Ow! Blocked duct? Mastitis? What to do?

[NotQuiteCockney]

DS2 is 11 months. No problems with bf so far. Last night, I felt overly engorged on one side, in the night. I thought this was ok, but it hurt quite a bit - using that arm hurt. This morning, feeding him on that side really really hurt (achy/sore/tender, not shooting pains), but I did it, anyway.

After feeding him, I found a bit that was a bit hard, still, so I fed him again on that side, massaging the hard bit. It got less hard, but within minutes, was hard again.

There are no red spots. I feel quite unwell (dizzy/nauseated), but I don't think I'm feverish.

I do have a local BFC, but her kids have gone away for a week, so I'd rather not wake her ... does this sound like mastitis? Or what?

Go and get some help girl!!! Best not to let anything like this go too far - especially if you aren't feeling that great yourself.

Hope all goes well.

Sounds like it might be the beginning...

From dw's experience (and LOADS of support from mears XXX): hot compresses / shower / bath / hand massage to encourage flow; continue to feed; feed from that side first, use cold compresses / frozen peas type thing in tea towel between feeds to reduce inflammation; start on the nurofen - carry on going; you can use paracetamol too for the pain (you can use them alternately IYSWIM), you may want to get a call to the out of hours GP for ABs so you have them ready should a fever kick in or you feel much worse.

(Sorry if I've got any of that wrong, mears)...

Also, they say attempt to put baby's chin in vague direction of engorgement so their pump-like action helps empty the duct IIRC.

Consider if any changes in position / timing of feeds / latch has caused a less efficient extraction of milk (but if you've been doing it this long, I'm sure you've got it sussed !)

Mastitis really is no fun, so I hope some of the above can help you.

I was advised when this happened to keep massaging it as it might not have developed to mastitis yet but if you leave it , it could well develop.I would get advice, but keep massaging in the meantime!

I've got a call in to the out-of-hours doctors, but our local surgery isn't open on Saturday mornings any more, so it's a pot-luck random locum for me. My experiences with them haven't been great, but let's hope.

I'm freezing to death, so I think I am feverish now. I think I know why this has come on so suddenly ... it's in my "good" boob, and I do tend to feed preferentially on the other side. DS2 is probably taking a tiny bit more solids and didn't have much from that side at his dreamfeed last night. (My guts are also falling out, and I feel like puking. Might be the pain?)

I have taken a paracetamol, will take an iboprofen, too. I have fed quite a few times on the painful side, relaxing as much as possible to try to encourage letdown. DS2 is in a bad mood this morning, but that might be because of me being in a bad mood and shrieking whenever he bumps into the bad boob.

Ooooh, I got an ok doctor maybe. A man, but seemed reasonably knowledgeable ... didn't say anything about DS2 being 11 months, and asked if there was any redness. I was expecting some sort of "what do you expect, you freak, feeding such an old baby!", which is probably unfair. No answer from my local BFC (I texted her ... as she can't prescribe anyway, if I need ABs, best to just go see the medics.)

The temps and pain don't sound good.

There is deabate about whether taking ABs is the right approach for treatment, but dw took full courses both times she had it, with two different ABs the second time.

Keep up your fluid intake and try and spend as much time in bed as you can.

If you get really feverish and crap, you may want to try and get a friend / dp / sitter in to help with childcare cos dw was well out of it at her worst...

Thankfully, it's the weekend, and DH isn't off on any sort of work jaunt this weekend. I must get back in touch with the emergency nanny service, so I have them ready for this sort of thing.

Looks like I'll be taxi-ing down to the hospital with DH and the boys coming along on foot. It had to be the weekend the car is away, didn't it? And we think the car seats are in the car.

Get the AB prescription so you can choose to have it filled if you want / need / choose them.

Hope your bfc can assist further. Perhaps a call to LLL / BFN / NCT etc. might give you best advice...

hth

I might try treating it naturally and waiting on the ABs, I'll see how it goes.

h2d, did your dw get BF sorted in the end? I think I was offline during some of that?

