Thank you so much to to those who took the time to post with ideas. I was feeling pretty defeated with how hard and painful it all was and your messages gave me a boost.
I thought other mums struggling with lumps and blocked ducts and mastitis might like to hear how I am getting on as I had tried all of the usual advice by the time I posted and was getting no better at all.
The link in the first response I received to brand new guidance from the Academy of Breastfeeding medicine (www.bfmed.org/assets/ABM%20Protocol%20%2336.pdf) has proved a real eye opener. It overturns a lot of the usual guidance on mastitis management, in particular the exhortation to empty the breast that I was given time time again by breastfeeding counsellors, GPs and the breast surgeon at the hospital. I had been diligently pumping each night after getting my baby down to get “empty” and thought I was helping to keep the recurrent problems at bay, despite the fact that I was dealing with these problems every week. The new guidance says trying to empty the breast is not helpful and does not advise pumping to achieve this. The idea seems to be that pumping stimulates milk production without emptying the milk as efficiently as baby anyway so creates more of a problem than it solves.
The document also advises against massage or electric toothbrush etc to try and jiggle masses about, or niggly interventions to remove blebs, or feeding lots “through” the mastitis pain and blockages on the affected breast - again, all things I had been doing. The key argument here in the new guidance is that many of the problems stem from inflammation in the breast tissue and that all of these issues make this worse.
The document also looks at lymphatic issues with swelling and inflammation and says that a supportive bra can help. Again - I had been avoiding bras when the lumps were bad on GP’s guidance. I bought a bravado body silk bra which is comfy and have been doing very gentle lymphatic drainage type massage in the shower.
One therapy advised in the new guidance that appears to be evidence-based is ultrasound. I have had this on both breasts now which was pricey but will have been worth it if I can continue without all of the horrible issues I had been having. At present I am three weeks clear in the breast I had the ultrasound treatment on first and two weeks clear in the other one with no issues on either side since beginning this new regime in line with the new guidance and since having the ultrasound therapy. I would usually have had several days of fevers and struggling with lumps in this amount of time. Fingers crossed things are really improving.
I’ve been taking the probiotic advised in the document as well as upping my fermented foods.
I had also ordered a tincture made by la vie called duct flow which purports to sort all issues out asap. May be magic beans type stuff but something I am now doing is working.
Anyhooo. This is enough from me, but I thought worth updating simply to encourage other women to read the guidance in the link
babythrive posted, which differs in all key areas to what seems to be the norm advised here. Good luck to any others with similar issues. Fingers crossed I’m on the mend now and can continue to breastfeed my baby cheerfully and healthily.