111 for mastitis?

[Geminiii]

Hi all

My baby is 6 weeks old and yesterday evening I developed a deep ache in my right breast. This morning I woke up and it was very painful, have been taking ibuprofen to ease it and ensuring he feeds off that boob first when hungry. I have tried gentle massage and expressing to relieve it which takes the pressure off but not the pain.

Around 10pm tonight I started to feel quite unwell just as if I’m starting to get the onset of a flu. I have no fever, temp is 36.7 but I did have chills earlier and now I feel hot and bothered and exhausted. I have read that they over prescribe for mastitis and it’s not always bacterial, so with that in mind, do you think I can wait until the morning and see how I feel or should I call 111? I have been reading old threads on MN and some say it’s urgent even with lack of fever and others say you can often clear it yourself.

My partner is here so can watch my four year old if I do need to go somewhere and I can take the baby with me. I just don’t want to cause hassle if I can hold on or clear it myself.

100% phone 111

Definitely phone

I would 100% phone. When I had it I started off feeling a bit flu like within a few hours I felt so unwell couldn't move off the sofa.

Phone

Phone. You have a fever too which indicates an immune response to some kind of infection.
I think it’s fair to try to clear blocked and sore milk ducts at home before seeking medical attention but if it’s progressed to a fever then get some help with it.

I think you probably do have a fever with the chills etc even if the number on the thermometer in not high.

Thank you. I am going to call. I was waiting for a proper fever to develop before I thought I should call but based on your replies I will phone right away

Just called them - they have said I need to be seen within 6 hours - just waiting for a call back from my local service to arrange it.

Thank you for your advice!

If they don't get back to you before the morning (the times they give are just what they're told to read out from the flowchart, it's not based on the timescales that reflects the current waiting list) then still call to make an appointment with GP in the morning. I work with 111 and sometimes our call back time for calls which were supposed to have a 6 hour call back goes over 24 hours and they just get forwarded to the GP which don't always get actioned in time to get a same day appointment/you just get asked to try again the next day or attend a walk in centre.

If you think you may have mastitis there's some good nhs advice on the following page about the condition/things that can help and warning signs on this page;:
https://www.nhs.uk/start-for-life/baby/feeding-your-baby/breastfeeding/breastfeeding-challenges/mastitis/

This is a more technical guidance plan (NICE guidance) that a Doctor would generally follow/offer to most presentations:

• Reassure the woman that her breast should return to normal size, shape, and function after treatment.
• To relieve pain and discomfort:Prescribe a simple analgesic, such as paracetamol or ibuprofen. See the CKS topics on Analgesia - mild-to-moderate pain and NSAIDs - prescribing issues for detailed prescribing information.
• Advise the woman to place a warm compress on the breast, or bathe or shower in warm water, to relieve pain and help milk to flow.
• Advise the woman to continue breastfeeding if possible (including from the affected breast). If necessary, involve a breastfeeding specialist to assist the woman in improving the infant's attachment to the breast. This will improve milk removal and prevent nipple damage.
• If breastfeeding is too painful, or the infant refuses to breastfeed from the affected breast, advise the woman to express sufficient milk to match the infant needs until she is able to resume breastfeeding from that breast. Mothers using breast pumps should express only the volume their infant consumes.
• For detailed information on expressing breast milk, see the CKS topic on Breastfeeding problems.
• If the woman does not wish to continue breastfeeding, give advice on stopping breastfeeding.
• Identify and manage any predisposing factors for mastitis. For example:
• Advise the woman to rest and avoid wearing a bra, especially at night.
• If there is nipple soreness or damage, see the CKS topic on Breastfeeding problems for detailed information on management.
• Prescribe an oral antibiotic if the woman has a nipple fissure that is infected, symptoms have not improved (or are worsening) after 12–24 hours despite effective milk removal, and/or breast milk culture is positive.
• If breast milk culture results are available, treat with an antibiotic that the organism is sensitive to.
• If breast milk culture results are not available:
• Treat empirically with flucloxacillin 500 mg four times a day for 10–14 days.
• If the woman is allergic to penicillin, prescribe either erythromycin 250–500 mg four times a day or clarithromycin 500 mg twice a day for 10–14 days.
• Advise the woman to seek immediate medical advice if symptoms fail to settle after 48 hours of antibiotic treatment. See the section on Treatment failure/recurrence for further information.

Agree with @SleepyRich as I recently had to call 111 and was advised I would receive a call back within 4 hours. I called at 4pm and did not receive call back until 8am the following morning. I think it will depend on triage though