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The Non-Joys of Breastfeeding, Part Two: MASTITIS

Jul06

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bounce_back_nursing.jpgREASON NUMBER 273,903 WHY I HAVE THE BEST JOB IN THE WORLD: When my boss, Isabel, chief of Alpha Mom, suggested I write about mastitis, I said sure! But only if you answer some questions about your boobs first. And not only was this a perfectly natural conversation for us to have, she went ahead and wrote half of my column for me. The column that she pays me to write.

LESSON LEARNED: When you feel like slacking off at work, just compliment your boss’s rack.

So first! Mastitis, from Isabel, Someone Who’s Been There:

I asked Amy to write about mastitis because my first bout of it was so fast and furious and I had no idea it was happening to me. Not everything presents itself in a textbook manner and my case of mastitis did not have any breast symptoms. I thought I had a very BAD case of the flu, which made sense as I was sleep-deprived and rundown those first few weeks postpartum. However, my so-called flu was not responding to repeated dosages of Tylenol and I felt crummier with each passing hour.

A full 24 hours later, when office hours opened (my fever was now at 104.5 degrees for quite awhile) , I called my OB-GYN who berated me for not contacting him sooner (gee, thanks, that’s what I really needed). He prescribed antibiotics and soon I was better.

What I learned from my experience is:
1) though you can’t prevent mastitis you can mitigate its chances of occurring by ensuring you don’t go prolonged periods of engorgement,
2) the minute you feel achy and feverish, contact your OB-GYN or pediatrician (who also yelled at me)
3) you can continue to breastfeed (I pumped/ breastfed for 10 months or until I had three months worth of breastmilk in the freezer. I was a milk machine.), and
4) just as you would contact your pediatrician in the middle of the night if your baby were ill, you need to realize that you, too, should be on high alert about your own well-being (i.e., know where there is a 24-hour pharmacy).

Yes, I went on to have two more bouts of mastitis but they were not debilitating like my first. I nipped them in the bud immediately.
***
Now, although I’ve never had mastitis (I still have a set of combo warm/cold compresses that I bought before I gave birth, though, JUST IN CASE), I do really want to pound home point number three. When my mom had her first baby, my brother, back in the 1960s, breastfeeding just wasn’t done. And it certainly wasn’t supported. When she came down with mastitis she was told, essentially: Well, that was fun! Time for bottles!

You would think, in the 40-odd years since then, what with the whole renaissance of breastfeeding support and acceptance, that women would get slightly better advice these days. And yet I know three (THREEEEE) women who have all told me that they breastfed until they got mastitis, and thus “had to quit.” Doctor’s orders.

(One of these women is actually my cleaning lady, and she tells me this story every time she sees me nursing Ezra, because she really didn’t WANT to quit, but was simply TOLD she had to quit, and she’s STILL sad about it to this day.)

(Her daughter is 10.)

(GAH.)

If you get mastitis, you may need antibiotics. (And then you may need to reread last week’s column about thrush.) You need rest and liquids and Tylenol and warm and cold compresses and looser clothing. You do not need to quit nursing. You can pump, if that’s less painful, but keeping the boobs as empty as possible is key. Nurse more, not less. Engorgement is the enemy.

Weaning in the thick of mastitis is actually like, a REALLY bad idea, since it increases your chances of developing a breast abscess. (That sort of thing has to be surgically drained, by the way. Oh, God.) It seems like some doctors tend to paint a bleak picture about repeated infections and a future of one clogged duct after another instead of encouraging MORE feeding/pumping sessions, thus making a sick and miserable new mother feel like quitting is the only tolerable option.

I can’t really say anything more than what Isabel said: Like thrush, you might not get *all* the textbook symptoms. You might have breast pain — terrible breast pain, from what I’ve heard — or you might just have the fever. You might have a specific area of breast pain — it might be red or hot or raised — or you might not. But if you do need antibiotics, you’ll definitely WON’T magically feel better in the morning, or after a nap. You’ll feel progressively crappier hour by hour, most likely.

