Blocked ducts/ exploding breasts - LLL help?

W

wanfamily

Registered User
Hi there,
Hoping LLL or someone who knows of a good clinic can help.
A few months ago, (I was living in Japan at the time), I ended up in hospital with a temperature of 39.9 and a nsaty case of mastitis. I called La Leche there who advised 'heat, rest and empty the breast', but ended up in hopsital being 'milked' by the nurses (ouch!), antibiotics and ice patches for my bra. They said my 'milk lines were thin and easy to block.'I moved here shortly afterwards and mentioned that my boobs were still tender to my GP, who just said it's normal. (This is my second child - both exclusively breast fed and there was no pain for my first one). Anyway, now my breast is all swollen and red again . Usually it takes me 10 mins to pump 150 ml. Today, it took me 40 mins, so I'm suspecting a blocked duct again. Scared of another bout of mastitis. Any advice appreciated. (I am still breast feeding exclusively).
 
It sounds like your mastitis has returned. Mastitis usually starts with a lump or tender spot in the breast where the milk isn't flowing well. Then because the milk isn't flowing infection sets in. The treatment is as follows:

Keep the breast as empty as possible. Breastfeed as much as the baby will allow. If the baby isn't feeding that much express the milk to keep the breast empty but getting the baby to feed directly will be much more effective.

Try changing positions while feeding. The place that the baby has the best suction is at his chin. Try to place the baby's chin on the lump - sometimes this means lying flat on your back with the baby lying on top of you. It is possible to swing the baby around as though he were a clock hand and your nipple was the centre of the clock. Another useful position is lying the baby flat on its back on the bed and crawling over the baby to dangle your breast into his mouth. This is difficult to maintain for more than a few minutes but often this is all that is needed.

Apply wet or dry heat especially just before feeding. Gently massaging the sore area of the breast before or during breastfeeding can assist the breast in further emptying.

REST - Getting plugged ducts is often the first sign that you are doing too much.

It is fine to take over the counter painkillers like paracetamol to help with the pain.

If you start to get a fever or flu like symptoms your body will need the additional help of antibiotics. Please see a doctor or go to the emergency at the hospital if he isn't available.

There is an article on the LLLI web site called My Breasts Hurt, What Can I Do? http://www.lalecheleague.org/FAQ/mastitis.html

There are many reasons why mastitis might return but the most common one is not getting rid of it the first time. Often the mothers aren't taking enough antibiotics - usually you need to be on the antibiotics for at least 10 days.

Other reasons are having lots of stress or getting too tired (very easy with a young baby). This is why the REST is in capitals. We often get mastitis around the six week mark when you have recovered from the birth and up back into your old life again - it is a warning to take things a little easier.

Another cause of mastitis is anaemia. Are your iron levels low? This is something your doctor could check.

There is an article on the LLLI web site called What can I do about my repeated cases of mastitis? http://www.llli.org/FAQ/repeatmastitis.html
which lists many reasons why mastitis might return.

Some mothers I know who have had repeated plugged ducts and mastitis use a lecithin supplement.

I hope you are feeling better soon.

Best wishes,
SARAH
 
Since you have had pain since, maybe it never went away. I agree than you need to see your Dr about getting on some antibiotics. Maybe you need a different antibiotic, someimtes if the infection is really bed people end up on IV antibiotics. Good luck.
 
Many thanks for the advice - I actually was getting treated for my last case just 1 week before we completely moved countries (with a toddler and newborn in tow - great timing!) and since I've been tender ever since, I'm wondering whether it actually completely cleared up. I've just made my hubby read the REST bit, so guess who's on toddler duty tomorrow!
 
Hi Sarah, or anyone who knows anything about this.
Many thanks again - one more question:
I went to the docs today. She confirmed what you said about the mastitis and gave me 2 creams to rub into the nipple of my affected breast: Fucidin (antibiotic) and Mycozole. She said that's it's quite ok if the baby ingests them, but I can wipe before feeding if I want. I decided to wipe before feeding, but for some reason my baby was really fussy when feeding. (He's not usually) I checked to see if the milk flow is ok and it was. I'm wondering whether the cream is affecting the taste and whether there is any other information to say the affect of using this cream. It feels a bit weird using a cream that has 'for external use' on my baby's feeding equipment! Surely he'll be ingesting quite a bit from such a direct route?!!! Second opinions/ experiences apprectiated.
Thanks,
Cath
 
Dear Cath,

Dr. Jack Newman has an all purpose nipple ointment made from the drugs mupirocin and betamethasone. These are not available in Hong Kong so doctors use other drugs which do the same thing. Usually it is fucidin and daktacort together but I believe that fucidin and mycozole will work just as well.

This ointment has three functions. It is an anti-bacterial, an anti-fungal and an anti-inflammatory. This is usually given for sore nipples rather than sore breasts. Did you complain about sore nipples too?

You only need a very small amount of the two ointments which you mix together in the plam of your hand first and then put on your nipples. It should be such a small amount that you can gently rub it into your skin ? so that by the time the baby feeds it has all been absorbed into your skin and there is none left.

If this is the only thing that you have changed then it is likely that it is the ointment/cream that is upsetting your son and making him fussy.

