gone to the hospital on both occasions. In the interim, I have felt pain/soreness to the touch approximately once a month in either breasts. I do not have a fever with this pain. Could this be the start of mastitis or a plugged duct? It has the same feeling as when I was diagnosed with mastitis, but I do not see a red or hot spot. The other times I have felt this I feel that it could be the start of mastitis, but it comes and goes and comes back full force. I was violently ill the two times I was diagnosed. I am trying to wean/the baby is weaning himself, but it seems every time I try to drop a feeding, I come up with this pain.

Please help.
Thank you.

Lisa

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ABOUT THE EXPERT

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

When you are having repeated bouts of mastitis, it is extremely important to have your Health Care Provider (HCP) order a culture of your milk (and your baby's throat.) This will tell them precisely what pathogen, if any, is present. A visit with your HCP is definitely warranted if your pain continues. Breast abscesses, though rare, can remain undiagnosed. Ultrasound can be used to determine if an abscess is present and if so, where it is located. It would also be wise to also have some blood work done to rule out the possibility of anemia, which also plays a factor in repeated mastitis.

I was not clear if you were saying that you were experiencing pain in both breasts at the same time. Mastitis is usually unilateral (one-sided), though it can occur bilaterally. If it does occur in both breasts at the same time, it is particularly important to visit your HCP and determine the pathogen involved. Bilateral mastitis can be the result of strep, rather than the more typical staph infection.

Since you are already in the process of weaning, there are a couple of things you might want to try to stay comfortable while gradually reducing feeds:

  • Proceed gradually. Drop one feed every 3 or 4 days, waiting until you are comfortable without expressing any milk in between feeds.
  • Express your milk as needed for comfort. When you drop a nursing session, express just enough milk so that you remain comfortable in between feeds. In the beginning, you may need to express quite a bit. Over a period of several days to a week you should find this amount decreasing until expression is no longer necessary.
  • Apply cold cabbage leaf compresses to your breasts. During the time of the missed feeds, use of cabbage compresses will help to relieve engorgement, and may also help to reduce your milk supply. To prepare, wash and separate cabbage leaves and chill in a large zip-lock style bag or airtight container in the refrigerator until needed. Crumple slightly in hand to crush veins in cabbage. Apply one or more leaves, covering your entire breast, and secure inside the cups of your bra. Wear for about two hours or until wilted. Reapply as needed. I would not recommend wearing cabbage leaves all day because it has been reported that they can diminish your milk supply.
  • Wear a comfortable supportive bra. While you are in the process of weaning, you may find a sports bra provides the firm support you need. Binding of your breasts is an outdated practice and is no longer recommended.
  • Get some rest! One of the best and most overlooked ways to prevent mastitis is to get the amount of rest you need. This varies from person to person, but you know if you are fatigued. I know this can be very difficult for busy moms, with one or more children to take care of! But it is very important to you health! Rest when your baby does. Take time during the day to recharge your batteries. Just as your little guy will need some extra loving care while weaning, you also must remember to take care of your needs. Even the busiest mom can fit a short "mental health break" into her schedule. Make it a priority.

It is important to have your breast pain evaluated by your HCP, even as you are weaning your baby from your breast. If mastitis or an abscess is present, there's a very good chance that it will not resolve on its own upon weaning. Take care of it now so you can be comfortable. Best wishes

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