Last month I had my second bout with mastitis. It is not pretty, let me tell you. But I got through it, again, without antibiotics or further complications. There seem to be some common conditions that bring it on, for me at least.
The first time I had it, Del had gotten his first round of newborn shots (at 8 weeks) and the pediatrician told me he’d probably be sleepy. That entire day, Del nursed only sporadically and yes, slept a lot. That night was the first time he slept “through the night” (a total of about 7 hours uninterrupted that night) which should have been marvelous. Except that my breasts got so full I was getting sore. Sometime in the night I thought it must have gotten very cold outside and our apartment was cooling down, because I had chills. By early morning I realized my chills were fever, and it was easy to tie the fever to the bright red, hot, hard and painful spot on my left breast, about the diameter of a Ritz cracker. My temperature was 101 and I was aching all over. Checking my breastfeeding books and the internet confirmed my suspicions: mastitis.
The second time I got it, the circumstances were somewhat similar in terms of what was happening in our nursing pattern. We had traveled to a wedding, and the day of our flight back was a busy one. Del had nursed in the morning but throughout the busy day was distracted and only nursed for short periods when he was hungry. On the plane, he nursed during takeoff, then slept in the Maya carrier on my chest nearly the entire flight. Following the advice of other moms who’d flown with babies, I planned to nurse him again during landing, but the kiddo slept right through it and would not take the breast when offered. After we got our bags and shuttled to our car, we had an hour drive home – all that time my left breast was very full and achy. I nursed Del as soon as we got home. I commented to my husband that “coming home from a trip always feels a lot like coming down with the flu”. HA! We made some dinner and sat down to watch Mad Men… by the time the episode was over I was feeling terrible. Checked my temperature: 103.4. I did not have a red spot yet but my left breast had a knot like a plugged duct. But the achiness was exactly like before. The red spot appeared the next morning, larger than the time before and hot to the touch.
Common circumstances: Tired (in the first case from the usual new parent, up-all-night life; in the second, from the busy weekend trip). Baby not nursing fully and frequently. Compression (in the first case, sleeping on a full breast can compress it enough to cause the initial plugged duct that leads to mastitis; in the second case, baby in the Maya wrap in a cramped airplane seat for 4 hours).
So, in both cases, I did the following things to take care of myself:
1) Tylenol for the fever. In both cases it did not knock out the fever, but brought it down to a much more manageable 99-100. I also took a cool bath the second time, because the fever was so much higher.
2) Sleep. One of the causes can be “overdoing it” – just running your reserves down. A tired body . With the first case, Del was little enough that he was content to sleep most of the day in bed with me. We stayed there together all day. In the second case, Del was old enough that he was not going to sleep all day, and fortunately Zach had the day off and stayed home with us (we missed going to the zoo, which is what we had planned with his free day – boo!). Zach played with Del, and brought him to me in bed to nurse and for his naps.
3) Nurse. Nurse. Nurse. The first bout, I kept Del beside me in bed all day and encouraged him to eat as much as baby-humanly possible. Nothing empties milk from a breast like a baby does. There is nothing wrong with the milk so it’s safe for them to nurse the affected side. You have to get the milk out. And nursing that side hurts. The second time around, though Del didn’t spend all day in bed with me, I still nursed very frequently, and I pumped in between nursings. Again, just have to keep pumping to loosen the blockage causing the inflammation. Ugh. It hurts and milk does not flow freely. And during every nursing or pumping on that side, massage.
4) Massage. Ouch-ouch-0uch. I had to massage the affected area at every feeding and while pumping, and frankly, anytime I thought about it, which was whenever I wasn’t asleep. This also helps to loosen the blockage that is causing the inflammation. Even more effective is massage plus heat.
5) Hot compresses. I applied wet washcloths as hot as I could bear to the inflamed area several times a day in both cases. I also took a cool shower to help the fever but ended with letting hot spray from a hand held shower head do some of the heat/massage work for me. Using the hot compresses before nursing or pumping also helps get that milk flowing again. In fact, the fever is helping you too – your body is applying its own heat.
6) Water. Drink a lot. You need fluids to help your body through the fever, and you need to keep your system as flushed out as possible while your breast is working out its problem. So I drank and drank. I was really not hungry at all though I think I ate a little both times. I drank some Emergen-C in both cases too, to provide electrolytes, Vitamin C and some B vitamins. I am sure it helped.
In the first case, the fever lasted about 24 hours and the red spot along with all soreness disappeared along with the fever. I took it very easy the next day though I felt worlds better. In the second case I think my fever lasted more like 36 hours, and the second day I still felt bad. The red spot lingered longer too, even after the knot underneath was gone and milk was flowing freely again. In either case, had the fever persisted into the second day, I would have called my caregiver to discuss antibiotics. Also, my husband was prepared to take me to the emergency room if the 103 fever had not rapidly come down following Tylenol and the cool bath.
I was relieved that in the second instance that I had my 6-month postpartum check up scheduled just a couple days later. I was able to discuss the mastitis with my midwife and show her the residual spot where it had been. She checked and agreed the blockage was cleared. She listened to my description of how it had come on and what I’d done. She smiled kindly, patted my knee and said, “You healed yourself.” It was corny and sweet, and so very reassuring and empowering. I did, and I can if it happens again.
Note: I am not a physician and this post is not meant as medical advice. It is “mom to mom” suggestions for ways to take care of yourself if you experience mastitis and want to try to avoid taking antibiotics right away. This post is no replacement for speaking to your caregiver about your condition. High fever and inflammation are cause to call your caregiver.