day 12, still struggling, now plugged duct?

[Bugaboom]

Hi. I posted last week about cracked nipples and engorgement when milk came and had some great advice. Nipples are still cracked but I think better than last week. Still struggling to get latch perfect but I felt we were making slow progress.

Now DD has started doing long feeds upwards of an hour. I can hear the milk transfer and she's gaining weight. But last night I felt shivery and flu like. I quickly started on the ibuprofen. Couldn't see any redness in the breast but felt a hard lump on left. I've been feeding her on the left first each time, had a hot shower and massaged. I got through the night, with a two hour feeding session at one point, but she did then sleep for 4 (as did i). Today I haven't felt feverish, but there is a red patch on the left. Should I see a doctor or just keep self managing?
Also, after such long feeding sessions, she will often go 3-4 hours without a feed. Should I be waking her or expressing in between? I don't want to cause the same problem on right so do I need to start some feeds on that side?
Sorry for the rambling, feeling a bit down about this latest setback and wondering how will get through things like this with a toddler when DH goes back to work.

[Bugaboom]

Just fed for best part of an hour on left (in three bursts because of fast letdown/ poor latch), but it's still red and firm

[Bugaboom]

Bump
I phoned doctor and described symptoms and he was sure I have mastitis. Then he checked swab results taken last Friday and there was already infection in the cracks.
Can anyone tell me whether the cracks are now more likely to heal with the antibiotic course? Just been in tears trying to latch her on. Dh thinks I need to see out the antibiotics and if it still this painful, switch to formula which I don't want to do but this this is really getting me down and I have a toddler to look after too.

[startwig1982]

The key with mastitis is to keep feeding as you need to clear the blockage. The Abs only clear the infection. Make sure you lather your nipple in lansinoh after every feed and try having a hot flannel on the lump when you do feed. Most of all, rest: it will get better.
If you want to change to formula that's fine, don't feel bad, but you need to clear the mastitis first.

[MoominaMama]

Sorry to hear you are having a tough time. The Kellymom website has some fantastic information/advice on clearing plugged ducts and mastitus.

I have had it 5 times now and become a bit of a pro at dpotting the signs early and sorting it out. My little boy is now 5 months old and fingers crossed tge last time we had an issue was around 13 weeks.
First of all do get checked to see if tongue tie is an issue. Poor latch and poor milk transfer could be a result of this (this was our problem).

Things that helped me with cracked/sore nipples ... tons on Lanisoh on before and after. Paranet if really bad. Breast shells to keep fabric off on the nipple. Little salt baths of the nipple (again see kellymom). When It got really bad on one side and I couldnt face latching him on I stopped feeding on that side for a few days (but did express from that side) which gave the nipple chance to heal.

How I have had success at clearing a plugged duct/mastitus ...

1. Get an hour to yourself in a nice hot bath and submerge yourself

1. Massage the affected boob, paying attention to the lump but dont focus solely on this

1. Look on the nipple for any blockage/milk bleb and if needed after a bit of soaking see if you can remove it

1. Comb your boob with a wide toothed comb (this really helps)

Finally immediatly after this nice hot bath do a dangle feed with your little one with their chin on the lump. This is the best position to drain the breast totally and I was amazed at how well this works.

It is painful/sore so do look after yourself. I would recommend a day or two in bed with lots of feeding.

To avoid in future .. feed in different positions if possible and definitely keep working at the latch. Try the flipple technique .. this really helped us.

[MoominaMama]

Sorry also meant to say that I never let my little one sleep longer than two hours at a time in the day. I also offered a feed often when he was awake.

I am so happy we persevered. Feeds now only take 5/10 minutes and are pain free with no issues for a few months now! Many people said to me if I could make it to 12 weeks things would settle down. They were right.

However .. please do whatever is best for you.

[Bugaboom]

Thanks both. She's been thoroughly checked for tongue tie and hasn't got it- she can stick her tongue right out. I've looked at the kellymom site and the advice looks good. I have got a white blob on the left- could this be a blockage/milk bleb?
I really don't want to stop but right now I can't see things improving. I feel like I'm neglecting my ds and spend half the day in tears. I've been to a group session and had support worker come to the house, but still we seem unable to master the latch consistently enough to improve. I'm hoping because the swab found infection in cracks that the antibiotics might help.