Engorgement, mastitis & going longer between feeds at night

[Sophie51]

Hello,

Trying to follow the EASY routine with my 4 week old son. I currently have mastitis, & midwife says that this could be due to missing a feed when my husband gave my son a bottle of expressed milk. Lump is about the size of a large plum. I have been on antibiotics for 2 days, & feel better in myself, but lump still hard & red, and throbs sometimes...does anyone know how long before the lump should go? I'm still feeding from that side.

Also, my son is going longer between feeds at night, but I get so engorged if he hasn't fed for more than 4 hours, so am having to wake up & hand express,  as I'm so worried that engorgement could make the mastitis worse, or cause mastitis in the other breast...are my worries substantiated, or is it ok to leave my breasts engorged if baby is still asleep? Sometimes my son can sleep for 5.5 hours, and would really like to not have to set my alarm to hand express!

I am feeding from both sides at each feed, and so neither of my breasts are used to going for a long time when they are full. I'm not sure if I can suddenly just swap to one side each feed, as my breasts just get so engorged...what would you do? Just let them get engorged & hope mastitis doesn't set in again, or carry on feeding on both sides?

Sorry for all the questions, and thanks in advance.

[MasynSpencerElliotte]

DD3 ditched all her nightfeeds at 4 weeks...that morning was painful, even though the bed was soaked I expressed a bit by hand for relief. The thing is if you express a lot at a time when he isnt feeding it will signal your body to make more milk! I just doubled up my nursing pads and let them be engorged...took a bit for them to get the message though and I have not had mastitis ever so hopefully someone with more knowledge of it will chime in.

[TB9]

Hugs for the mastitis   When I had mastitis (3 times between both girls!) I would try to go no longer than 4hrs at night until I was finished the course of antibiotics.  Then I gradually increased time between so I wasnt pumping every 4hrs overnight.

It may take a few days for the lump to clear.  Have you tried a hot shower, or warm compress on the area?  Are you taking any anti-inflammatory meds?  I found I needed to take a hot shower and massage the area, and take advil/ibuprofen to get the swelling down so it would clear.

[Fiver]

It may take a few days for the lump to clear.  Have you tried a hot shower, or warm compress on the area?  Are you taking any anti-inflammatory meds?  I found I needed to take a hot shower and massage the area, and take advil/ibuprofen to get the swelling down so it would clear.

This. Mastitis itself is an infection in the breast caused by milk stasis. It sounds like you may have a blocked duct which could have caused that. You need to keep milk flowing to stop it happening again.

With the lump you can try what's suggested by pp or use a warm compress before feeding to help it along and massage while feeding. You could try dangle feeding too where LO lies on their back and you kneel over them and feed from above which then means you can get LO's nose and chin (can't remember which way it's meant to be) pointed at the lump.

If it doesn't clear up soon please pop back to the Dr and get it looked at again

[*Ali*]

I agree with pps, normally I would say only get up at night if you wake and feel uncomfortable but with your medical issues right now I think expressing will help keep the milk moving. You could try to just do enough to relieve the discomfort or pump a whole bottle. Is it an option to leave the bottle for your other half (sorry, I'm assuming you have one here) to give if the baby wakes shortly after (e.g. 1-2hrs) so you can get some sleep and your breasts aren't getting the message to produce too much milk?

Hugs. I had mastitis twice with my DS2 and it is no fun at all!

[Jdowloew]

Sorry you're having a rough go right now.  Those first few weeks are tough enough!

I had almost the exact same scenario you're describing, but I had constant blocked ducts on one side.  When I stopped pumping, they stopped happening but that wasn't until 7 months or so in.  Sometimes they would take days to clear.

I think it's early enough that your milk supply is still establishing itself so I would express for relief if you need it, especially on the side that's blocked.  But it is a supply & demand situation so if you can get through the night, your body will adjust sooner.

I tried anything & everything to relieve my blockages & I would recommend a warm compress prior to feeding, start your feed on the affected side (their suck is stronger when they start) and massage the lump during the feed.  Trying different positions can help too.

Good luck.