Medical (mis)mangement Of Mastitis

By Author: juli cottle
Total Articles: 1
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This article deals with severe mastitis requiring medical treatment. In my work as a maternity expert and Naturopath I recently had an alarming consultation with a young mother.

The consultation with this Mamma went a little like this: Can you tell me how to wean my 4 month old baby? I kind of got the feeling that she didn't really want to talk about it, just wanted the info. I got half way through the sentence It depends on the reason you need to wean and was cut off by her hurriedly asking Should I go cold turkey or do it slowly? I answer the question telling her that it needs to be done as slowly as possible since sudden weaning will cause blocked ducts and mastitis. She then tells me that is the very reason she needs to wean. She became teary and said that she keeps getting mastitis and has made the decision to wean so that she is doing her best for her baby. She feels she can't look after him properly if she is sick.

I ask how many times she has had mastitis and she tells me twice in the last month. She then said it was her Doctor who told her that weaning is the best way to prevent her from getting mastitis ...
... again. Hmmm I get the feeling this Doctor does not know much about breastfeeding management.

We continue

Me: Do you remember how long you had the antibiotics for when you got mastitis the first time?
Her: Not long, I think it was 5 days.
Me: Do you know what antibiotic you were given?
Her: I'm not sure, he said it was a low dose of penicillin, he said we should try that first and if it doesn't work to try something stronger.

I suggested as delicately as possible that she find a Doctor who has some training in breastfeeding management. She tells me she has been seeing this Doctor for a long time and trusts him.

Even as a naturopath I recognise that if the infection is so severe that Mum has fevers and is vomiting as this Mamma was, she will probably need antibiotic treatment. You've got to get rid of the infection as quickly as possible and deal with it thoroughly. There are certainly natural therapies that we can use to treat mastitis, but once I see a vomiting, feverish mother, I would never wait to see if the infection will respond to herbs, nutritional therapies or homeopathics.

However I have several major problems with the way this Mum was treated by this Doctor. In the full length version of this article at my blog http://www.naturaltransition.com/blog/ I go into more detail about what the issues are that I have. In the interests of expediency I have edited this article for easier reading.

So here's my advice for a feverish, vomiting Mamma with severe mastitis.

1. Never, ever stop breastfeeding while you have mastitis or blocked ducts. Never ever ever. You are just giving the bacteria time to breed as well as providing the little suckers with the perfect medium for growth. Even while you have a really bad active infection and are expressing lumpy discoloured milk, it is still absolutely 100% safe to breastfeed your baby.

If you have blocked ducts that have turned into mastitis: Continue to follow these management guidelines until they are gone. This will help resolve the infection more quickly.

Apply heat to the affected area of the breast - you can use a heat pack or soak a hand towel in hot water (but not hot enough to burn) then wrap the breast in it. Do this before every feed.
Gently massage any breast lumps - start on the outside of the breast and use the heel of the hand to massage towards the nipple.
Breastfeed or express the breast until the area is softened and feels more comfortable. Feed with your baby's chin pointing towards the reddened area. Often this is hard due the position of the sore spot, you may need to get creative - where there's a will there's a way.
You may need to repeat this process a number of times before the blockage resolves.
Keep the breast as empty as possible. Feed your baby as frequently as they will feed and express after a feed to ensure the breast is completely emptied.

2. Between feeds use a cold pack to relieve swelling and pain. You can fill a zip lock bag with rice or lentils and put it in the freezer for a quick homemade cold pack. Don't use it directly against the skin. If engorgement is a problem you can use cold cabbage leaves, but don't use them for too long as they are really effective at reducing supply.

3. Go and see your doctor - If you have a favourite and trust them; great but don't be afraid to question the wisdom of their prescription. If possible, find a GP who keeps up to date with breastfeeding management. If you can't access a Doctor who specialises in women's health, I recommend asking for a women who has children of her own. They are more likely to know about breastfeeding than a 60 year old man.

4. To help maintain balance in your digestive system while taking antibiotics you can take a supplement of Saccharomyces boulardii (SB). This is a probiotic which is related to brewer's yeast and is naturally resistant to antibiotics. Other probiotics such as acidophilus will be killed off by the antibiotic you are taking. In USA and Europe SB is sold over the counter in health food stores to prevent traveller's diarrhoea. In Australia, there are several companies that sell it as a practitioner only product, so you will need to get it from a naturopath or GP. Many health food stores and pharmacies have a naturopath on site who will be able to supply it for you.

5. Rest, drink plenty of fluids and take care of yourself!

6. See an IBLC lactation consultant if you get more than one bout of mastitis. She will be able to work with you to resolve any issues causing the infection.