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Mothering › Mothering Forums › Archives › Pregnancy and Birth Archives › Due Date Clubs 2004 - 2008  › July 2008 › UPDATE: experience & advice with mastitis???...alternative treatments & options?
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UPDATE: experience & advice with mastitis???...alternative treatments & options?

post #1 of 17
Thread Starter 
Hi everyone, we came home on Friday (twins born Sunday a.m. in the wee morning hours.) We have been without internet today (even though everything looked fine and dandy as far as connection and everything, so I have been able to do zero research on this.

I think I may have mastitis. It's either that (I have a fever, I feel the "flu-like symptoms" of aches and pains and a mild headache, I don't feel like eating stuff like dinner--but I ate a yogurt just fine and have been able to drink water, but not in huge quantities because I'm sleeping a lot...) or something like another infection (bladder infection? UTI? I think those were mentioned as possibilities for fever on my discharge papers) or MAYBE something like part of the placenta retained?

The thing is I don't seem to have any plugged ducts or red/painful spots on the breasts themselves and the babies do a decent job of draining them when they nurse. They do get hard-ish when they fill, and Linus (the bigger one) naturally goes a bit longer between feeds... I really think the over-filling is because of the pumping I did in the middle of the week.

Anyway, I didn't realize this thing was happening in time to act earlier....I think things got going on Wednesday, but I'd already been discharged from the hospital (they kept the boys and I roomed in with them, but they couldn't give me meds or poke & prod me so nobody was taking my temp. I did send Joe to ask a nice neonatal nurse about my symptoms...he mostly asked her about the uterine cramps/afterpains, which were significant & alarming to me even though I know they're "bad/worse" with second pregnancies, and she said that's just what it's like to have a second/third baby....you pretty much feel like you're dying.)

That was the day that Linus had a spike in his bili levels that took him to (I think) 20, my milk just was coming in (it started transitioning 3 days postpartum, not shabby for someone who needed a transfusion because my hg dipped to, I think, 5 on day two pp), and I was "sympathetically" encouraged (it felt like pressure) to supplement a few times with 20 MLs of formula to get him out of the woods. Instead, I pumped.

Pumping that soon (in my limited experience of one previous baby) is kind of a guaranteed way to screw up my supply & demand, at least when my milk is coming in. I learned this for similar reasons with my first daughter and I was opposed to all of it this time, except my transfusion situation & my (as yet unknown) milk supply with twins & physical stress, AND the uric acid crystals (brick dust) pee diapers & dry mouths of my babies made me nervous about saying No thanks, we'll go home and try the process the way I KNOW it works.

So that day, I cried a lot, and instead of resting, I was up pumping frequently through the night.

Buddy boy pulled through, but that was the stress & lack of rest & pumping (increased supply, harder breasts, sudden increase in pain & weariness that I thought was a message to slow down....) The next day got kind of hellish for me in terms of not being able to walk around without pain, etc. I woke up saturated in sweat, and got the shakes (badly) from chills when I got up to pee, but they resolved and I just took it as all the plastic in the bed (chuck pads, mattress covers) heating me up and then me getting a chill because I basically was naked (shirtless & mesh panties) in the bed with the boys. Since home, I've had some wicked bad "I'm so hot I'm going crazy" moments, but it's hot & humid here and I'm still used to the crazy "running hot" days of pregnancy that it didn't make me wonder. I asked Joe if the skin of my breasts felt hot, but he didn't notice them giving off heat, particularly. So I was even more delayed in checking my temperature.

Here's the poop:

I am concerned about using antibiotics for mastitis if I don't have to. I don't want to risk bouts of thrush at the very beginning of nursing twins, I don't want to nullify the gut colonization benefits of the double vaginal birth by using antibiotics if I could kick mastitis some other way through some kind of herbs or compresses or whatever (and I don't if that concern of mine about the babies' gut colonization being thrown off with MY antibiotic use even IS a risk. But I've read that there are differences with gut pH and type of colonization in c-section babies versus vaginal births, and that the guts of c-section babies mimic more the pH & virulence of the formula-fed gut over the breastfed gut. And it can take months/weeks to return to a more balanced pH after supplementing just once with formula, etc. etc. So I was wondering about the factor of antibiotics....) But I don't know what alternatives there are.

Also, I guess I wonder how likely it is that the symptoms might be something else. And what treatment would be. (D&C for placenta issue?)

At first, I checked my temp and it was 100.8 F (The discharge papers said call if anything over 100.4) Then Joe put the window unit AC on for me and I immediately got chills and needed to be under the covers. When I got him to turn it to less of a cold blast, I uncovered and checked my temp again and it had spiked about 3 degrees, I think. But then I got under the sheet and nursed/rested, and was again in the 100.8 range, or at least lower. (Didn't right down any of this stuff, unfortunately.) After a couple of hours, I opened the sheet to sit up and drink something, checked my temp, and I think it was in the 103 or 104 range.

