What's the solution to this?

[stripeyZ]

DS is 5 weeks, EFB on demand which is fine during the day. He feeds every 1-1.5 hrs, one boob per feed. At night he goes 3.5-4.5 hrs which sounds great but is doing my boobs in.

I become engorged at night & had masitis A couple of weeks ago ecause of this. I've been advised only to express the minimal amount to be comfortable at night which I've been doing & told they will adjust. When will this happen?!

Woken tonight with two huge boobs, one of which is lumpy & looking red. Have feed the baby as much as he will take & dont know know what's the best thing to do. Really don't want to get mastitis again. 6 hours between feeds is too much for them. If I express will this increase what is already an oversupply?

What would be the best way to manage this, it's the same thing every night.

Sorry about mistakes on my phone.. .

Boobs are painful & getting me down

You poor thing, I've had two close shaves with mastitis and it has become a bit of a fear of mine.

I'm not an expert it has to be said, how much are you expressing at night because you are right that will tell your boobs to make more milk and that at that time of the night need to make. How long has lo been sleeping like this? Does lo have trouble latching when your boob is engorged? You can express a tiny amount to enable a good latch when it's bad. (oh tge relief when you are engorged and then baby feeds)

Hopefully in the morning someone with done proper advice will be along with some advice.

Mastitis has given me the fear too! It was pretty horrific.

I'm expressing 20-30 mls twice a night ish & was advised to slowly reduce this. DS has tongue tie & is a bit of a nipple sucker anyway so he can always get on. Trouble is he's just not very hungry at night. From day one he slept 3-4 hours & I have to wake him to feed. I guess that's why I got mastitis so early on..?

If he feed from both boobs at each feed it would be better but he's stuffed after one.

Don't know where tiktok et al will agree but could you just get him to feed of the other side a little before settling one tge other to make you more comfortable?

You say he is more of a nipple sucker, are you certain you latch if right everytime? Also I found it useful to change bf position sometimes, don't know if it is in my mind or not but it seemed to help empty a slightly mor efficient way in a slightly different area if tgat makes any sense.

I was worried he might get too much fore milk if I start him on one & then change but may be it's the way forward.

His latch is pretty shallow. What is a good latch for us is still classed as nipple sucking apparently. As it doesn't hurt & he's put on a kilo they said snipping it would be an unnecessary procedure. Not sure how true this is.

Try not to worry too much about fore and hind milk. Have you tried this I know it's not exactly tge same but ds has an upper lip tie and I found myself doing this and them heard about it afterwards. I'm certain it's why he's done so well.

Thanks for the link, I will definitely give it a go. Would love to get his latch a bit better. He's a good feeder by day but is having trouble staying latched on at all at the mo. We were diagnosed with thrush yesterday, so they put it down to that rather than the TT. Hopefully it will improve once it clears up.

Its such a relief for it to be daytime again. He's fed like a demon since 8am & boobs are back to normal thank god. One's still lumpy so will work on that today & pray it does turn nasty.

the problem is, that the less you express/feed, the more likely you will get mastitis.
You need to fee as normal when you're suffering, because it helps to ease it.

I wonder about the night time thing - DD sleeps in with me, and normally, if I've got a lumpy boob (or engorged), she feeds on it during the night and in the morning it's gone.

the only time I've had a problem is when the engorgement started during the day, and then DD couldn't get rid of it.

does your DS sleep in a cot?
maybe when you get engorged, you could have him in with you for the night?

I have had mastitis a few times with DS, after never having it at all with DD. My commiserations to you :(

I don't have much advice to offer, except to say that 5 weeks is still early days. With both my kids, 7 weeks seemed to be the magic stage: lots of niggles and pain before this, then afterwards everything improved markedly. From reading around, I understand that this is quite common. So, things might improve for you soon without you having to do anything drastic.

