Re: Plugs, mastitis, and pain. Oh my!

[Guest guest]

has she tried a nipple shield? it's possible that baby could do a better job draining that breast. also, i wonder if the flange fits correctly since she has a cracked nipple... Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/--- From: yvonne

Subject: Plugs, mastitis, and pain. Oh my!To: Date: Sunday, November 28, 2010, 4:25 PM

Need some help and suggestions. I have permission to post.

Saw a mother last week with symptoms of mastitis and severe plugs in left breast. Baby (6 weeks old) only latches on right breast.

As per my suggestion she got abx and has been on them for 5 days. The "shooting pain" is "90% gone". The problem lies with the "radiating pain" from the plugs that are still on the left side.

She pumps the breast to maintain supply while trying to introduce it to the baby regularly. Now has a cracked nipple on that side.

She says that she pumps the breast and for 10-30 minutes the lump and pain subsides. After that, the pain returns.

I have suggested cold between pumping and warmth before, cabbage leaves, gentle massage. The mom says that cold feels good but I don't think she can go on much longer with the breast like this.

She called her doctor about the pain and was told to come in to the hospital today for an ultrasound. She went in, pumped the breast, another doctor took one look and said that she didn't need an ultrasound and sent her home.

What do you think???

[Guest guest]

Thanks . The mom says that she has the cracked nipple now (not last week

when I saw her) because she has tried to get the baby to latch and got chomped

on. The mom has a shield but wasn't too keen on using it.

I am thinking galactocele or absess? She is in a significant amount of pain.

Will both of these cause this much pain?

IBCLC, LLLL

Massachusetts

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> Subject: Plugs, mastitis, and pain. Oh my!

> To:

> Date: Sunday, November 28, 2010, 4:25 PM

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> Need some help and suggestions. I have permission to post.

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> Saw a mother last week with symptoms of mastitis and severe plugs in left

breast. Baby (6 weeks old) only latches on right breast.

>

>

>

> As per my suggestion she got abx and has been on them for 5 days. The

" shooting pain " is " 90% gone " . The problem lies with the " radiating pain " from

the plugs that are still on the left side.

>

>

>

> She pumps the breast to maintain supply while trying to introduce it to the

baby regularly. Now has a cracked nipple on that side.

>

>

>

> She says that she pumps the breast and for 10-30 minutes the lump and pain

subsides. After that, the pain returns.

>

>

>

> I have suggested cold between pumping and warmth before, cabbage leaves,

gentle massage. The mom says that cold feels good but I don't think she can go

on much longer with the breast like this.

>

>

>

> She called her doctor about the pain and was told to come in to the hospital

today for an ultrasound. She went in, pumped the breast, another doctor took

one look and said that she didn't need an ultrasound and sent her home.

>

>

>

> What do you think???

>

[Guest guest]

What kind of things are you guys trying to get the baby to latch on to the other side? Is this something that has been going on since birth? Is there a difference in the nipple shape or flow in the breast that is making the baby refuse that side, or is it a birth injury perhaps? I also agree that she may need a different flange size for the pump. You may also look into lecithin supplementation for recurrent plugged ducts. These are just random thoughts that I wanted to share with you. :-)

Carla

To: From: Mybaby4343@...Date: Mon, 29 Nov 2010 00:25:58 +0000Subject: Plugs, mastitis, and pain. Oh my!

Need some help and suggestions. I have permission to post.Saw a mother last week with symptoms of mastitis and severe plugs in left breast. Baby (6 weeks old) only latches on right breast.As per my suggestion she got abx and has been on them for 5 days. The "shooting pain" is "90% gone". The problem lies with the "radiating pain" from the plugs that are still on the left side.She pumps the breast to maintain supply while trying to introduce it to the baby regularly. Now has a cracked nipple on that side.She says that she pumps the breast and for 10-30 minutes the lump and pain subsides. After that, the pain returns.I have suggested cold between pumping and warmth before, cabbage leaves, gentle massage. The mom says that cold feels good but I don't think she can go on much longer with the breast like this.She called her doctor about the pain and was told to come in to the hospital today for an ultrasound. She went in, pumped the breast, another doctor took one look and said that she didn't need an ultrasound and sent her home.What do you think???

