Disconsolate - Repeat Mastitis. Shall I give up??

[kitstwins]

I'm just on my fourth bout of mastitis in eight weeks (first at 6 weeks). I've had it pretty much every two weeks which means I have a week free of mastitis after I've finished my antibiotics before it flares up again. It's always in the same breast and same location and it's getting worse with every bout. With the second bout I found a small milk blister which I popped with a sterile needle but the next two bouts I haven't found a milk blister.

I've been working on my latch with a lactation consultant and she says my latch is fine. I can't do the rugby hold as my baby just won't feed that side (screams blue murder and gets hysterical). I suppose I could refuse to feed him any other way and I guess he'd eventually cave through starvation but I don't feel emotionally robust enough to go through that for several feeds. Plus, I've also got two four year olds to look after. I express all my milk off every evening so my breast is getting cleared every day.

I don't want to give up but I just feel I have to and it's a horrible situation. Mastitis aside (and thrush, etc.) I've found feeding a joy this time around, which has been lovely after my experience with premmie twins first time around. I'd love to make a success of it and have plenty of milk and my boy is a great and greedy feeder so it just seems so tough that I keep getting this.

If it was just me and the baby then I'd plough on with gritted teeth as I could retire to the sofa/bed when I got the mastitis. HOwever, every time I get a bout I'm really ill and can't really do much for a day or two, which is horrible for my daughters. They've already been so patient with me being incapacitated after a grisly caesarean so it doesn't seem fair that mummy is constantly ill and unable to look after them or play with them. It's just not nice for them. It's all very well me feeding the baby but I'm mindful that it can't be at the expense of everything else.

What to do? If I've checked my latch and I'm expressing every evening it seems pretty hopeless. If someone could reassure me that this was my final bout of mastitis then I'd carry on happily but I just don't feel I can put myself and my girls (and my husband) through a fifth bout. Plus it's not good for me to be on antibiotics so persistently. I spoke to my GP and he said to give up - thought I probably had a 'damaged' duct, hence the repeat infections and there wasn't much I could do to prevent another bout. However, he isn't my normal GP (she was away) and he's not the greatest authority on children/postnatal matters.

Some advice would be wonderful. I'm hormonal about it so feeling quite wobbly and tearful about it all.

lactation counsellor is shit if you are getting mastitis. are you paying this person?

i got over bf difficulties by being stubborn. it was horrible and i'm glad i did. only one child though. and as the baby grows so does their mouth and the feeding experience of both.

ok recurrent mastitis. they're allowed one go. the lc not you kt.

Poor you, that is really tough to have suffered so many times with mastitis in such a short space of time.

Have you been getting a long enough course of ABs to really knock it on the head? Recommended length is 10-14 days although some GPs only give 7 days. Many women take probiotics too afterwards to stave off thrush.

I suspect you may have already read the page from Kellymom, but here it is if you haven't.

Maybe one of the bf helplines would be able to offer you some more advice and support.

HTH

kitstwins - I know you are seeing a LC, has she talked you through any of the causes of mastitis (aside from poor latch)? Do you have a 10 day course of anti-biotics or a shorter one? Which anti-biotic do you get prescribed, the same each time or a different one?

Have you seen this or this on mastitis causes and treatments?

Sometimes mastitis can occur due to a poor fitting bra, holding the breast (which might cause compression in the ducts [a bit like standing on a hose]), lying on the affected breast or even trauma to the breast tissue. Did you have this issue with your twins or has it only occurred with this baby?

It might be a good idea to talk through things with one of the bfing helplines with one of the breastfeeding counsellors that staff them, you never know what a fresh pair of eyes can see .

I really hope you find out the cause and you get to bf for as long as you are happy to. Good luck.

I'm not sure what to say that can help you, but my baby is 4 weeks old and I started antibiotics for my second bout of mastitis yesterday. I also have older DC and so I utterly sympathise both with how awful physically you must be feeling and also the guilt about other DC.

