BREAST ISSUES AFTER BIRTH
Erin’s story
The first time I got a clogged duct was 2-3 weeks after having Peyton. I don't remember it extremely well, I just remember feeling a hard lump in my right breast, trying to feed Peyton a little more that day, and thinking it had resolved itself when the discomfort went away. I was wrong.
I had briefly heard about mastitis from one of my best friends, who had a sister that had ended up getting it with each of her 3 kids, but I didn't think it was something I would have to deal with. Well, that clogged duct I thought I had taken care of quickly turned in to mastitis by the next evening, and that part I do remember well. I remember leaning over P's bassinet crying, and my husband (Jordan) coming out of the bathroom freaked out that it was postpartum depression, when in reality I couldn't remember ever feeling so terrible. It was like the worst flu ever, but without the head cold symptoms. My whole body ached, I had a fever, and worst of all I had a giant red triangle on my breast that was radiating heat. I called the on-call doctor, and was seen the next day by my hospitals lactation group. I definitely had mastitis, and little did I know this would be the first of many visits to lactation specialists and doctors for mastitis, engorgement and clogged ducts. The first time I got mastitis they gave me clindamycin (I'm allergic to amoxicillin) and it cleared up within about 24 hours.
I thought if I made a conscious effort to nurse diligently I wouldn't have any more issues with clogged ducts, but at this point I hadn't started pumping. Well at 5 weeks I got mastitis again in the other breast. I knew how to recognize the signs/symptoms so I called the doctor right away, they called in a prescription for me since I was heading to Hawaii for 5 days, and I assumed that I would have the same experience as the first time and it would clear up quickly. It's also worth mentioning that my left breast was extremely engorged. I'm talking the size of a melon, while the other one was closer to an apple. I managed through the pain and awkwardness of having quasimodo boobs while in a place where I was planning to live in bathing suits most of the day, but the after I returned I knew something was wrong.
I had been out shopping with my mom and noticed the pain in my breast starting to radiate to my arm. It was afternoon so I figured I would go home, call the doctor, and have Jordan go in with me after work rather than just telling my mom something was wrong and asking her to go with me (I'm stubborn). By the time I got home I was in tears, I couldn't lift my left arm and could barely carry P inside. I called Jordan in tears to come home right away and drive me to the lactation specialist at the hospital who had gotten me in for an emergency appointment. Once we got there I broke down in tears before I could even tell the specialist what was wrong. After a quick exam she transferred me to the ER, who transferred me to the Labor unit where my regular OB-Gyn was working a shift.
I ended up being checked in to the hospital for 2 nights. They did an ultrasound of my breast to make sure I didn't have an abscess, and I ended up having to be given 3 IV's of antibiotics. The first antibiotic I was on no longer was working, so the second 2 doses were Bactrim, a heavy duty antibiotic used to treat MRSA.
After being released from the hospital I started looking more seriously in to how to treat clogged ducts and engorgement, and avoid another bought with mastitis. I thankfully found an amazing local lactation consultant (Lotus Lactation for any Portland, OR based moms!). These are the treatments that worked for me as I battled multiple additional clogged ducts over the 18 months I breast-fed my daughter
Treatment of Clogged Ducts
Adjust Position : Depending on where the clogged duct is located on your breast, changing the position of breast feeding can help your baby drain the milk from that area.
Pump : Clogged ducts develop when your baby doesn't fully drain the milk in the ducts. We discovered that I had a pretty significant oversupply of milk, so while Peyton and I got in to a routine of feeding and pumping those first few months I had to pump nearly every 2 hours to ensure my ducts remained clear. I was slowly able to spread out the time little by little, but at the first sign of a clog my BFF the pump was pretty much attached to my side.
Hot Shower & Hand Expression : The hot water, especially on a shower head with a massage setting, can help to loosen up a clog in conjunction with hand expression. I'm not an expert but I think of this similar to a way that pores on your face react to steam.
Hot Towels : These were a life saver for me. Jordan was an angel any time I had an inkling of a clog, and would bring me hot towels (soaked in water and microwaved) in the middle of the night to use before and after nursing and while pumping after nursing. For some reason these worked wonders in helping to quickly address clogs.
Lecithin : This is a natural supplement that was recommended to me by my lactation consultant. The simplified reason to use this is that it can affect the fats in your milk and makes it less sticky
Wear Soft Bras : I found that any time I tried to wear a more structured nursing bra or one with underwire I triggered clogged ducts. I ended up wearing the soft medela nursing bras for most of the 18 months I spent breast feeding.
