Expert: Sally Wendkos Olds - 1/26/2006

Question
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My sincere thanks for replying my mail. A blister ( 6 days old) on my wife's mastitis affected nipple has not recovered. She has already suffered from mastitis for a month (now recovered). I fear she may again contract mastitis because of unhealed blister when she breastfeeds from that breast. Right now we are manual pumping from that breast. What medication does she needs to take to prevent re-occurrence of mastits? I've heard she need to take light antibiotics for 2-3 months. Any suggestions?

Another question is how my wife can increase her supply and if we feed using bottle too how is it going to affect her milk supply?

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Followup To
Question -
Now our baby is 75 days old and is being breastfed however since breast milk is not sufficient for the baby we are feeding remaining apetite by formula using spoon. We are tired of spoon feeding. Can we feed our baby using a bottle instead of spoon? Will it not cause nipple confusion and discourage baby to breast feeding?

I also want to tell you that my wife had started breastfeeding only after some days of birth due to some confusion of late milk supply. And we had initially given bottle to baby. With difficuly our baby is now back to breast. We have tried all ways to increase the milk supply. Now I've got a medela manual pump too. My wife is breast feeding after 3-4 hours of last breastfed time.
My wife could not reduce her breast feed time delay below 2.5-3 hrs. Max delay will be somtimes 5 hours during late night.
Around 40 days back my wife suffered from mastitis and for that she took antibiotics course four times. Now it seems to be cured. Since one breast was paining she was hand expressing it and for past 4 days we are manually pumping the affected breast after 3-4 hours ( to increase supply) and other breast is being offered to the baby.
I also would like to tell you that previously when my wife was breast feeding from both breasts we then had to give baby around 30-50 ml of powder formula. Now my wife is able to express 30-45 ml using medela pump from the affected breast.
It's very difficult for my wife to increase frequency or reduce the time differece of breast feeding times to below 2.5 hours.
It takes 30 minutes for breast feeding from one breast and then 30 minutes for spoon feeding. Usually the baby gets sleepy and refuses to take more. Sooner the baby starts crying and we start running around finding no more time.

Please advise. I need your advice immediately.

regards,
Anurag

Answer -
Dear Anurag,

First, congratulations to you and your wife for giving your baby the best start in life by breastfeeding, despite all the obstacles you and she have run into. How fortunate for your family that your wife is so persistent and you are so supportive!

I can understand how frustrating and slow it is to be feeding your baby with a spoon. You don't have to use the spoon any more, but before you switch to a bottle, you might try feeding your baby with a cup. Even very young infants can drink from a cup, and this might go faster than the spoon feeding. However, if this too is too cumbersome, I think you can probably safely use a bottle.

Breastfeeding seems to be well enough established that the baby won't suffer from nipple confusion. However, it's best if you don't feed from the bottle at every feeding. Some babies get a little "lazy" and will not nurse vigorously at the breast since they get milk from the bottle so much more easily.

Good luck!

Sally

Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters.  

Answer
Dear Anurag,

Yes, antibiotics are usually the treatment of choice for mastitis, and most antibiotics are safe for the baby and will not affect the milk supply. Your wife really needs to see her doctor -- preferably an obstetrician/gynecologist who has experience treating nursing women.

As far as her milk supply is concerned, I am attaching an excerpt from my book about building up the milk supply, and I hope that these suggestions help.

Because of a family medical issue I won't be available for several days, so if you have other questions, I suggest that you contact one of the other breastfeeding experts on allexperts.com. I hope that you and your wife will resolve your problems soon. Please try to find a knowledgeable doctor or lactation expert to help her.

Good luck.

Sally

Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters.
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  BOX 10-2:  WAYS TO BUILD UP YOUR MILK PRODUCTION
New mothers sometimes fear that they won't have enough milk to feed their babies. They hear stories about other women who "didn't have enough milk," and they worry that they might be in this category. But when you look closely at the situations of these other women, the problem can almost always be ascribed to lack of information, lack of encouragement, or faulty nursing technique by either mother or baby. You need to tell yourself that millions of other women nurse their babies, and you can, too. Following one or more of the following suggestions should increase your milk supply within a few days.
  *  Nurse your baby more frequently for several days, using both breasts at each feeding. This is the single best way to enhance your flow of milk.
  *  Wake your baby sometimes to deliver your milk more often, or pump or express milk between feedings.
  *  Pump from one breast while your baby is nursing from the other.
  *  See a lactation specialist if your baby is not suckling well or nurses only a few minutes at a time. This may indicate serious problems.
  *  Cut back on your schedule. Do less. Rest more. Nap at least once a day, more often if you can manage it. Maybe you can close your eyes while riding the bus to work or lie down while your older children play quietly nearby. Ask someone else to help with marketing, cooking simple meals (or getting take-out food), and doing basic laundry. Most people like to help a new mother, so take advantage of this willingness now. You can always reciprocate later on. Ask visitors not to come for a few days unless they're people who will wait on you, not expect you to entertain them.
  *  If you can, take an occasional day or two off from work or from other obligations (by, for example, having someone come in to care for your other children) so that you can focus only on nursing your baby.
  *  Check your diet. Are you eating enough? Are you eating the right foods? Are you drinking enough fluids? Some women find that eating or drinking more seems to produce more milk.
  *  Take extra Vitamin B complex. Some nursing mothers have found that one to three teaspoons a day of brewer's yeast helps.
  *  Make a special effort to relax, as suggested in Box 10-3. Of course, this is hard when you're concerned that your baby isn't getting enough milk -- but the more you can relax, the more milk your baby is likely to receive.
  *  Believe in yourself and trust your body. The most effective milk producer of all is the stimulation of your breasts by a nursing baby.

NOTE:  Do not offer your baby formula. A few ounces soon turn into a bottle, which soon turns into several bottles, until you find that you're producing even less milk. If your baby is drinking from a bottle, he is not stimulating your breasts and thus not doing the most effective thing that will increase your supply of milk.
  The only exception to this is if your baby is sick or so small that his health is endangered, and if your baby's doctor (not your friends or relatives) feels that he absolutely needs a supplement. If so, offer it through a nursing supplementer (see Chapter 15 and the Resource Appendix), a dropper, or a spoon.