Well done to you for EBF despite having to express - it must be so much work, especially with all the pain of mastitis to have to deal with. You're doing a brilliant job :)

DS sleeps in his cot usually although I do bring him in with me in the mornings sometimes once DH has gone to work. I'm not very confident with co-sleeping tbh, although will try it if he feeds more. Last time we did it he was massively sick (out the nose job & everything) which frightened the life out of us both. I guess your supposed to still wind them but I kept falling asleep poor thing

Cheesy_ thats what happened to me so I've pretty much given up wearing a bra at all now. I find them too uncomfortable at the mo. I'm spending a fair about of time airing various parts of my body in the hope it might help with mastitis/thrush/anything. How did you improve the latch? Was it just by paying close attention to it?

Really hope i turn a corner at 7 weeks. The thought of weeks of this really gets me down. Plus I really need to put some clothes at some point!

Thanks for the support it really does help

I wouldn't recommend wearing a bra in bed, anyway. :)

I couldn't not wear a bra at night.

You mentioned falling asleep before he is winded, could you be nodding and him then moving and falling into an incorrect latch? Just a thought.

Thanks for all the advise. Hoping for a better night tonight. Think I definitely need to work on the latch issue, which has been appalling all day.

Thankfully lumpy boob is now not so lumpy, fingers crossed it stays that way!

Has the tongue tie been snipped yet or are you waiting for an appt?

Tongue tie can mean that the baby is ineffectively bfing and part of the breast tissue isn't having the milk removed as well as other parts are which can make you more vulnerable to plugged ducts/mastitis in that area. This is especially true when the latch isn't great as it a poor latch can be the cause behind mastitis anyway.

Kellymom has some great self help info for dealing with mastitis/plugged ducts here.

I went to the BF clinic to discuss the assessment/referral they had been doing. Because he is gaining weight (a kilo at 5weeks) & breast feeding is pain free for me (minus the mastitis & thrush!) i was told it would be an unnecessary procedure, therefore no referral has been made.

He always has a shallow latch. The not staying on is a new thing this week & I was told is thrush related. It's a particular problem on one side. Today he was off every minute or so & is really nipple sucking & there's lots of lip smacking etc. in fact he could barely stay on bless him.,I assumed because is mouth was sore..?

I will be v annoyed if it turns out to be TT related after all. He has a vey obvious anterior TT with a very short frenulum. The first thing I said when I saw him was 'oh he's tongue tied' it's that obvious.

Funnily enough the problem/engorged boob is the one he has trouble with. I wonder if he's not emptying it properly.

How has the thrush been diagnosed? Thrush symptoms can also be TT symptoms (or misconstrued as) - the deep breast pain during and after feeds, the nipple soreness, the colour change (thrush can make nipples go pink and raw looking but poor latch that is taking the skin off may also make it look pink....), etc.

Shallow latch (to the best of my knowledge) isn't a thrush symptom at all but a TT symptom or a sign of poor positioning and attachment (which wouldn't be your fault - one of the HCPs who have watched you feed baby should have helped you to resolve this earlier!).

TT can also make thrush more likely due to the nipple trauma (the thrush organism then has a doorway into the nipple!) so I'm not discounting thrush entirely just wondering if it has been put forward as an answer to the bfing problem because TT has been dismissed as a consideration.

Here is the Breastfeeding Networks leaflet on Thrush.

If the TT is behind the mastitis then it does need to be treated as otherwise mastitis may be a regular visitor due to the poor latch from the TT.

I don't know if you have heard of 'deep latching/exaggerated attachment' but it is a way to get round the TT in the short term - here. It's worth a try!

One more point from this fairly ignorant poster: is your 'problem boob' equally engorged all over? I sometimes get engorged just in one patch. Changing DS's position when he feeds, or massaging the engorged bit and expressing when I'm in the shower, helps get rid of it. Your comment about your DS's poor latch made me think of this.

I think thrush has been put forward as a solution as they don't seem keen on referring him. I've been told me to forget the TT as I've had pain free feeding so it couldn't be, as the nipple redness/boob pain is a new thing. I don't have the symptoms on the leaflet but was told this was because it had been caught early

Thrush fitted at the time as I've had multiple antibiotics since labour & suspected thrush elsewhere. I now wonder if it is, as DS has no signs of thrush & I don't think my other ailment is thrush either (but that's another thread).

DS seems to have completely forgotten how to latch at all this week and is literally just sucking my nipples, so no wonder they're sore! May this is contributing to the engorgement? I feel like he's just snacking rather than proper feeding.

