Over T-day weekend, I had mastitis, possibly along with some sort of virus. In any event, my left breast was very painful. After a couple of days I noticed I was expressing pus from it along with the milk (ew) and I had a fever of 101 for parts of two days. Because this started the Wednesday before T-day, I called the consulting nurses hotline to decide whether I had to get myself and my baby to the clinic. After arguing with them about whether I had to come in immediately, and indeed whether it was mastitis (I was at that point still thinking plugged duct), I found out that clinic was open until midnight and again on T-day, so I decided to stick it out at home and try to fix it without antibiotics. I hate antibiotics; a lot of them make me really sick to my stomach. I had already thrown up and wasn't able to eat anything and was not eager to deal with that for another week or ten days.
What ultimately fixed the problem was getting in the bath and then later a shower and expressing. I could not fix it in one session, because it got too painful, but each session helped matters a lot. While Newman suggests fixing it exclusively through breastfeeding, Teddy was not getting enough out, either because he wasn't that hungry, or it did not taste good to him.
Why did this happen to me? Well, Teddy had been nursing hourly a few days earlier (growth spurt? frequency days? You decide.), then dropped back to a more normal amount, leaving me with uncomfortably full breasts. I had worn a nursing bra tank that may have been a bit too small, especially with the fuller breasts. I had stopped eating eggs (lecithin may help avoid mastitis, and eggs have a good amount of lecithin in them) in favor of muesli in the morning because it was faster. Finally, Teddy had been on and off the left breast a lot, causing me to switch him to the right breast as the nipple became sore. That was a huge mistake. I needed to figure out why he was on and off the breast so often, and the answer to that had several parts.
First, he wanted to have his body tilted downhill somewhat, probably to help the milk roll down better. And he was willing to thrash about to make that happen. Second, sometimes after a few minutes of nursing, he really needed to pee and/or poop, and he was trying to get me to take him to the potty (we're doing infant potty training/elimination communication/whatever you want to call it). Third, occasionally he needed to be turned upright to help him get a burp or fart out. By trying to keep him on the breast (where he did want to be, he just needed to take care of some other business first), I was encouraging a damaging (literally) cycle of unlatch/relatch.
The mastitis I fixed by enlisting extra help from my husband, so I could sleep, express, nurse and do nothing else until I got better. But the underlying problem required other changes. I had to give up the boppy, and be very careful about adjusting the regular pillow when nursing so that he would be comfortable enough to nurse steadily. When he thrashed about, I developed a habit of first turning him upright and leaning him forward, to give him a chance to burp. If he did not burp, or he continued thrashing, I took him to the potty and changed his diaper if it was wet. I also put aside the books, remote controls, su doku, etc., until he settled in to nurse. Multitasking is great when it's working; trying to multitask when breastfeeding wasn't working drove us off a cliff.
After telling my story to a few friends, I've learned that antibiotics do help fix this problem quite nicely, but you do not listen to any idiot who prescribes them and tells you you have to wean while on them. Most antibiotics are also prescribes for infants in larger amounts than they will get through your milk. Get a second opinion if necessary, or request an alternate antibiotic, if there genuinely is an issue. Also know that antibiotics can trigger yeast infections/overgrowth, which can in turn cause problems for you and your baby.
This episode was, while painful, very empowering for me. I know as a result that even if something does go awry with breastfeeding, with the help of my husband, Teddy and I can get through it. All that reading and research I did on breastfeeding helped me recognize the problem for what it was, and come up with a plan that addressed the entire issue in a way that worked well for me and my baby.
I mention above that Teddy had a few days of nursing hourly. I mean that around the clock, which meant I wasn't thinking straight either, as I was quite sleep deprived. On two separate occasions (both days when he did not nap well, either), Teddy has woken up when he nursed to sleep in my lap, and I tried to transfer him to the bed next to me. On both occasions I solved the problem by having him sleep for a few hours on top of me. After that, he would nurse and fall deeply enough asleep I could put him on the bed next to me. I can only imagine what parents who do not cosleep go through on similar nights.
I gave that some thought, however, and realizing that side lying had been working okay on one side fairly consistently, and on the other side even occasionally, I tried another night when he objected to the transfer nursing him to sleep on his side. Sure enough, he stayed asleep when he unlatched, since he did not have to be moved. Side lying is worth getting working, but I am more convinced than ever that side lying nursing really works a lot better when the baby is old enough to help position himself.
While I learned a lot, I had more to learn on Christmas, with a second round of mastitis.
General Discussion of Plugged Ducts and Mastitis
Copyright 2006 by Rebecca Allen.
Created January 27, 2006 Updated March 8, 2006