Best wishes,
SARAH
 
this may be a british thing, but everyone I talked to about sore breasts recommended slapping cabbage leaves on straight from the fridge after feeding. And also massaging the breast downwards towards the nipple using a wide toothed combe. This breaks down the small lumps of blocked milk. And directing the babies chin towards the lumps certainly helped me stay infection free, even when I got pretty close quite a few times. The cabbage (dark green savoy like stuff if poss) is a herbal remedy, but they are a perfect shape for cooling purposes anyway. mastitis is so nasty though, my heart goes out to you!
 
gentle manual expressing in the bath or shower usually makes things flow more easily too... warm water can be soothing, and also guarantee a bit of privicy!
 
Thanks Sarah,
I'm a bit confused as there is nothing wrong with my nipples....mmm (she did mention it was bigger than the other, but hey, I'm not perfectly symmetrical!)Also, when I did a search on the drug, UK and US sites say that 'safety with breastfeeding is unproven'. He's definitely rejecting the 'treated' one now - was happy when given the other one.
I'm thinking that now my fever has gone (it just lasted a day), and although I'm still tender, I'm not in agony any more and the milk seems to be flowing better, I might be alright without the cream as long as I take all the advice on the lll sheets? Is there any harm with risking letting my body take care of any potential remaining infection?
Thanks for all this help - finding it hard to find medical support in this area at the moment - ahhhhhh!
 
mji
Funny - I did the cabbage thing yesterday after talking to my sister (a Brit). Talk about relief!!!! Yes - It REALLY helps!
 
LLL_Sarah said:
Dear Cath,

Dr. Jack Newman has an all purpose nipple ointment made from the drugs mupirocin and betamethasone. These are not available in Hong Kong so doctors use other drugs which do the same thing. Usually it is fucidin and daktacort together but I believe that fucidin and mycozole will work just as well.

This ointment has three functions. It is an anti-bacterial, an anti-fungal and an anti-inflammatory. This is usually given for sore nipples rather than sore breasts. Did you complain about sore nipples too?

You only need a very small amount of the two ointments which you mix together in the plam of your hand first and then put on your nipples. It should be such a small amount that you can gently rub it into your skin ? so that by the time the baby feeds it has all been absorbed into your skin and there is none left.

If this is the only thing that you have changed then it is likely that it is the ointment/cream that is upsetting your son and making him fussy.

Best wishes,
SARAH
Click to expand...

Hi. I used both the all-purpose nipple ointment and the mixture of miconozole and fucidin. Both exacerbated the problem as the root cause was dermatological. I think it's a good idea to have a dermatologist take a look at your nipples if they are bothering you. It is assumed that it is a yeast-type infection usually but sometimes (especially with the all-purpose nipple ointment that also includes a steroid) that is not the case. I'll tell you, neither of those creams made things better for me.
 
wanfamily said:
mji
Funny - I did the cabbage thing yesterday after talking to my sister (a Brit). Talk about relief!!!! Yes - It REALLY helps!
Click to expand...

I was going to mention that too. I had serious problems with breast engorgement for the first 6-8 weeks of breastfeeding--along with some major dermatological-caused nipple issues. But....cool cabbage leafs were the only thing that helped in any regard of the many, many things that the lactation consultant recommended (everything from pharmaceutical treatments to naturopathic/organic remedies). I really did run the gamit of treatments and never did find a solution to my problem (apart from stopping breastfeeding when my son was 5 months old) but the cabbage leaves--those at least provided immediate relief.

Glad you tried that!
 
The most common cause of sore nipple is poor positioning and latch. So the first thing to do is get help with this - have a LLL leader or a lactation consultant watch you breastfeeding and suggest tips that could improve things.

If after this your nipples are still sore then you may need medication to help as well. Please don't self medicate but go to a doctor who will be able to see actactly what sort of infection you have.

As MLBW mentioned if you don't have a yeast infect, thrush medicine won't help. The usual types of infection are: bacterial, fungal and thrush but the soreness could have other causes too so it is best to check with a doctor.

Best wishes,
SAAH
 
LLL_Sarah said:
The most common cause of sore nipple is poor positioning and latch. So the first thing to do is get help with this - have a LLL leader or a lactation consultant watch you breastfeeding and suggest tips that could improve things.

If after this your nipples are still sore then you may need medication to help as well. Please don't self medicate but go to a doctor who will be able to see actactly what sort of infection you have.

As MLBW mentioned if you don't have a yeast infect, thrush medicine won't help. The usual types of infection are: bacterial, fungal and thrush but the soreness could have other causes too so it is best to check with a doctor.

Best wishes,
SAAH
Click to expand...

Yes, I know that this is true. However, in my case, my son had a really great latch and was a breastfeeding natural from the beginning--made several trips to the lactation consultant and had her observe me--it wasn't a problem with his latch. It was a problem with my skin so as LLLSarah said, it could be caused by several things. And I still think cabbage leaves are awesome! It's amazing how something so simple can help so much when all the other prescribed medications and ointments failed.
 
Yeah! Cabbage leaves is very well known method to cool down the breast (when duct is blocked or when you have mastitis) in Japan. But make sure to wash it clean before use them!

Other thing we do is use cold taro potato or normal potato. Just grade them (mix them with flour if you want), wrap them with moslin square or you can use plastic bag and put it in your bra! If works great, too!

Anyway, I hope you gets better soon!

Sucellia
 
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