Mastitis- please please any advice?

[whiterabbity]

I’m suffering extremely from mastitis. On Monday evening I felt very unwell and breast slightly sore. Tuesday- rock hard, red agony. Got antibiotics from gp. It’s now like baby is trying to pull glass through my nipple, I was writhing earlier and I think I cracked a tooth at the back from gritting my teeth too hard. My breast is about 3x the size of the other, Red but no discernible lumps. Absolute agony. Tried warm shower and comb/ massage- nothing came out. Tried hand expressing, nothing apart from a few drops. 10 mins of pumping for about 5ml out, would usually get at least 50. Have managed to feed Dd on it but didn’t relieve pain or swelling. Have tried cabbages. I feel awful. Does anyone know what I should do? I’m begging. I tried to call health visitor this afternoon but couldn’t get hold of her.

After 48 hours I would be seeking further help if it’s getting worse for sure.

I have a picture of it after I got it drained at hospital but before it reached its peak. Hard to see but it was immensely swollen and red hot. Weirdly it didn’t seem to affect milk production or feeding for me, but the doctor just about fell off her chair when I presented her with it at 4pm on a Friday evening! She was on the phone to the hospital immediately and they saw me within two hours.

Sorry here is the pic. It got worse after this. I still have the scar from it 2.5 years on, it left an indentation!

If you don’t see improvement with antibiotics (hoping you will) soon, go back to doctors - I had similar and turned into abscess - it didn’t respond to antibiotics I was given - ended up having emergency op to get it drained. I left it too long before going back to doctors, wish I’d gone sooner.

https://www.nhs.uk/conditions/mastitis/

https://www.formodernmothers.com/blog/new-mastitis-protocol

There are new guidelines for mastitis

This is a brilliant 7 mins video with excellent graphics, please do find time to watch. Many cases of mastitis are caused by poor positioning and attachment https://globalhealthmedia.org/video/attaching-your-baby-at-the-breast/

Lansinoh hot and cold pearls are amazing for this. I freeze them and put them on and take ibuprofen, clears in a few days. Stop massaging just sweep towards the lymph nodes. Check out the latest guidance from la lèche as above. 101 keeps giving out old advice re massaging lumps so don’t do that. Hope it gets better soon. X

111 asap. They take mastitis very seriously and you should be improving after 48 hours not getting worse. If nothing else they might be able to prescribe for the pain. I have never felt so ill before or since than I did with this.

Oh you poor thing, mastitis is horrendous and it sounds as though you have a nasty case. When I had it recently the GP said if the antibiotics hadn’t helped in 24-48 hours, call right back as it can turn nasty quite rapidly - if I were in your shoes I’d ring 111 as hopefully they’ll either be able to prescribe something remotely or get you seen in an urgent treatment centre. Do keep on top of your pain relief in the meantime, and hope you’re feeling better soon

If you’ve been on antiboltics for 48 hours and it’s getting worse then you need medical attention.

Make sure you take iburofen.

Another abscess sufferer who says get it looked at. You need an ultrasound to check for abscess then it needs aspiration drainage. If you leave it to come to a head and burst it can create a massive hole that I had to have packed and dressed by district nurse for weeks and then permanent scar.

If the antibiotics don't work by the morning, I'd seriously go into A&E. You could get really really sick

Agree with everyone saying you need to get further medical attention, but in the meantime take ibuprofen, use cold compresses (not hot) and don't try to unblock by expressing - look up how to do lymphatic drainage massage instead. All these things aim to reduce the inflammation and congestion that's causing the milk stasis.

Put cold on it NOT hot! Cold cabbage leaves etc. avoid hot/warm showers or baths and definitely no hot water bottle! Keep letting baby feed

As others have said - not hot!! Very outdated advice.

Frozen peas for 10 mins every hour, lymphatic massage and ant inflammatories.

I get it a lot. This video has meant I so far haven’t needed antibiotics - I know you’re beyond that but it should still really help:

https://www.instagram.com/reel/DBOH9DbtF5i/?igsh=aWc2aHB6Ymd6bGs1

@whiterabbity

A friend in my NCT group had to go into hospital for IV antibiotics when the oral weren't working. That might be an option?

Also adding my voice to those saying not hot showers or heat, current advice is cold compress.

No helpful tips except to say you have my sympathies.

It is serious, and awful, so do get more help.

Wishing you well - it will all be behind you one day.

I think you shouldn’t wait until morning to go. It should be getting better by now but it’s getting worse.

I can’t realistically go to A&E tonight (given that it’s not a real emergency ofc).

I’m not discrediting any posters but why did HV say hot which is what I’ve been doing up until now and potentially making it worse

Maybe you need to make a written complaint. It sounds your HV needs some training. However the priority is for you to get better. Echo other advice- if things don't seem to be improving you need to call 111 and arrange to be seen

Unfortunately that's outdated advice - I've not found HV's to be the best at keeping up with things TBH. As far as I know the most up to date advice comes from this 2022 evidence based assessment by the ABM:

www.bfmed.org/assets/ABM%20Protocol%20%2336.pdf

Apply warm compresses, nurse frequently (start on affected side), massage gently toward the nipple, rest, stay hydrated, and contact your doctor—antibiotics may be needed if symptoms persist or worsen.

It's quite a long and medical document, which isn't easy when you're knackered and feeling ill. Apart from the recommendations about ice, ibuprofen, lymphatic massage and avoiding exacerbating the inflammation with deep massage/pumping/heat, I think this bit is now relevant for you:

"If there is no symptomatic improvement after 48 hours of first-line therapy, consider a milk culture to evaluate for resistant and/or less common pathogens"

And I think you also need to be checked in case an abscess is forming.