Recurrent mastitis! How do I make it stop?

[Givemepickles]

I've got mastitis for the third time. DC2 is 4 months old. First time was at 6 weeks. Then it came back last week and I've just completed 7 days antibiotics but within 48 hours it's come on again.

Anyone got any tips for stopping it coming back? I didn't get it at all with DC1 so not sure why it's happening this time. It's been the same boob each time.

I had a lot of mastitis too, 20 years ago now.

I was advised to take the max (400mg I think. Do check) ibuprofen at the first twinge of mastitis starting (has to be ibuprofen, not paracétamol as ibuprofen reduces inflammation/swelling internally) and then to feed like mad from the affected side to flush the milk ducts through from the inside. Keep taking normal dose ibuprofen from then on for the next 24 hoursand keep feeding from that side first.

It worked for me. I got very good at recognizing the first tingle and could catch the mastitis early and stop it taking hold. Never needed antibiotics again, apart from when I went away and forget my ibuprofen. By the time I got some on that occasion, it was too late. Oh and if/when you get pregnant again I think ibuprofen isn't recommended, but that may not be for a while yet.

Hth

I also had a lot of issues with mastitis and blocked ducts. It became my mastermind subject as I think I read every single thing I could on the internet! Like pp I became more accustomed to the feelings indicating there was a problem and acted early.

It helped to think about the mechanics of it. Basically you have a deposit of hardened milk somewhere in the tube, and you have to get it moving. Antibiotics clears any resulting infection but if you don’t break up that clog of milk, you will continue to have problems in that area. I also believed that I had some scarring or damage to my ducts in places that had mastitis and hence milk would collect and solidify there - who knows if that’s true.

With any hint of tenderness in your breast, you should use moist heat. Baths work best but when it’s not possible you can dunk your boob in a jug of hot water, or take a shower. Dry heat like hot water bottle helps too but not as good. You need to massage from behind the tender/vulnerable spot, with firmness down toward the nipple. Milk ducts unfortunately don’t always follow a straight linear path but massaging near it should help. Often the pain is concentrated very close to the nipple anyway.

Sometimes you can actually see thickened clogs at the nipple, which you can massage/squeeze out. Or if really unlucky, you could see a ‘bleb’ which is white skin grown over the end of the duct - I used to release these with a pin which is as horrific as it sounds, not recommended.

Ultimately, you need to be regularly massaging your breast and expressing as above. Oh and haven’t said of course feeding the baby on that side - works best in combination with moist heat just before feeding, so they can help you clear whatever you have broken up. Sometimes you may not know a blockage has cleared after a massaging/feeding session, and you just feel better later. Other times it’s really obvious and like a sense of palpable relief. The symptoms of fever etc can disappear very quickly.

As an aside I actually developed a blocked duct a few months ago, 2 years post stopping breastfeeding. GP was amazed and I assumed it was to do with how dodgy the inside of my ducts were after all they went through! To comfort you, most of my problems were in the early months like you and it would happen more occasionally after - I breastfed both of mine happily to 2 and nearly 4, despite all this, so hang in there if you want to. I also wonder if my issues were related to oversupply, as that was chronic for me - is this an issue for you?

How is your baby’s latch?

@Notquitegrownup2 great tip, thank you I'll try that if it comes again. I took ibuprofen this morning but that's about 12 hours after it began.

@Elderberrier ah OK so it could be that there is still an ongoing blockage or an area that is liable to be blocked? That does make sense as its the same side of the same boob each time. It's on the side next to my arm, quite far from the nipple.

The advice is so conflicting now as I thought using heat and massage was good but now they say not to! But to me it feels like the right thing to clear it. I have those breast pads that heat up in the microwave so will put them on for a few minutes before feeding DC.

@Garman as far as I know his latch is fine. I have no pain bf and he's growing like a weed. He had some issues in the first couple weeks but that's all resolved now.

Oh that’s so interesting, I didn’t know the advice had changed. I suppose there is the risk that heat adds to any inflammation. But like you say, it feels soothing and certainly makes sense with helping to break down hardened milk. I don’t see how massage could be a problem personally. Being a mum is so confusing with so many different sources of advice! Hopefully you get a few more experienced BF mums here to give you their experience - after all that’s how women have learned for centuries before experts and the internet came along.

The mastitis protocol has indeed changed, cool, rest, comfortable breast. Heat makes inflammation worse, cool (ice pack wrapped in fabric) soothes and reduces it. Comfortable breast, feed or express so your breast is comfortable, not until it feels empty as this creates more milk making the problem worse. If you’re using massage this means very light tapping touch, like petting a cat, not forceful or deep massage which can also increase damage or inflammation.