This is different than a plugged/blocked duct, by the way. Another thing I’ve been lucky enough to avoid. A plugged duct is sort of like mastitis without the infection part — it’ll gradually start feeling better on its own, with frequent nursing and warm and cold compresses. If you aren’t sure what you have, monitor your temperature. If it rises above 101 degrees Fahrenheit (38 degrees Celsius), call your doctor immediately. Hell, go ahead and call before that, particularly if it’s getting near closing time and you’ll need to wait until morning otherwise. Remember how I yelled at you, back when you were pregnant, about not being afraid to call your doctor WHENEVER you thought something might be wrong? About not worrying about looking foolish or silly or taking up the nice Labor & Delivery nurses’ time?
Same thing. So you’re not pregnant anymore, but last time I checked, you’re still a very important person undertaking a very important life-sustaining task.

* Photo by bobster855

If you landed here but are still pregnant, visit Amalah’s Pregnancy Weekly. You won’t regret it.

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About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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15 Responses to “The Non-Joys of Breastfeeding, Part Two: MASTITIS”

  1. MommiePie Jul 07 at 11:43 am Reply Reply

    I came down with mastitis during week #2. I felt like I was coming down with the flu – body aches, feverish – but I hadn’t been anywhere except on my couch to catch anything so I looked through the “when to call the doctor” list they sent me home with from the hospital and the symptoms fit. I did not have any breast pain, but I did have a perfect pie shaped wedge of bright red hotness on my boob. Another telltale sign. A call to the advice nurse, a frantic trip to the urgent care center before they closed for the evening and a round of antibiotics later and I was feeling better within 12 hours. Catch it early – that’s the key – well, it was for me anyway.

  2. kelly Jul 07 at 11:53 am Reply Reply

    I read somewhere that when nursing mothers get run down, they often come down with mastitis instead of getting a cold or flu. This has definitely been true for me. I’ve had mastitis twice so far, and in both cases, I was just really stressed out and a little overwhelmed – I hadn’t had any engorgement.

  3. Alissa Jul 07 at 12:40 pm Reply Reply

    In my fun experience with mastitis, I felt physically fine, no fever, no aches, no flu-like stuff. I just looked down in the shower one morning and said “huh. Wonder why that boob is red?” I was going to see a lactation consultant that morning, anyway, so I showed her and she suggested an immediate OBGYN visit and some antibiotics. The midwife didn’t even need to cop a feel – simply looked at my nice red boob and gave me a prescription. I, apparently, have a fairly high tolerance for pain…

  4. Meredith Jul 07 at 1:15 pm Reply Reply

    Okay, I started a little rant about this because I had a horrible experience with mastitis concluding with admittance into the hospital for IV antibiotics. So…reallly nip it in the bud as soon as possible. And if you think you have an abscess, don’t let anyone tell you the redness is a symptom of mastites. Because no one wants to see a self-draining breast abscess and the ongoing tests you need after it happens. What did I learn? Be forceful in your convictions and yes, it is possible to breastfeed from only one breast.

  5. Jackie Jul 07 at 10:33 pm Reply Reply

    I’m so glad you covered this. I had no idea mastitis existed until I got it myself. Fever of 104, flu-like symptoms, but no breast tenderness at three weeks postpartum. I’ve had it twice more for a total of three times in the first three months. Antibiotics are certainly the only way to treat it. And a plugged duct too. According to my lactation consultant, it has something to do with milk overproduction. Apparently my body doesn’t have a very good feedback mechanism so it took forever for my initial crazy milk supply to slow down. Going through that was awful, but five months later, I couldn’t be happier to be nursing!

  6. Cheri Jul 08 at 9:31 am Reply Reply

    I got mastitis shortly after introducing a pacifier in week 4. I don’t generally run fevers when I am sick, but I had a pink streak on my breast and it KILLED me to hold the baby or anything against me. I told my mom, who was a nurse- she told me to call the OB Right Now (insert mom tone here) I got antibiotics, and was much better in a couple days. Oh yeah it was the weekend before new years eve, I went to the Dr. on Friday, and the ob said if I had left it until Monday, I probably would have been in the ER by Sunday. This can hit you fast- so don’t wait if you feel funky or have pain.

  7. Lippy Jul 08 at 9:06 pm Reply Reply

    I also had mastitis with my first. I had a bit of breast pain but not much. I kept feeling achy, and wow did I have a fever. It was over 100 degrees and I was freezing, in my sweatsuit. I was lucky the quick care doctor told me to nurse more. And I read somewhere that wherever the babies chin is pointing gets the most suction. Which I think is why it seems plugged ducts happen underneath and toward the armpit most often. So if you get a plugged duct position the baby so their chin is pointing towards the ouchie spot. You may need a spotter to get the baby into some odd position!

