Mastitis - What would you suggest?

[VSisFlouncing]

Talking to a lady today (I am a volunteer BF supporter) and she has a 4 week old son. Perfect latch (I've checked it, as have others, plus no pain after initial latch).
He is feeding approx 2 hourly.
She has mastitis and what looks like early thrush.
GP has given anti-b's but also told her to express hourly.
I gave her the usual advice ~ massage, combing , hot shower, continue to feed etc..
Her nipples are sore, not just due to the thrush but is not liking expressing, though her GP has told her she has to express hourly to get rid of the mastitis.

WWYS?

BUMP!

I have no idea really on this subject, but I am sure some other cleverclogs will be able to comment. I have much sympathy for her though.... ouch!

Feeding in different positions to ensure that all areas are fully drained was a godsend for me.

A great one was with lo lying on the bed and me kneeling over him kind of dangling my boob into his mouth - not pretty but v. effective!

I never expressed and am actually shuddering at the thought of expressing with mastitis! Why not just feed the baby?

isn't feeding better than expressing? I have to say it was always the anti-b's that worked for me.

Also v hot flannel - best way to get it hot is to wet and wring, then m/wave - gets it hotter than you could stand to wring hot water out.

Not sure if this will help make her more comfortable, but when my breasts were really painful first time my milk came in, they told me to put cold cabbage leaves on them. Replace when warm. It worked brilliantly, and I've seen it recommended in a couple of threads on here too, so must work for others too.
Warning: slightly smelly, but at that point the least of my problems!

Tbh, the expressing thing made me a bit
Her baby is happy to feed every hour or so, surely expressing is just putting her nipples through extra (unnecessary) pain?

Yeah, that Sal! She stank up our whole post-natal thread with her fecking cabbage leaves!

My mother always says about the cabbage leaves thing so will be interested to hear if it has any basis in fact

I'd say definitely not express, just keep feeding the baby, doing the massage in the hot shower and treat the thrush. God, the idea of expressing with mastatis... horrendous AND unlikely to empty the boob as efficiently as the baby. AND likely to increase the milk, which may be some of the problem in the first place. v odd I'd say.

second the cabbage leaves for relief too.

Hi, have just joined and this is my first post.
Had mastitis with both DDs and still going strong with DD2 at 17 months.
In my experience pumping does more harm than good, you never really 'empty the breast' and this makes things worse.
She could try altering feeding position as much as poss, even feeding on hands and knees (v uncomfortable but could support with cushions and seemed to help me).
Make sure she is feeding for long enough on each side, if the baby becomes sleepy wake it up and try back on same breast before changing sides.
Obvious stuff like checking fit of bra, sleeping topless (for sore nips)etc.
Some people seem prone to mastitis, I was. Re-assure her it will settle eventually and she will look back on this as a minor blip!

Phew, I told her to stop expressing and if she really felt she wanted to to just hand express a little in the shower during the massage.
Was worrying I'd missed some important thing about expressing ever hour!

Pain Relief! I was prescribed heavy duty pain relief - Tylex then, think it would be Diclofenac now, so that I could actually allow ds to feed. Didn't know about cabbage leaves then but as a BF Peer supporter that would be my suggestion now.

Not sure I would express hourly as that only increases supply when you really just want to cope with current demand and not encourage any further back log.

Definitely suggest pain relief so that feeding can continue....

One of the ladies in my RL postnatal group was very susceptible to mastitis, and she swore by hot compresses, savoy cabbage leaves (apparently it has to be savoy ) and changing feeding positions. VS you could possibly help her by making sure she can feed comfortably and well lying down, with rugby-ball hold - it took me a while to learn how to use different positions and I definitely appreciated having a second pair of hands to show me/check positioning/move pillows etc when I finally got a breastfeeding support specialist come to see me

BTW, I meant lying down or with rugby hold, not lying down with rugby hold, IYSWIM...I'll shut up now...

Would have tried nude ballet dancing back then if I thought it would have helped!

Chipmonkey! You're just jealous as you didn't know about the wonders of cabbage leaves! Seriously, it's cheap and works wonders.

Found this on New Scientist, written by Richard Eden, Consultant botanist, Southampton, Hampshire, UK in response to cabbage leaves' healing powers:
"Cabbages are members of the Brassicaceae, a large and diverse plant family. Among many other chemicals, brassicas produce glucosinolate compounds, one of which, sinigrin (potassium myronate), gives rise to the pungent smell associated with cooking cabbage.

In the presence of water and the brassica enzyme myrosinase, sinigrin forms "mustard oils", which are noted throughout history for their healing properties when applied as a poultice. "

Here's the link. It says heated cabbage works even better, but the cold ones worked great and it was so nice to feel the cold against my boiling skin.

I used savoy cabbage last time and it was great. I also massage the area whilst Dc feeds from that breast...hurts like hell, but is very effective IME.

BTW, VS, was it a male GP?

hi VS

I used the foamy net thingies in the shower on my affected breast to help massage and they were wonderful

also had a bra FULL of cabbage leaves too - smelled a bit funny but worked

LOL! Oh yes! the smell! worth it though...washed, refridgerated and applied...aaaaaaaahhhhhhhhhhhhhhh!!!

I got mastitis and engorgement as soon as my milk came in last week, found an electric breast pump invaluable in relieving the engorgement, and got antibiotics from GP immediately which helped. Besides the pump, hot compress'/ flannels helped, and putting pressure on the lumps whilst I pump-expressed. It's pretty much cleared now, dd is 12 days old. Oh and paracetamol helped too. I also had thrush too, and baby - she has still got it but it's clearing nicely, i'm not convinced mine has fully gone yet, the shooting pains have gone but nipples still pink and slightly itchy.

I don't think she should be expressing every hour, this will increase her milk supply, and if she has toomuch milk, when she stops expressing, she'll probably get mastitis again!!!

I would recommend feeding baby regularly, good latch, change positions to make sure baby empties all parts of the breast, ie rugby ball, lying down. I'm assuming she doesn't wear an underwired bra! Check for mild tongue tie in baby as this sometimes means they don't empty the breast as efficiently.

Thrush comes after anti-bios usually. The main symptom is a stabbing burning pain that continues well after the feed and goes right up deep into the breast tissue. If it's just nipple pain, it's probably just over-expressing as you said!

Doctors really don't know much about breastfeeding generally!

Ginni, use a vinegar/water solution on cotton wool to wash your nipples after each feed, then thrush cream. I got thrush 7 or 8 times in my breasts to date and I found that method the absolute best!

Hi i've had mastitis put on anti-bios and was told to rest and check latch with h/v.
h/v told me to feed through,then we both got thrush.doc treated babe but told me that i did not need treating that night i was in tears with each feed saw h/v nxt day she got me treated and suggested that babe had every other feed as a bottle. We got through and are still breast feeding.