The babies do okay draining my breasts but they (the breasts) ALWAYS get FULL and pretty hard, so draining them completely (or nearly completely) sort of perpetuates the problem. But what else to do? If it pools there, undrained, I can develop plugged ducts, right? Haven't tried compresses, and don't know what herbs/alternatives to try.

I took my temp a few minutes ago and it was 103.3 (I'm wearing a tank top and an open robe (just nursed Noel because he was a-screaming.) Just now it was 102.9 I took it in the bed before getting up & drinking water, but I can't remember what it was after sleeping covered up.

Can anyone help me out? Our network connections have gone in and out a few times while I've typed this, and I have to rest & nurse babies, so I don't know how much searching I can do on my own behalf, though we will try. Joe is pretty wrecked and tired out, I must admit. Kind of the straw that broke the camel's back.

I thought somebody might likely just know a lot about this. I do feel a bit better after even more rest than "usual" (I really haven't been doing much since we got home.) Thanks for any help you can offer!

Looks like we may be looking at Lyme disease. I'm getting a second opinion this morning and probably will start abx since it looks like this thing I found on my butt yesterday is an inflamed tick bite. Great. But glad to find out some explanation for this fever that won't quit...
post #2 of 17
Thread Starter 
my pms box is 100% full right now...sorry about that!
post #3 of 17
With my dd I got mastitis A LOT. I would put a hot compress on my breasts for awhile or get in a hot shower and then let the baby nurse or pump to empty them. As long as I kept emptying them and putting heat on them, it would go away on its own. I'm not sure about herbs, I hope someone knows something more as it can be miserable! :
post #4 of 17
Try taking a hot shower while massaging your breasts and /or manually expressing. Also, pumping, especially if you have access to a good pump- like hospital grade. Massage the lump/knot feeling area from outside towards your nipple as you pump. That's what's worked for me in the past.

I'd call your cp, though- if you don't have redness, heat, tenderness, or a lump in one breast, it might not be mastitis. It'd be better to call and make sure, imho. If you do have something going on, the earlier it can be treated the better, I'm sure.

Cranberry juice is good for UTI's, don't get ocean spray or crap like that, it needs to be unsweetened. Sugar will just help all the yuck to proliferate.

Hugs to you mama, I hope you feel better soon!
post #5 of 17
First off -- call your health care provider NOW. This is definitely an infection of some kind & it can get really bad really fast. Once you get to the point of infection where you're at - you've just GOT to act.

It actually doesn't sound like mastitis to me. But, you need to go over your symptoms (have someone go with you to help explain) with your provider. I would look for a specific lump, red spot, burning hot breast area for it to be mastitis. I mean, it could still be mastitis, but it actually doesn't sound enough like it to me.

I think antibiotics are probably what they'll do for you. If they do, make sure you match it with acidopholis/bifidopholis supplements for you and babies. Then, you can also up your probiotics in foods, too.
post #6 of 17
I've had lots of plugged ducts in the past and 2 rounds of actual mastitis--to me it doesn't sound like that's what you have. But it can't hurt to try homeopathic "phytolacca decandra"; even though I'm not a big believer in alternative medicine, this stuff seems to do the trick for me and is what most midwives and homeopaths recommend. Cold cabbage leaves might feel good too if you are engorged.
post #7 of 17
When I have had mastitis I have had both fever AND chills. I agree with pp's--not sure if that is what you have going on. I have been able to kick mastitis with massive amounts of water, grapefruit seed extract, probiotics and extra rest, but I caught it early and figured out what was going on in time to treat it without abx. I also wouldn't mess around with it for too long because if it gets bad, you have too much going on with the twins to risk it getting nasty. I'd call your provider and see what they say. You can make a better decision about how you treat it once you are sure what it is.
post #8 of 17
My midwife gave me something called EHB to fight off infections after I gave birth http://www.shop-enzymatictherapy.com/store/nf_ehb.html

it has all sorts of herbs and vitamins in it, I was taking 2 a day for the first few weeks after i had the baby and it had no ill effects on the baby. midwife says it will knock out mastitis and UTI and uterine infections
post #9 of 17
i also have great luck with phytolacca decandra if it is something to do with the breast. but get it checked out if needed, infections are not anything to mess around with!
hope all goes well!
post #10 of 17
If you had mastitis you would be having a lot a pain in your breast(s), even if it's not localized in one spot. Are you having severe breast pain other than engorgement?

Could you have a post partum infection?
post #11 of 17
Thread Starter 
Thanks for the replies. I ended up staying in bed and so I didn't really get to check them out until now!

We went in to see our family practitioner this morning (she was checking out the boys) who is my doctor, as well. She usually does all my gynecological care....I don't really have an OB and wouldn't have had one except for the twins factor.

I told her my symptoms and my concerns. She checked my fundus and noted that I winced and that it's tender. She said that because my breasts were soft and not tender or painful, she didn't think it was mastitis. She called my OB and gave her the scoop, explaining my misgivings about antibiotics and that she (my doc) was going to send me to the lab for a blood draw and urine sample...to check my CBC for elevated white blood cells, sed levels, and urine for bacteria. She told my OB that I would call her office after the labwork and if my OB wasn't comfortable with the results we could go from there. She advised me that if the labs showed signs of infection, I should treat with antibiotics, and I agreed.