How long a course of antibiotics have they given you each time and were they the same ones? I initially had a 7 day course but this time have 14 days worth as literature i read suggested a 10-14 day course was best. I've also read that a culture can be taken to determine the best antibiotic for you.

I'm hoping in my case it's either caused by my oversupply, so may settle eventually or because my first course of antibiotics wasn't long enough. I've had breast surgery though and am hoping that isn't the cause as obviously if it is it's not rectifiable.

Well done for carrying on so long in spite of the mastitis, it reay is soul destroying.

omg. well done to you sounds like you've been through hell. it's so tough with awful pain when trying to feed, well done for keeping going.

If I was you I would probably give it one more try, surely doctor isnt happy that it keeps recurring?
If this is the last time, great. if I got it again .. would possibly switch to bottles.
dont worry about your twins, they will forget , they have each other for company
I always found that for every new baby in the family, the older ones kind of have to develop as parent time is spread so much more thinly. it's like suddenly the toddler has to climb into car seat themselves, use a big cup etc etc as mummy can't lift them after c-section/ IYSWIM

good luck and WELL DONE, you rock

Been a while since I breastfed but for what its worth, I found massaging the affected breast with the heel of my palm, whilst the baby fed from it a great relief. It was very painful but it helped to clear the blockage. I had several bouts of mastitis one after the other with antibiotics too. Antibiotics really don't agree with me and so I worked out how to clear the blockage and avoid the antibiotics. It is worth a go if you haven't done so already. It is painful though and you do need the baby to feed from that breast - expressing didn't do it for me. HTH

Sounds to me like the infection has never cleared. What abs have you been taking and how long was the course?

Hello, sorry it's taken me so long to reply and thanks for all your emails.

I've been taking flucloxacillin (sp) and also cefalexin (sp) for the first bout (for 10 days). For the next two bouts I took flucloxacillin for 10 days again and then this final bout I've had it for 7 days although I've added another day's antibiotics to this as I had some spare fluclox left over from treating my wound infection.

Oh yes, I got the first bout of mastitis on day 9 of antibiotic (flucloxacillin) treatment for my wound infection so I already had the drug in my system.

No idea what is going on in there. It's a nightmare.

Is there anything that could be rubbing or pressing on your breast? I had a nighttime bra that gave me mastitis twice before I realised that it was pressing (really only very slightly) on a specific area of the breast when I was sleeping and causing a blockage.

I also was very prone to blockages/mastitis because I had a very abundant supply and expressed a lot which would increase that supply. I had to be very careful about not expressing too much.

If it's the same part of the breast each time, then assuming no underlying and unresolved infection, I had a lot of success in catching blockages early by being scrupulous massaging/using hot & cold compresses and taking ibuprofen at the very first signs.

It's horrid I know, I hope you get relief soon.

You poor thing - I had mastitis 7 times in the first 6 months and it was grim grim grim. I don't think I'd have coped with older children to look after.
Have a look at this from LLL. It's a list of possible causes of recurrent mastitis. I have now had nearly 5 months of mastitis free bf so it may well be that if you can work out what's causing it and avoid that then you can go on to have months of lovely feeding.
Obviously what worked for me may not for you but I tried reducing my supply a bit, taking lecithin supplements (as suggested on kellymom) and reducing the amount of saturated fat in my diet (kellymom again i think).

OP, can you get tested to see what bug is going on? The BfN's mastitis leaflet suggests this.

How about ringing the BfN drugline and talking to them about antibiotics etc? 0844 412 4665 here

I'm on my second bout of mastitis :( it's shit but I reckon stopping BF would possibly be the worst thing to do cos of engorgement?

Poor you and well done for keeping going. I also had recurrent mastitis from weeks 2-6 and it is very dispiriting.