I'm not a health professional so my advice definitely should not take the place of talking to your doctor, but if you experience signs of mastitis definitely call your doctor!
Other Resources
KellyMom.com : provides a ton of great articles and resources from professionals
Feel free to reach out to me if you have any questions for me or want to know more about my experience. I'm happy to share and hope that some of the things that helped me will help someone else avoid some of the experiences I went through.
MOLLY’S STORY
Breastfeeding wasn’t a question for me. I thought Fritz and my boobs would be BFF’s. I was fully committed it to do it for as long as my body and sanity would allow. But you know how plans go, just the opposite of what you would expect.
Fritz was in the special care nursery at Mayo Clinic and I pumped exclusively, during those days. He wouldn’t latch and was hooked up to monitors. If I wanted to hold him I had to buzz in a nurse to remove him from his bassinet. I tried and failed to breastfeed him. I wanted my baby to eat, so he was given a high flow nipple. Every time I attempted to feed Fritz he became agitated that my let down wasn’t instant. I didn’t want to give up on breastfeeding, so I met with a fantastic lactation consultant. This is a service that Mayo Clinic offers for free to new mothers and my husband and I learned so much. We practiced feeding Fritz at my breast and with a nipple shield, he had zero interest. It was apparent that I would be exclusively pumping to feed Fritz, we would make it work!
Pumping was going really well for me. My production after two weeks was over abundant, and I already had a great supply frozen. However, the grass isn’t always greener, overproducing can be a burden. My breasts hurt, they were engorged and no matter how much I pumped I always felt full. I have a large chest to begin with and physically I was entering a territory of bust size that was inconceivably huge and made me so self-conscious.
I was producing between 60 and 100 ounces a day and my breasts weren’t emptying, with the help of my LC we decided I needed to drop two pumps. She warned me about Mastitis because I would be pumping less often, so the buildup of milk could cause me some discomfort. It was important to express my breasts manually if they felt too full and monitor how I felt. Mastitis was something I had heard of before, but I didn’t realize how severe it could be. I didn’t really understand how sick you could get. We talked through the warning signs: a temperature, chills, flu-like symptoms, body aches and pink breast that felt warm to the touch. I left the meeting feeling confident that I could make feeding my baby this way work and maybe even enjoy it.
Spoiler alert: 48 hours later I thought I was dying. I do have a flair for the dramatic, but this was a kind of sick I had never been before. Picture it: a first-time mother, helpless, a 104-degree fever, attached to her breast pump, under four down comforters, all while sobbing. I had chills, I was sweating, I was emotional and honestly didn’t know how I could get through it. They leave this out in perinatal class. I felt broken and was heartbroken for my child.
Thankfully Mayo has a protocol where you can send in your symptoms to the lactation consultant and they can get antibiotics to you right away. It took me four days to get back on my feet. I couldn’t care for my baby (my mother in law did everything for me), I couldn’t eat and only got out of bed to take a scalding hot shower, change out of the sweat-soaked clothes or pump. I also cried, all the time. I would go downstairs to look at my sweet newborn in his dock-a-tot, but it hurt to hold him. The tears didn’t stop.
My sweet friends texted, and I told them all, “I WOULD RATHER GO THROUGH LABOR AGAIN.” To this day, I still would.
Getting sick, while being a new mom brought me to my knees, but oh my goodness, it taught me to never take my health for granted.
Here is what helped me get through the dark days of Mastitis:
Use a warm compress. This opens up any clogged ducts. I picked up gels that could go in the microwave and they were a lifesaver.
My lactation consultant also recommended not wearing any restrictive clothing. I was changing my shirt every few hours from sweating through it, so leaking didn’t matter.
This tip was barbaric but really helped me break down the lumps I had in my breasts due to clogged ducts. Take a scalding hot shower with your new best friend – a wide tooth comb. Lather your breasts with soap for lubrication and run the comb vertically from top to bottom, applying moderate pressure.
When I had the energy, I would also take Epsom salt baths to submerge in the hot water and massage where the ducts felt clogged.
If you are breastfeeding – FEED! If you are pumping – PUMP! This was the hardest part for me. Taking a shower felt like a marathon, but I was determined to get better and also didn’t want my supply to dip.
Don’t be afraid to ask for help. I was so lucky to have my MIL staying with us.
Sleep. Your body needs rest. Your baby won’t remember you being sick for those few days. As heartbreaking as it feels, just rest. The more you do, the faster you can get back to baby and being the amazing mother you are!