Later this afternoon, my OB called back and said that my white blood cell count looked normal, sed (?) level was elevated in the range she would expect at this point postpartum and nothing to worry about, and that my urine sample was fine. She said she felt comfortable telling me to rest, and to call the office with any further concerns or changes.

On another note, my hemoglobin & hematocrit levels have rebounded nicely in the week since my transfusion....I'm now at a 9.5 and 30-something. She seemed pleased.

It was a rough day today, going into town, and my bleeding picked up accordingly. I still have the fever but it has dropped since I came home and got in bed.

The twin moms on the multiples forum have let me know that, infection/fever or not, their postpartum recovery after twins was HARD and took a solid 3 weeks or so. It was blowing my mind, because the actual rebound from the birth (pelvic floor issues, swelling, etc) was so easy this time because of the natural birth. Then all this stuff with the bloated belly, tenderness, achiness, etc. which seems more about the PREGNANCY than the BIRTH.

We've had some stresses, even though the twins are great. My four-year-old is having some challenges (and creating some for us) and our strategies for deflecting and distracting aren't always up to the task. My husband has been really reactive to her (as have I, sometimes) in addition to being really sensitive and warm toward her, and that has been stressful. Then, we were supposed to go to the hospital for a weigh-in yesterday, and we were driving down the hill when Joe realized we had almost no brake response. We turned around and went back home, which was a scary proposition (had to drive to the top of the hill, then start back down the other side to get to our house, and it's fairly steep & windy. Joe put the van in low gear and we got home safely that way.)

Took it to the shop today and turns out the brake line was rusted in one place and the fluid had drained out.
post #12 of 17
Thread Starter 
bump to add an update (Lyme disease)
post #13 of 17
Are you just wondering if it could be Lyme disease or did a test come back saying you have it?
post #14 of 17
Thread Starter 
The labs aren't back on my blood test, but I found a raised welt on my left hip Tuesday evening. I felt it when I put my hand back there walking to the bathroom, and it was sore and raised. Felt like a bug bite type thing. I asked Joe to take a look and he said "Oh my God!" It's a half dollar-sized welt in the center with what looked like fang marks with a center dot--a pair of them on each side, and a lighter pink area about 4 x 2 inches all around. My doctor saw me (our family physician, not OB) and said it looked like a tick bite and the fang marks weren't breaks in the skin but rather broken vessel-type stuff around the central bite...with the "bullseye" rash.

She sent me to a dermatologist the next morning for a 2nd opinion, and he said he was 80% sure that's what we were looking at. Considering that we live in an area with a very high rate of Lyme, a large deer population/woods/deer ticks, and we have a cat from whom we remove deer ticks on a daily basis, it seems even more likely. Plus, we've been trying to break our cat from spending time on our bed, but in the later weeks of my pregnancy it was so hot and the bedroom had the only a/c...every time we returned from being out, we'd find him back on the bed....I'm sure I could have gotten bitten in the bed and it (back side of hip/lower back) is in a spot I wouldn't have noticed. I did find a tick on my forearm (in the bed) a few weeks ago, and removed it when it still was teeny and hadn't been on long.

My symptoms of fever, aches (esp. head & knees) fit, too. It went up to 104.9 last night, after the stress of yet another trip into town to get checked, get a prescription, go talk to lactation consultants re: prescription, etc.
post #15 of 17
Yikes Amy. My dog got a nasty tick bite like that before, all welted and stuff. I'm sorry you are going through this, I hope it all gets resolved soon.

If it makes you feel any better I ended up having antibiotics my ENTIRE 10 hour labor and we have had 0 thrush problems (knock on wood!).
post #16 of 17
Oh my! I'm sorry you are dealing with lyme disease, but happy that nursing seems to be going well, and that you didn't develop an infection from the birth.
What will you do to get well again? I'm not really familiar with Lyme disease...
Get better!
post #17 of 17
Thread Starter 
We've caught it early enough that I think a round of antibiotics is basically it for treatment. If people don't find the bite, or if they don't happen to get/notice the telltale bullseye rash (everyone around here, nurses etc., keep commenting that I'm lucky I got the bullseye, so I guess it doesn't always present that way or it can be missed--like I was missing it!), it can be hard to diagnose and if it goes untreated Lyme disease can do major organ damage.

I had read somewhere (in a thread on MDC, actually!) that you "can't" nurse if you have Lyme disease and so I was scared about that....the prospect of not being able to nurse, or not during treatement or something. I was thinking about milksharing and who I possibly could ask (um, could you pump for my, uh, twins?) on the way to have the bite checked out, but it turned out there was no reason I couldn't nurse.

They are (I think) in the middle of a growth spurt. At least I think that's it. They have been nursing nonstop, one or the other or both, since I don't know...4 p.m.? I was nak when I was in here at the computer earlier.

Now at ten minutes before midnight, they suddenly both decided to crash into a deep sleep, so I totally need to go sleep. I just came to post a question about swings....
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