You are only expressing once a day - I know it is really difficult to fit in expressing (especially with older DCs - I only have DS1, but found it hard to do as he is very clingy), but if you can try to express in the shower or bath in the morning as well, that may help. Once I started doing this, expressing little and often, and in water, this seemed to be the breakthrough in getting rid of the mastitis (after several courses of ABs). I also used a wide-toothed comb in the shower, combing towards the nipple. I was very dubious about this being helpful, but it did seem to make a difference.

The other thing was that the aforementioned clingliness meant that DS1 would tend to sleep on my chest alot, which I think with hindsight was putting pressure on ducts and possibly causing the blockage, so like others have said, think about anything that could be causing it.

Hope you have some success - I am still BFing now at 10 months after having loads of issues as a result of mastitis (being unable to get DS1 latched on to engorged boob and then him refusing it), so you can do it if you can tackle the blockage and infection.

Oh op this is awful and it was me exactly the same - you must try a differnt antibiotic. I had it 6 times before baby was 4 months just awful for the whole family as you feel so so Ill. My fantastic doc finally figured it out and told me to stop expressing and when I did it went and didn't come back. This is what I did - when I felt it coming on - expressed just a tiny bit every hour to keep the milk flowing - used those wonderful gel boob cushion things heated in hot water as soon as I felt it coming back - basically she said it was oversupply in one boob - even now at 8mths ebf that boob is still bigger. When baby is chopping and changing it's patterns it reared it's head but thses tactics kept it at bay - however expressing was increasing supply and making it more likely. I can send you the gelling cushions if you pm me your address thru were a godsend - good luck!

Kitstwins - I think you are me. Bad experience of feeding my twins, now great experience of feeding my singleton marred by repeated mastitis alongside uterus infection which is wiping me out. Did yours resolve itself?

Hi there, first of all I totally empathise, I have a 5 week old and have had 2 bouts of mastitis and had 3 bouts with my daughter 2 years ago. it's a horrid thing and makes you feel so low mentally and physically doesn't it? I have made a very tough decision to stop breast feeding because in the 5 months I've done bf I've had 5 bouts of mastitis. I also managed to have an allergic reaction to the penicillin in my first lot of antibiotics and was quite poorly with that too !!! Like you I also had lots of help with latching and positioning, my boy was rugby hold on the right and cross over on the left breast and seemed to be doing really well.

When I got my 2nd bout my left breast stopped producing milk altogether and whilst I carried on feeding off the right I had to top up with formula as he is a hungry boy!! My docs and midwife concluded that I probably had some sort of underlying issue which caused the frequency of attacks but both also concluded that there really isn't any sure way of knowing.
In the end for me the anxiety I felt about mastitis creeping back up was what made me decide to stop. It was with a VERY heavy heart I have to say but I felt I had to make a decision that was right for my whole family, my toddler, husband ( who hated watching me go through it and urged me to stop!) my little boy ( who frankly never seemed satisfied feeding from me) and me.

The best advice I had was from my midwife who said "make peace with your decision and enjoy your child" ... It took me a while to 'make peace' with not being a bf mother any longer but I also think I'm a better mummy for it. If you feel in your heart of hearts that you want to carry on then you must do and get as much support and help from experts and helplines etc, there are some fantastic people out there. I also think you have to not be too hard on yourself and remember that if you decide to stop you have given your child a very good start and given it a very good shot and should be proud of that.
If you carry on I would suggest taking each potential problem in turn, as people have said mastitis can be down to a number of things, latching, efficiency of feeding, your health and supply, bra, susceptibility to infection, nipple shape etc etc etc .....!!! If I didn't have a toddler I may well have persevered and addressed all these potentially issues but eventually I decided life's too short and I want to enjoy both my kiddies as a fit, healthy and positive mummy!!!
Very, VERY best of luck with it.

This is an old thread, not mine, but wanted to hive anyone reading hope... my baby was 4 weeks old when I replied last time... I just wanted to say that DD is now 2 and despite having had 11 bouts of mastitis all in one side, I am still breastfeeding. I decided to slowly dry up the affected side in the end so have just been feeding from one side since DD was about 10 months old and haven't had mastitis since.