Mastitis, inflamed nipples, bleeding, AB allergy - ideas? - Mothering Forums

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#1 of 5 Old 07-19-2013, 12:37 AM - Thread Starter
 
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DS2 was born last October with Spina Bifida, so there was never a time to get the rest I should have had as a breastfeeding mama of three, and I had two bouts of mastitis, one in each breast, when DS2 was still in the NICU after the initial surgeries.

 

DS2 is doing well, taking one serving of pureed veggies and meat for lunch and one serving of pureed fruit of the spoon, the rest is breast. However,  I have had on and off problems with my breasts for months and am at the end of my wits. Now there is chronic inflammation behind my nipples, they are always bleeding after feeding, there is mastitis (hard red hot lump) in one breast, I'm in pain and have had bouts of fever and chills. Earlier this week, I caved in and let my obgyn finally put me an antibiotics (I held out this far because resistancies are extremely dangerous for kids with SB who are at high risk for UTIs due to neurogenic bladder). I have already had to switch from cefuroxim to a penicillin derivative bacause I developed an itchy rash and I am still somewhat itchy, though it's better. Fever is down, pain is better, but so far bleeding, painful lump and inflammation are still there. Apparently this is my last option before taking something that's not compatible with breastfeeding.

 

Weaning is not an option. Nuff said. Y'all get it. (Even with the little solids he gets, he is already constipated, as kids with SB get due to neurogenic bowel as soon as they're not EBF any more, and we do enemas and laxatives. With formula, that'd be so much harder to control, and he needs his gut flora and stuff for when he needs to take antibiotics himself, which for kids with SB is more often than AB kids, too - again, UTIs, surgeries, etc.). If he were to take a bottle, which currently he isn't.

 

Things I've tried:

Nipple shields. Forget it.

Block nursing. I did that with my older ones due to oversupply, did not do it with DS2 thinking keeping supply up was critical, but have now switched cause I couldn't take the pain from my right breast any more. Now I do one side for three hours, that's usually one feeding, sometimes two. I feel better doing it, not sure whether it really helps. 

Lansinoh and coconut oil on my nipples. Appears to make no difference, but haven't been religious about it. Would it help if I got obsessive?

Warming before and cooling after. Do that when someone else is in the house to help me with DS2. Again, should I make sure I do it every time?

Night weaning. He can sleep through the night, but does not always want to. But the switching back and forth from round the clock nursing to sleeping wreaked havoc on my breasts! Now poor DH has to get up and offer water, while I stare at my kindle to distract myself from the screaming, wanting nothing more than to just nurse him, but I just can't do it anymore - it's nightweaning or it's over.

 

I am eating an antiflammatory diet, but had, coincidentally or not, wheat the two weekends before the last two flareups, for a wedding and a birthday. That's it for wheat for me now, can't take the risk that it had something to do with it.

 

can you think of anything else? Am truly lost.


MeDH DS1 10/06 DD 08/10 DS2 10/12with SB and
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#2 of 5 Old 07-26-2013, 03:09 AM - Thread Starter
 
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#3 of 5 Old 07-26-2013, 06:59 AM
 
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You poor thing. Mastitis is horrible!

I disagree with your doctor that the next step is an antibiotic which is incompatible with breast feeding. Very few ABs are incompatible with BF and you've only tried two! How long have you been on the penicillin for? The first time I had mastitis I was on IVABs for 3 days before there was any improvement. Sometimes the area of infection is so dense that the blood flow is restricted and it takes a while for the drug to penetrate and start to work.

Another possibility, especially since you've been in hospital, is that you have a resistant strain. Most likely MRSA. It may be worth getting cultures done if you don't improve.

I have heard that acupuncture is good for mastitis but I haven't tried it myself.

The main thing is to keep the breast as empty as you can. I know it's hard when it's so painful but feed and express as much as you can.

Rest is also really important. Which I also know is difficult when you have other children. If there is any way though, it's worth doing.

I'm very happy to look up any drug your Dr suggests in Hales for you and to try and find alternatives if he is suggesting something which truly is breast feeding incompatible.

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#4 of 5 Old 09-01-2013, 10:03 PM
 
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Yikes! What an ordeal. You must be exhausted.

 

I'd recommend a visit with a private practice lactation consultant to find out what is causing the constant problems. It could be hypertonia, hypotionia, or something not connected directly to the SB. However, babies with SB often have midline issues and a tight lingual frenulum (tongue tie) or tight labial frenulum (lip tie) could be at work.

 

You'd need to be seen by an IBCLC to find out as even good Peds are not trained in diagnosing these conditions.

 

I wish I could help more, but this is something that needs a hands on, eyes on LC visit.

 

Good luck. I'll send healing thoughts to you. :)


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#5 of 5 Old 09-01-2013, 10:06 PM
 
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Oh, I wanted to add that agree with  katelove that nearly all oral antibiotics are compatible with breastfeeding. The MDs and NPs I work with and I use Dicloxicillian or Cloxicillian  (both are compatible with BF) to treat mastitis and one of these usually work with the first round. Penicillin won't work as simply most bacteria strains that cause mastitis are resistant to penicillin.  .


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