Preventing mastitis

[lsmama]

I am returning to work as a teacher in 2 weeks.  I had to go back to work in June for 3 weeks only when DD was 3 months.  I went from nursing on demand to pumping 3x per day in addition to the exhaustion of working and mothering an 11 week old and a 3 year old, and I ended up with mastitis which resolved with antibiotics.  Fast forward 6 weeks.  Older DD had croup, baby had a cold, I caught the virus too and we were in the middle of moving, so I ended up with mastitis again in the other breast.  I seem prone to it and especially during times of stress.  Pumping seems to throw me back into oversupply mode which I also think puts me at risk.  I am desperate for a regimen that will help me prevent another attack when I go back to work.  Aside from sleeping more (I'm trying but baby DD is not cooperating) what should I take?  If you have suggestions, please tell me dosages.  Thanks!!!!

[doublemom]

Unfortunately, it looks like there is no effective preventative measures. I had mastitis two times. Both got after pressure from bra or during sleep and both treated with amoxicillin. I think the key is to be very very careful with your breasts.

[Marissamom]

do what you can to boost your immune system, eat well, rest, exercise, a lot of people say upping your intake of fresh garlic can help. 

[jewel1288]

I have had mastitis one and an onset a second time, but it didn't hit me full throttle the second time. I'm so proud of you for pushing through and continuing to nurse and pump! What a persistent momma you are. :) 

Mastitis is brought on my stress, more than anything else. If working is a must, then you may need to pump more, like every 2 hours. If you're not emptying your breasts, the remaining milk can apparently (from what I've been told) cause your ducts to become plugged, which leads to mastitis. :-( In addition to pumping more frequently while you're away from your little one, try massaging your breasts while pumping if you feel a plugged duct. This will increase the circulation and unclog your duct(s). While home, apply a hot compress and steamy water to your breasts while showering. When you are able to nurse your little one, nurse as much as possible because nothing will unclog your duct as well as your baby's suckling. :) I know it may be very painful, but in the long run, it's worth it! 

You mentioned oversupply. Oversupply and stress is what I concluded was causing my mastitis. A friend of mine suggested block nursing. Are you familiar with that? If not, it's nursing baby on only one breast for a block of time. I have always done 6 hour time blocks because it's easiest for me. This allowed my LO to empty my breast and it corrected my oversupply. Since I began block nursing, I haven't had mastitis. So you may try nursing baby on one side or the other from say, 12pm-6pm anytime they're hungry, then switch to the other side from 6pm-12am and so on. I've had great success with it. 

I'm also wondering if you're wearing an underwire bra. If so, some women experience clogged ducts because of underwire, whereas other women do not. If you're wearing an underwire, try something different as it may be the root of your clogged ducts. 

For healthy milk production, I would suggest mother's milk tea; it's flavor is super mild and it's enjoyable hot or chilled. Agrisept is a very healthy anti-fungal liquid you can encapsulate to ward of infections, yeast, and fungi. Take this in small dosages though, as some babies are sensitive to it. 

I hope this is helpful!

[lsmama]

Thanks so much!  Stress, fatigue and oversupply are definitely my triggers I think.  I have been block feeding since DD was 2 weeks, but I've been switching every 2 hours.  I'm intrigued by every 6 but want to be cautious since I don't want my supply to plummet.  Hmmmm.  I do think pumping brings on mastitis for me since I pump both breasts as opposed to block feeding.  Not working is definitely not an option - DH is a SAHD.  Just curious, how did you land on 6 hours as the magic # for you?  Right now my pumping output and DD's appetite seem pretty well alligned - I nurse her at 7 am, pump at 9:20 and 12:40 and then try to make it home by 3:30 or 4.  I'm getting about 5 ozs per pumping session and DH says she's taking about this much over the course of my absence though she tends to take it in much smaller doses than I pump - maybe 2 ozs at a time (I think he's trying to mimic the way she eats when I'm home to nurse).   When I get home from work (this is only my 2nd day back) the milk is spraying and she's choking a bit.  I feel like we are a bit out of balance.  What are your thoughts on increasing the duration on each breast before switching?

[jewel1288]

I haven't heard of block feeding every two hours. Really, my only education regarding block nursing was from a friend of mine who had an oversupply, like I was experiencing. She told me every six hours, but perhaps you could try four hours instead. I have read from another momma that she did lose her supply when she began block nursing, but I'm thinking there must have been more factors involved. Neither my friend, nor I have lost our supply. Nursing is about supply and demand, so if baby is being put to the breast and successfully nursing or you're pumping, then I don't know why your supply would decrease, as long as you're otherwise healthy. It's essential to drink a lot of water, which was something I slacked off on for a few days and at that point, I did notice a significant difference in my supply. Otherwise, I haven't had any issues with a decreased supply. The best way to determine that your baby is getting enough (even if you don't feel like you're producing enough), as you probably already know, is to observe the number of their wets and dirty diapers, and to ensure that their dirties are frequently mustard in color and curdly, like cottage cheese. If they're more frequently green or are tinged with blood or even mucus, this indicates either an allergy to something you're eating, like the cow's protein found in dairy, eggs, soy (which is in a LOT of processed foods), or a nut allergy OR it indicates they're getting too much foremilk and not enough hindmilk: aka oversupply. Thankfully, it does not sound like your LO has an allergy. My LO didn't develop any signs to allergies until about three months. 

Anyway, back to mastitis and block nursing. I know nothing about pumping and block nursing, but I would take a guess that you would want to only pump one breast at a time, just as though you were nursing. Before taking my advice on that, I would encourage you to contact Le Lache League about that because I now only nurse my LO exclusively. When I was pumping, I didn't have the need to block nurse. Regarding the pumping frequency, like every two hours, instead of every three is to ensure you don't lose supply because when you pump, your body isn't going through the same hormonal process and let down as you experience when you're nursing your DD. Pumping also doesn't bring as much milk out of your breasts as a nursing baby, so pumping more frequently will ensure you keep your supply and have plenty of milk for your DD. How long are you pumping? When I was pumping, my midwife and LLL suggested 15-20minutes. Sometimes I went a little longer because I loved seeing all that milk, but it's not necessary if your DD is having healthy colored dirties and your supply is in balance. I would guess within the next week that your supply will balance out, just make sure your LO is having plenty of wets and mustard dirties. :) 

If you do go to a longer period of block nursing, just a heads up that your breasts may feel uncomfortably large and maybe a little uncomfortable, but that will eventually change one your supply balances out. You will certainly want to keep breast pads in place or handy because you may leak a little.

Be sure to get in touch with a LLL consultant because I know they'll be able to offer more information regarding block nursing and pumping. They even offer phone support if you don't have the need or time to meet with them! :) 

I hope this has been clear and helpful. If I haven't been clear or something is confusing, please let me know. I wanted to quickly respond while my LO is napping.