Recurring Mastitis

[Makar]

Trying to find some info for my daughter who has just started her 3rd set of antibiotics in 9 weeks for mastitis. Her baby latches on well and has been gaining weight steadily at around half a pound a week since they were born. Despite following advice on changing positions and making sure of a correct latch at each feed she continues to suffer from lumps appearing and no amount of massaging them in a warm shower or pumping seems to help. I know babies can carry Staphylococcus aureus in their nasal passages and if this staph is passed on through cracked nipples it can cause swelling within the breast tissue which then puts pressure on the milk ducts and can cause blockages which obviously can then lead to mastitis. Just wondering if anyone using this site has heard of or in fact encountered any baby passing on this staph infection whilst feeding on cracked nipples? If yes, then is there any advice on how to break this never ending cycle?
This is merely a theory I've been looking at as a possible reason for her recurrent mastitis and have obviously advised her to have a chat with her GP and ask about the possibility of a nose swab from the baby to confirm or dispel this theory.

At this age her nipples shouldn't be cracked - this is showing that the latch isn't right so I'd definitely get an IBCLC breastfeeding consultant to check that. Once her nipples are properly healed the route for infection won't be there and things should be much better. The only time I got mastitis was after my eight month old bit me when feeding and I needed IV antibiotics and a hospital stay to try and head off sepsis.

I agree, after 9 weeks nipples should be healed if there is no issue with latch- if this isn’t the case she should see a feeding consultant asap as there may be underlying issues like tongue tie.

Other things to look at would be is she wearing a correct fitting bra? Any style that squashes the boobs especially during feeding can cause mastitis. She might benefit from a soft cross over style for now, and going braless around the house if possible.
She might also want to stop pumping for now too, as it could actually be making things worse by increasing her supply so meaning she is not emptying each breast fully each feed , babies are much better at getting milk out of breasts than a pump is!

Oh bless her. How miserable for her.

I fed for 7 years and had phases of developing mastitis. I was advised that if I could catch it early, as soon as I felt the first tingle/the first lump developing then I should take max dose of ibuprofen, then feed, feed, feed from the affected side,even if it was painful. The ibuprofen reduces the internal swelling,candy the milk flowing over it is soothing/a natural antiseptic. It worked for me but I learned to take ibuprofen everywhere as you have to catch it early. Keep taking it for 24-48 hours, always offering the affected side first.

Oh and yes, do get her latch checked too.

Best of luck to her. The early days of feeding can be tough. She's done well to hang on in there.

I had mastitis so many times. It's miserable. I used nipple shields to help prevent more damage but even those would sometimes have blood in. I had over supply which made latching difficult.

Thanks to all for your replies. She's attended a breast feeding clinic since the get go. Doctor has ruled out tongue tie. She wears a soft well fitted bra and due to cracked nips she's aired them many a time. Problem is she keeps getting conflicting advice on all sorts - feeding from both breasts at each feed or only feeding from one. To pump if she feels baby has not emptied one of her breasts.To use nipple shields when cracked then told not a good idea if she wants to continue breast feeding! If the latch was the only problem then I can't see why baby would be putting on so much weight. Hey ho, she is a fighter and will do her absolute best for her baby but continuous problems like this is enough to weaken anyone's resolve. That was the main reason I looked for another possible cause

Firstly, warm shower and massage is the OPPOSITE of what she should be doing. Medical advice has changed recently and at the earliest signs of mastitis, she should use ice packs and ibuprofen. Do not pump extra milk as that makes it worse.

At 9 weeks her nipples should not be cracked. GPs know NOTHING about breastfeeding. Something is wrong with the latch, the best thing you can do is pay for an IBCLC certified lactation consultant. Best money I ever spent (think it was £500 but it included a pre-birth consultation etc, I think it would be less for a one off). Please please get her some help on this as this will massively affect her mental health. I am still breastfeeding at 10 months, thanks to getting that professional help early on.

And baby will be putting on weight even if the latch is not perfect. They find ways to compensate. That's not the best indication. Pain at 9 weeks is not ok at all.

This is true. Look for the up to date guidance on lumps. 111 and GPs give out the old guidance and say to massage which you shouldn’t do. Lansinoh hot and cold pearls are amazing and you should sweep the lumps into the lymph nodes. Ibuprofen and ice at the first hint of a lump. If your daughter has Instagram, Lucy Webber and Kathryn Stagg are the best lactation consultants to follow. They do private consultations too.

Agree with PP, mastitis protocol has changed and advice is feed to comfort (I.e. do not pump or try to empty breast as this makes engorgement worse), and reduce inflammation by cooling the breast and taking ibuprofen. Do not massage the breast as this can cause more damage, gentle stroking (like you would a cat) only. If you want to fully nerd out, the info with key evidence to support is here: https://www.bfmed.org/assets/ABM%20Protocol%20%2336.pdf mastitis can be inflammatory which is where the milk leaks into the breast tissue and you have an immune response, or infective, where the same thing happens but obviously it gets infected. There’s no way of telling which it is at first onset as symptoms are the same but basically if it isn’t improving within 12-24 hours, or you feel really ill, you should get antibiotics. The threshold for intervention is low as if it is infective you can have major complications.

But OP your daughter has my full sympathy, mastitis is bloody awful. I got it several times with my son and had it twice now with my 5 week old DD too, I seem to just be prone to it until supply settles. Doing the above has headed it off very quickly and I haven’t had to have antibiotics with DD yet (touch wood). Lots of rest, fluids and TLC also very important - my lovely health visitor keeps reminding me this is a key treatment too!