  8. Emily Jul 09 at 6:24 am Reply Reply

    With my first, I escaped the horrors of mastitis until he was TWENTY TWO MONTHS OLD. Then, he decided to abruptly go from 6 nursings a day to 2 to none over the course of 4 days. And there we had it.
    Antibiotics made it better in a day. GET ANTIBIOTICS! :-D

  9. qwyneth Jul 10 at 9:25 pm Reply Reply

    Two good mastitis prevention tips: 1. Smear bacitracin on your nipples after every feed or pump if your skin is broken. This helps prevent infection. 2. Take Soy Lecithin if you get plugged ducts. It helps the milk move through the ducts.

  10. Kim Jul 10 at 11:48 pm Reply Reply

    I have to echo Emily; I got mastitis when I was weaning my first child. I just felt nauseated and hot, flu-like. I was dragging myself around the house on hands and knees after him, hoping he wouldn’t hurt himself while I moaned.
    I happened to have an appointment with the OB the next day, and only when she pointed it out did I notice the red streaks on my breast. We picked up the nursing again and I took antibiotics.

  11. Laura Jul 11 at 12:06 am Reply Reply

    I’ve had mastitis once, and luckily I caught it pretty quickly. My first child was admitted to the hospital when he was 9 weeks old. The chaos of finding out what was wrong with him, changing his feeding schedule, etc., made me weak, run down, achy, etc. When my breast started getting hot, red, and painful I mentioned it to one of the nurses. She paged the OB/GYN on call. He came ACROSS THE HOSPITAL to examine me in my son’s room. I was stunned. Doctors who encourage breastfeeding take mastitis seriously. After starting antibiotics I felt better within 24 hours. Moral of the story: All Moms must get the medical care they need!! A sick Mom does not make for a healthy baby!!
    On the topic of blocked ducts, they are not always so easily cured. When it happened to me, the pain was localized to one area, very severe, and persisted no matter which way I nursed the baby. It lasted about a week or so. I tried everything with no luck. In desperation, I kneaded the sore area of my breast until the blockage finally broke up. The pressure released all at once, but I was sore for a few days.

  12. mary Jul 13 at 5:49 pm Reply Reply

    This is great- please tell me you’re going to cover what happens when the little buggers start biting- because REALLY? I don’t want to flick her face.

  13. Faith Aug 19 at 3:20 pm Reply Reply

    I never once got mastitis with my first, but my body has threatened me with it twice with my second. Yesterday being the most recent episode. I started to get the fever, the body aches, and I grabbed two cloves of garlic and ate them quickly. I never want to have to risk thrush by getting anti-biotics. You’d be surprised by how quickly and well the garlic works.

  14. Anonymous Nov 17 at 5:53 pm Reply Reply

    Meredith, I hear ya. Mastitis x3, breast surgery due to abcess x1. It really makes the first two months post-partum more interesting, because you need more to worry about! Get your mastitis treated with _proper_ antibiotics, ladies! I was given the “wait and see” after the first round of pills with my OBGYN, who had coincidentally given me the “call me if you get a fever” lecture in the hospital. Wouldn’t you know it, a week later when I can’t get through to the OB’s office to report that the lump in my breast _didn’t_ go away with antibiotics, I’m continually told by secretaries to wait, call back later, etc, until over a week later and I’m hysterically phoning the emergency number. And by that time, my abscess (yes, it was an abscess by now) was nearly rupturing through my skin, and I was put into surgery immediately. Worse than the 28 hour labor, I’ll tell you that! So after weeks of rehab and incredibly painful hand-expressing of milk, here I am 8 months later with scars on my breasts that rival my stretch marks for their scare factor and an enormous fear of weaning my 11 month old. Needless say, I’m never going back to that OB.
    Take care of yourselves, ladies! And never let a secretary tell you it’s not serious. You know. She doesn’t.
    And continue to breastfeed! My lactation consultant was _way_ better than my OB, and would always just call to check on me after my big debacle. Support is a must! We made it through on one breast, then back to two, so you can do it!

  15. K Jan 19 at 6:08 pm Reply Reply

    I am pretty late on the comments here but wanted to put it out there that it somehow is possible to get mastitis while pregnant! I still have 8 weeks to go in this pregnancy, no idea how it happened but came down with some serious boob pain, redness, swelling, all of it. My OBGYN insisted that I take antibiotics right away (even though I am anticipating a nice round of hives from my penecillian/sulfa antibiotic sensitivity).

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