Not really. She didn't want to risk any more mastitis and felt bfing would increase that risk (wrongly, IMHO, but her choice ). She is still expressing, slowly reducing pumps / increasing spacing to reduce flow.

If your fever does kick in, it is usually fairly short from my experience (less than 24 hours).. but you'll feel tired the next day too probably.

Use the ibuprofen and paracetamol to manage the pain - obviously guided by max dosage on packet - they really help...

h2d, that's a pity. Now I'm experiencing the pain of mastitis (just had a blocked duct before), I can understand why she did that. Your DD had a rough start, though, from what I remember, which makes things harder.

My trip to the docs was fine - the GP suggested trying with painkillers etc for 24 hours, then using the ABs. He gave me a prescription to fill then. I'm going to rest loads and drink fluids and all that, and hope for the best. He was a bit surprised that DS2 doesn't have formula at all, but not rude about it. Apparently they've stopped using locums and only use actual regular GPs from all the practices, on a rota. Which presumably explains why he wasn't crap.

It is a pity, I think, for her, really... but it was her choice... I think she felt pretty scared by the mastitis, and sadly it came on, coincidentally I am sure, after successful breast feeds... so that put her off too IYSWIM. (Possibly the good feed triggered increased flow and that played a role too IYSWIM).

Anyway, glad your GP session went so well, and hope the next 24 - 48 hours go OK.

An update - it seems to be clearing. My left boob still feels horrid, but not as bad as yesterday. Lining the chin up with the bad bit seems to be helping.

One weird thing, though - when I haven't fed for a bit, I get a hard bit near the surface, which is fine, I know what that is. But there's a harder-than-normal (big) lump under the surface too, all the time. What is that?

And if iboprofen helps reduce the inflammation, would it be sensible for me to take diclofenac/voltrol if I had some, er, kicking about? It's a more serious anti-inflammatory ...

Hey, I'm no boob expert, LOL... but dw had large lumps which were just engorged ducts I think.... but really a GP or bfc would be the person to ask... I just drive trucks and comb the backs of my hands.

re: voltrol... LOL... I have no clue... you need a mw / doc / pharmacist - maybe post on a thread where mears has been just posting and ask her to comment perhaps ?

Really glad things seem to be going in the right direction. I understand that it is good to continue with max doses of ibuprofen / paracetamol until things are back to normal, ITH.

Yeah diclofenac is good. I had breast abscess and had to use that after the op! R u taking both paracetamol and ibuprofen? Sorry only had time to skim thru the thread!I would get abs just to be on the safe side if the lump hasnt gone. I think I am just a bit more cautious with these things cos of my experience but you know how your own body feels.Are you managing to massage whilst feeding?
Hope everything works out

The lump is getting smaller and less painful. I took one diclofenac, and have been taking a bit of iboprofen. No paracetamol.

Also, I started out feeling unwell, but have felt ok(ish) since then, so I think it's sorting itself out.

What are the symptoms of a breast abcess? My local BFC was telling me she knew someone who had one, but I didn't get the details.

Spoke to our friendly neighbourhood BFC, who had a few interesting things to say:

First, she didn't think it was likely to be an infection because it came on too quickly. Normally, to get an infection (I think), you need to have a blocked duct for a little while.

Second, she says the lump under the surface is caused by: the duct get blocked, milk leaks into the surrounding tissue. My immune system says "bugger, we're under attack" and starts protecting me from the evil invading milk. So I get a temperature, inflammation, etc.

At any rate, it is clearing.

NQC an abscess is very similar to mastitis which is why mine got so big (tennis ball)! My gp didnt notice and just said it was mastitis. I had very very high temp, shaking, screaming in pain and when I say screaming I mean like giving birth screaming!!!!By the time I found out it was an abscess 3/4 of my boob was solid and very bright red.An abscess is very rare and normally ppl just have needle aspiration but cos of the size of mine I had to have the full op
Im glad you are getting better now, not very nice being in pain, breastfeeding and looking after baby!