[Guest guest]

Hello, .

You have gotten a number of good suggestions.

I would also suggest you go through the information here, http://www.lowmilksupply.org/craniosacral.shtml, with the mother to see if there are signs in the baby that craniosacral therapy might be helpful.

Also, have you checked for a tongue-tie? Although intuitively it does not make sense--a tongue tie ought to make it tough to eat on either breast--I have seen a number of cases over the years where a baby with a tongue tie can nurse very well on one breast but really tears mom up on the other side.

Besides checking for appropriate flange size, what kind of pump is the mother using? Since she is exclusively pumping on L breast, she should really be using a hospital-grade pump to drain that breast well.

She could try a cold-pressed castor oil compress on her L breast to see if it helps resolve the current plugs. There are instructions for that in our archives.

However, if the lumps actually go away after pumping, they may not really be plugged ducts. They might be storage areas for milk that feel firm again as milk re-fills for the next feeding. Does her bra cup go back far enough under her arm so it doesn't ride on these areas, possibly causing pain? Different brands of bras are built in different ways. Some women have breast tissue that really sits far back along the rib cage. These women need a bra that has the seam between cup and band set back along the ribs so that the seam doesn't place undue pressure on the breast tissue and cause plugs.

Dee Kassing

Need some help and suggestions. I have permission to post.Saw a mother last week with symptoms of mastitis and severe plugs in left breast. Baby (6 weeks old) only latches on right breast.As per my suggestion she got abx and has been on them for 5 days. The "shooting pain" is "90% gone". The problem lies with the "radiating pain" from the plugs that are still on the left side.She pumps the breast to maintain supply while trying to introduce it to the baby regularly. Now has a cracked nipple on that side.She says that she pumps the breast and for 10-30 minutes the lump and pain subsides. After that, the pain returns.I have suggested cold between pumping and warmth before, cabbage leaves, gentle massage. The mom says that cold feels good but I don't think she can go on much longer with the breast like this.She called her

doctor about the pain and was told to come in to the hospital today for an ultrasound. She went in, pumped the breast, another doctor took one look and said that she didn't need an ultrasound and sent her home.

[Guest guest]

Dee I know you weren't posting to me but I wanted to thank you for the site! It is very informative.

Carla

[Guest guest]

You're welcome, Carla. Isn't it great how one person asks a question and the rest of us get to learn so much in the process?

Dee

Subject: RE: Plugs, mastitis, and pain. Oh my!To: ibclc-pp Date: Monday, November 29, 2010, 12:04 AM

Dee I know you weren't posting to me but I wanted to thank you for the site! It is very informative.

Carla

[Guest guest]

Just as some other folks suggested, when I see this kind of difference between

breasts, I look at what might be mechanically different. It sounds as if she

experienced these problems before she began pumping, but I would clarify that as

many moms pump for no reason other than that they have a pump or think they

should. If she was pumping before the problem began, then the flange is even

more likely a source or at least a factor.

Aside from that, I would take a good look at the baby visually. It doesn't take

long to learn to assess structural misalignments and restrictions. As Dee said,

I have even seen kids with posterior TT cause damage to only one nipple or

breast. So, I would rule that out and refer for structural work immediately. I

would suggest you evaluate for birth trauma, but given the state of medicalized

birth, it's almost a given.

Obviously, I would not have referred for abx (since I never do), but since she

is taking them, she needs to be on a probiotic, so she doesn't end up in worse

shape with thrush. My first approach acutely is castor oil compresses at least

4X per day for 20 minutes, the homeopathic remedy phytolacca (initially one dose

every half hour for 6 doses) and the homeopathic cell salt calc fluor 4tabs

every 2 hours. I would also want her on vitamin D, magnesium and zinc for

healing. And coconut oil on her nipples after every feeding/pumping.

