Mastitis is a biotch.

I’ve been meaning to post about my fun little postpartum experience with mastitis that I had two weeks after Jenson was born.  And by fun, I actually mean completely awful.

Breastfeeding had been going pretty well and I was starting to get the hang of it and get used to the discomfort.  No matter how many experts try to say breastfeeding shouldn’t hurt (and if it does, they say you’re doing it wrong) – it hurts..especially in the first few weeks.  Babies eat so frequently in the beginning and your nipples are sore and your boobs are rock hard when your milk comes in while your milk supply is trying to match up with your baby’s needs. I didn’t even feel like I was very engorged and certainly didn’t suspect any blocked ducts.  So that Monday evening when my left breast felt sore, I didn’t think much of it.  It hurt to hold Jenson against my chest to burp or carry him, but I just assumed my nipple was sore and irritated and held him against the right side of my chest instead.  I don’t know when my body started to feel a little achy, but I remember thinking I didn’t understand why my abs and legs felt a little sore, considering I wasn’t doing much more then sitting on the couch most of my days, other than a few walks around the neighborhood when the weather was nice.  I still didn’t think anything of it.

Jenson had his days and nights mixed up for the first few weeks, so Lo and I would take turns staying up with him through the night and trying to get him back to sleep when he woke up often.  He slept the best in the bouncer at first, so we’d either both sleep on the couch (it’s a sectional) and he’d sleep in the bouncer, or one of us would go up to bed and the other would stay downstairs with him so we could watch TV and mind him while the other got sleep.  Lo usually would take the first shift while I slept until Jenson needed to eat again and I’d come down and nurse him while Lo went up to get a couple of hours of sleep.  I don’t remember feeling terrible when I came down around 1 a.m., but the longer I was awake, the worse I started to feel.  Over the next few hours I went from feeling a little run-down to feeling like I was hit by a truck…with the point of impact being my boob.  I was freezing and shivering, my entire body was achy, my head hurt, and my boob was painful and hard, even after nursing.  Once Jenson was sleeping, I put him in the bouncer and tried to get some sleep, but I was too miserable to fall asleep.  I remembered the lactation consultant mentioning signs of mastitis, so I started looking up the symptoms and was 99% certain that it was the issue.  If it wasn’t that, I definitely had the flu.  I felt almost exactly like I felt the day I came down with the flu when I told Lo I was pregnant, plus the boob issue.

I knew I needed to call the doctor in the morning to get on antibiotics, but in the meantime I used a warm, moist compress on that side a few times, as my internet search suggested.  The best way to make a warm compress for mastitis is to take a diaper and run hot water on the inside, wring it out a little, and hold it against your breast.  It stays warm for much longer than a washcloth.  That provided little relief, but I didn’t know what else to do and I didn’t want to wake Lo up since he’d be awake in a couple of hours when Boof demanded her breakfast.  I finally fell asleep and heard him come down, but I was so tired I couldn’t really wake up to tell him what was going on.  Once I woke up enough, I went upstairs and told him I either had the flu or mastitis and was really sick.  He came down to help me and I was pretty much in tears at this point, I was in so much pain.  I knew that pumping would probably help, but I hadn’t even taken my breast pump out of the box so I asked him to get it out and ready to use while I nursed to see if that would help.  Nursing him on that side was so incredibly painful that time…tears were just pouring down my face.  After he was done, I pumped to empty out that breast and that made it feel a little better.  I was still miserable with the flu-like symptoms, so I went upstairs to sleep for a few hours.  I called the doctor when I got up and was really hoping I wouldn’t have to go in for an appointment because I was in so much pain and couldn’t imagine trying to sit in the waiting room without crying.  Luckily once I described my symptoms to the nurse, the doctor called in a prescription for the antibiotic keflex, which Lo picked up right away.  I had every symptom (breast tenderness or warmth to the touch, flu-like symtoms, swelling of the breast, pain or burning continuously, skin redness, and fever), except the area of redness on the breast, but that symptom showed up later that day.  The nurse told me I needed to pump after each feeding to try to keep the breast empty, massage the area towards the nipple, use warm compresses/warm showers, and take ibuprofen or Tylenol (for fever and aches), and that it should feel significantly better in 24-48 hours, or I needed to come in.

I slept for almost that entire first day.  Other than for nursing, Jenson pretty much slept all day too, which was perfect because Lo was on his own.  I could barely sit up from laying on the couch without Lo’s help, and I’m not a wimp when it comes to pain or being sick.  Luckily, within 24 hours of starting the antibiotic, I was starting to feel better.  Within 48 hours, I felt mostly back to normal.  I often fail to complete a full course of antibiotics because I’m terrible at remembering to take meds, but you can bet I didn’t forget to take any dose because I was terrified the mastitis would return.  Luckily you can continue to breastfeed during treatment (and should).  I pumped almost every time I nursed for a few days, but once I started to feel better, I only pumped the “bad” side after every few nursings when it still felt full.  Pumping more than Jenson needed could cause a big oversupply that would require more pumping, so I thought that I could prevent engorgement by slowly cutting down on pumping.

Now that everything is back to normal, I just pump when I’m too full on one side.  I switched to block feeding, which is nursing on one side only, because his poop started being green and stringy instead of yellow and seedy.  That can indicate that he is getting too much foremilk versus hindmilk and by nursing only on one side, he should get plenty of both.  Hindmilk is the good fatty stuff that he needs to stay full longer, and it comes during the second half of nursing.  It seems to have helped and it’s easier, so I’m sticking to it.  I’m still nervous that I’ll get mastitis again, but at least now I know what it will feel like and how to manage it from the start.

This post is longer than I intended, so here’s a separate post about how to be better prepared and what products can be helpful in case you get mastitis.  These are also applicable to engorgement, blocked milk ducts, and can be very helpful in general in the early tough days of nursing.

In other news, we tried out bottle feeding with him when he was 4.5 weeks old, and he took it well (from Lo) and didn’t have any trouble going back to the breast.  Since we had no idea how much he’d need at a time, he gave him a 2 oz. bottle, but he still needed to nurse more after that.  The next time he gave him a bottle, he took 4 oz. and was happy with that.