Interestingly the engorgement is ineven & mostly at the top of my boobs with a lumpy bit on the side. Is there a position I could use to help this?

Im starting to think it is more likely to be the TT now. Having tried a couple of other positions I'm not getting the pain consistently which I guess I would with thrush.

I might look into getting it snipped privately.

If he isn't suckling but sucking (slight change in spelling but huge change to pain levels!) then it may well be contributing to the engorgement and 'lumpiness'.

How is baby's output - at least 6 wet nappies and some pooey ones?

Have you got access to a pump or can you hand express some to clear the milk in stasis? If you already have redness on the breast you do need to act fairly quickly to knock it on the head and getting the milk flowing is part of that.

You can try massaging the affected areas while baby nurses to see if that helps clear it, but if that doesn't then pumping while massaging or hand expressing concentrating on the lumpy/sore areas will do.

Would you be able to go back to the TT clinic and ask for the TT to be released given the new circumstances? If you have NHS provision in your area, it seems daft that they are effectively forcing you to pay for what you are entitled to because they are short sighted and haven't been pro-active in tackling this. Could you go to the Infant Feeding Lead in your HV team to ask for support in getting it dealt with (phone your HV/GP surgery and ask for the IFL's no.)?

If you decide that is a faff (and it may well be unfortunately) then there is a list of TT dividers on the IBCLC UK website.

Output is good although he has diarrhoea at the mo from the thrush treatment

I managed to get rid of the redness yesterday thankfully. I seem to spend more time nursing my boobs with compresses, massage, expressing etc than I do DS. It's like a full time job. I've woken up again with lumpy, engorged boobs. I picked the worse once & fed DS so he emptied it. I will no doubt spend the next hour or more trying to sort the other out. I'm completely paranoid about mastitis since i had had it.

Tbh I don't have the energy to go via the HV/MW route for the TT as I know it will be a battle. For swiftness & my sanity I will just pay, although I agree I shouldn't have too. just really hope it helps.

I can relate to your concerns. My daughter is now 18 weeks and feeding is going very well. I couldn't have said the same earlier on though. She had posterior tongue tie, was a nipple feeder, but put on weight well and didn't cause me pain..... untill 8 weeks. It was like the weeks of bad latch crept up on me. I wanted to give up for the pain. It took a local breast feeding counsellor to diagnose the tongue tie and weeks for my doctor and HV to decide who should make the referral. As it turns out in my area a doctor can refer tt treatment but a HV can get a priority appointment faster. I'm telling you this as it might be your best strategy is to get your HV on your side. Mine only took me seriously whenI said I would have to give up breast feeding.

I had mastitis twice and suffered engorgement regularly. I still do actually when her feeding habbits change but it isn't as painful as the early days. As far as engorgement goes, I am no expert but I got through it by not expressing, I felt that would only extend the problem. I took paracetamol when painful and had lots of hot showers and warm baths where my let down would kick in and release a little. my body took about 2 days to adjust to night feeding being different. It still does actually. My daughter is now sometimes taking one or 2 feeds a night and my body is always a day behind in adjusting.

Sorry for the long post. Hopefully you will be able to get sorted. Do push the tongue tie, it really helped me and my daughter. And it will get better.

Interestingly the engorgement is ineven & mostly at the top of my boobs with a lumpy bit on the side

From your talk of a 'problem boob', it sounds like this happens just on one side at a time, i.e. it is not symmetrical. I've also experienced this several times, although not as frequently as you, by the sound of it. What helped for me was watching DS as he fed and noting his position: is his position on each side the exact mirror-image of the other? If not, try to change his position on the problem side so that it exactly mirrors the good side. In my case, I noticed that, when feeding on the problem side, his head was turned towards my lap. I solved it just by putting a hand under his head and tilting his face upwards as he fed. If something like this doesn't work for you, maybe just try different positions: lying down, 'rugby hold' (i.e. lying on his left side to feed from the left boob). The last time I had this problem, I couldn't get him to empty the engorged bit whatever I did, so I got in the shower straight after a feed, massaged it, and expressed it out.