I would also strongly encourage mom to get adjusted when she takes the babe as

this could be no more than a structural problem on her part. Otherwise,

acupuncture could be quite beneficial.

Tow, IBCLC, Toulouse, FR

>

> Need some help and suggestions. I have permission to post.

>

> Saw a mother last week with symptoms of mastitis and severe plugs in left

breast. Baby (6 weeks old) only latches on right breast.

>

> As per my suggestion she got abx and has been on them for 5 days. The

" shooting pain " is " 90% gone " . The problem lies with the " radiating pain " from

the plugs that are still on the left side.

>

> She pumps the breast to maintain supply while trying to introduce it to the

baby regularly. Now has a cracked nipple on that side.

>

> She says that she pumps the breast and for 10-30 minutes the lump and pain

subsides. After that, the pain returns.

>

> I have suggested cold between pumping and warmth before, cabbage leaves,

gentle massage. The mom says that cold feels good but I don't think she can go

on much longer with the breast like this.

>

> She called her doctor about the pain and was told to come in to the hospital

today for an ultrasound. She went in, pumped the breast, another doctor took

one look and said that she didn't need an ultrasound and sent her home.

>

> What do you think???

>

[Guest guest]

I always recommend organic coconut oil. ly, I recommend folks buy it by the

gallon and eat a lot of it! It is a fantastic food and heals the skin. Yes, it

is a powerful anti-fungal--eating it helps to normalize intestinal flora.

I am delighted you plan to come to the workshop in FL! It will be wonderful to

meet some of the folks from that area who I only know o the internet.

I am living in France with my younger 2 children for now. All things are in

flux.

Tow, IBCLC, Toulouse, FR

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> I have been curious about coconut oil as treatment for sore nipples.

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> I have seen it available in the health food store in jars similar to small

> mayonnaise jars.

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> Additionally, I have read some research on coconut oil that showed that it

> has antifungal and antibacterial properties.

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> What's the best way to buy coconut oil and apply it from a jar?

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> Also, I have wondering what you are doing in France?. I have a flyer

> announcing your workshop in ville Florida in March? . My plans are to

> attend!.

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> Ellen Simpson, BS, IBCLC

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> Private Practice Lactation Consultant

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> Tampa, Florida

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> _____

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> From: [mailto: ] On Behalf

> Of

> Sent: Monday, November 29, 2010 7:19 AM

> To:

> Subject: Re: Plugs, mastitis, and pain. Oh my!

>

>

>

>

>

> Just as some other folks suggested, when I see this kind of difference

> between breasts, I look at what might be mechanically different. It sounds

> as if she experienced these problems before she began pumping, but I would

> clarify that as many moms pump for no reason other than that they have a

> pump or think they should. If she was pumping before the problem began, then

> the flange is even more likely a source or at least a factor.

>

> Aside from that, I would take a good look at the baby visually. It doesn't

> take long to learn to assess structural misalignments and restrictions. As

> Dee said, I have even seen kids with posterior TT cause damage to only one

> nipple or breast. So, I would rule that out and refer for structural work

> immediately. I would suggest you evaluate for birth trauma, but given the

> state of medicalized birth, it's almost a given.

>

> Obviously, I would not have referred for abx (since I never do), but since

> she is taking them, she needs to be on a probiotic, so she doesn't end up in

> worse shape with thrush. My first approach acutely is castor oil compresses

> at least 4X per day for 20 minutes, the homeopathic remedy phytolacca

> (initially one dose every half hour for 6 doses) and the homeopathic cell

> salt calc fluor 4tabs every 2 hours. I would also want her on vitamin D,

> magnesium and zinc for healing. And coconut oil on her nipples after every

> feeding/pumping.

>

> I would also strongly encourage mom to get adjusted when she takes the babe

> as this could be no more than a structural problem on her part. Otherwise,

> acupuncture could be quite beneficial.

>

> Tow, IBCLC, Toulouse, FR

>