Expert: ruth kraft - 11/12/2009

Question
Hi,

I have been having recurring mastitis and constantly having plugged milk ducts. I finished two cycles of antibiotics, and have been doing everytime by the book (warm compress, nurse/pump regularly,...) but nothing really help. My son is a preemie (32wker, now 11 wks old). At NICU he nursed and bottle fed with expressed milk. After coming home he nursed exclusively for a while, but he couldn't empty my breast and took hours to nurse. So I switched to pump and feed in the bottle. I don't pump too much, just 1 let down and about 3-4 oz on each side everytime.

My questions are:
1. With pump and feed, I feel a little better but I still experience soreness on the side of my breasts and still have lumps here and there. What else can I do to prevent/cure these problems? Is it possible these problem might never go away no matter what I do?

2. I'm going back to work soon and want to only pump 2-3 times a day.  Will this cause more problems given my history?

3. If I decide to stop breastfeeding, should I do anything differently vs. normal weaning process, given my recurring problems?

Very confused, frustrated, and would very much appreciate your help and advise!


Answer
ok... answers..

1.  if lumps are still there then it isnt going away. It seems reoccuring but it really is never gone. When nursing or pumping, take some olive oil for lubrication and massage rather hard each lump over and over and over until it releases. then, after every one is released, you keep massaging for a week or so every time you nurse to stop them from getting clogged again. Just because the clog gets released doesnt meant the duct has healed immidiatly. it is like taking antibiotics until they are gone. symptoms might be gone but the issue isn't. so symptoms keep co ming back.  I have never met a woman , who stayed on top of it, that it didnt go away.

2.  when you go back to work, pumping a few times a day should be fine. then nursing when the baby is with you. I had a 36 weeker and did just as you are... Figure out what your schedule at work will be so that you can pump while you are there. Then, about 2 weeks before , change your pumping sessions to match those times so your breasts get used to them. that way, your most effectivly getting milk and not confusing your breasts.

Because you have a preemie, I would suggest that you try as hard as you can to get that baby nursing well and for a long time. Also having a preemie with latch issues, feeding issues etc, it is more imperative for many other reasons that nutrition that the baby nurse. I have had so many therapists tell me that because I refused to give up nursing, that is why my daughter can speak well, and has the brain development she does because of what nursing does to the infants brain. If I have to help you by phone or help you find someone who can help you more in person, I cannot stress enough how important it is, especially with a preemie , to stick it out. take lots of deep breaths, ask as many questions you would like. my email is Ruth@honoringwomen.com. Email me directly if needed. You have come too far to give up now :)

good luck :)