What causes mastitis?

I wound up with mastitis for the first time - and my nurseling is
nearly 2 years old! I thought it was rare this far into a
trouble-free nursing relationship?

I woke up Wednesday morning (after having no symptoms previously) with
a sore breast, and felt awful - fever and muscle aches (on top of the
cold I already had) and when I sat in the hot tub, I managed to
express - pus. Yuck. Doctor said to pump and dump on that side, to
avoid having Kivi ingest pus. After 36 hours on antibiotics I started
nursing on that side again, and 4 days into it, I'm much, much better.
It was sore, had a red streak, and a red patch, had hard areas, was
hot to the touch, the works. No fun.

So what causes it?

Cathy Weeks
Mommy to Kivi Alexis 12/01

Cathy Weeks wrote:
I wound up with mastitis for the first time - and my nurseling is
nearly 2 years old! [...] After 36 hours on antibiotics I started
nursing on that side again, and 4 days into it, I'm much, much better.
It was sore, had a red streak, and a red patch, had hard areas, was
hot to the touch, the works. No fun.

So what causes it?

Had you been having a plugged duct beforehand?
Have you noticed red streaks on the side of your
breast or pain (like a bruise) or white spots
on the nipple?

I've been getting those and been frantically
staying in the hot shower (I normally like tepid
showers) trying to express the plugs out. I think
one of the causes of mastitis is if plugged ducts
stay around for awhile and bacteria build up
behind them...

-- Anita --
--
SUCCESS FOUR FLIGHTS THURSDAY MORNING ALL AGAINST
TWENTY ONE MILE WIND STARTED FROM LEVEL WITH ENGINE
POWER ALONE AVERAGE SPEED THROUGH AIR THIRTY ONE
MILES LONGEST 57 SECONDS INFORM PRESS HOME CHRISTMAS.

Cathy Weeks wrote:

I wound up with mastitis for the first time - and my nurseling is nearly 2
years old! [...] Yuck. Doctor said to pump and dump on that side, to
avoid having Kivi ingest pus.

A healthy two year old is at no risk from mastitis milk. Unless you're a
_really_ good pump responder and experienced with a breast pump, a
nursing baby is likely to empty your breast a lot more thoroughly than a
pump, which is the key to successful mastitis treatment. Antibiotics are
just an adjunct. Rule One in mastitis treatment is "nurse, nurse,
nurse".

Lara

So what causes it?

Like any infection, mastitis is caused by bacteria. Hard to say what caused
you to get it this late. Getting overtired, Kivi not nursing well for some
reason, (is she nursing less often lately?) causing your breasts to become
engorged, a crack or sore spot on the nipple.. (is she teething?).

Glad you're feeling better.


Naomi
CAPPA Certified Lactation Educator

(either remove spamblock or change address to to e-mail
reply.)

(Lara) wrote in message ...
Cathy Weeks wrote:

I wound up with mastitis for the first time - and my nurseling is nearly 2
years old! [...] Yuck. Doctor said to pump and dump on that side, to
avoid having Kivi ingest pus.

A healthy two year old is at no risk from mastitis milk. Unless you're a
_really_ good pump responder and experienced with a breast pump, a
nursing baby is likely to empty your breast a lot more thoroughly than a
pump, which is the key to successful mastitis treatment. Antibiotics are
just an adjunct. Rule One in mastitis treatment is "nurse, nurse,
nurse".

Hmmm.... I'm not so sure. I just looked up mastitis in the Breast
Feeding book, and it doesn't mention nursing in the presence of pus.
Let me be a little more clear about what was happening:

1. About 7 years ago, I had my nipples pierced. I didn't like it, so
removed the piercings after about 5 or 6 months. The holes never
fully closed, and during nursing, milk leaks out the hole on the side
of my nipple, in addition to the end of my nipple.

2. When I woke up that morning, I nursed Kivi, knowing the advice is
to nurse, nurse, nurse. I felt so wretched after we got up, that I
let Kivi watch TV while I got into the hot tub (knowing moist heat is
also recommended), and massaged my breast. I was more than a little
grossed out when I expressed pus. The pus, which is thicker than milk
didn't come out the holes in the end of the nipple, rather it came out
the hole in the side of my nipple, which is bigger, and more easily
allows the pus to come out. It was greenish-yellow, and oily. It
wasn't just a little amount, but I got it to come out repeatedly,
small amounts each time. When I pumped, a small amount came out, too.
So I know that my daughter would have (and probably did) ingest it
prior to me realizing it was there.

So, that said, is the advice still to nurse a child on the affected
side, given that pus was coming out? I'm not so sure. I asked my
doctor, and she said that mastitis without pus, the recommendation is
to nurse often, but with pus, to pump instead.

So, I guess I'm asking you to go back to your sources and check to see
if it still holds true with pus. I have to admit - it seems pretty
icky to me.

Cathy Weeks
Mommy to Kivi Alexis 12/01

OSPAM (Naomi Pardue) wrote in message ...
So what causes it?

Like any infection, mastitis is caused by bacteria. Hard to say what caused
you to get it this late. Getting overtired, Kivi not nursing well for some
reason, (is she nursing less often lately?) causing your breasts to become
engorged, a crack or sore spot on the nipple.. (is she teething?).

For the last six months, I've not pumped during the days she goes to
daycare (three days per week). This is for 8-9 hours. She gets an
extra-milky nursing as soon as she gets home. But the engorgement is
only slight, and after six months, you'd think I'd be used to it.
When she's with me, she nurses pretty frequently - 5-6x per day, and
usually 1-2x a night. The infection cropped up after 5 consecutive
days at home, so I tend to discount the skipped feeding due to daycare
as being the cause.

No cracks, and no she's not teething. However, I did have some latch
problems and soreness. But that was a few weeks ago, and things were
better.

I did have a very bad cold, and I suspect my resistance was down.

Cathy Weeks
Mommy to Kivi Alexis 12/01

"Cathy Weeks" wrote in message
m...
1. About 7 years ago, I had my nipples pierced. snip
The pus, which is thicker than milk
didn't come out the holes in the end of the nipple, rather
it came out the hole in the side of my nipple, which is bigger,
and more easily allows the pus to come out. snip

Maybe these larger holes allowed bacteria to get in easier, and that's
what caused the mastitis?
--
Cheryl S.
Mom to Julie, 2 yr., 8 mo.
And Jaden, 3 months

Cleaning the house while your children are small is like
shoveling the sidewalk while it's still snowing.

Cathy Weeks wrote:

So, that said, is the advice still to nurse a child on the affected
side, given that pus was coming out? I'm not so sure. I asked my
doctor, and she said that mastitis without pus, the recommendation is
to nurse often, but with pus, to pump instead.

I can't find any evidence base for this recommendation anywhere. Even
mainstream sources such as
http://www.emedicine.com/aaem/topic300.htm
say it is safe to nurse. Here's our local guide:
http://www.health.gov.au/pubhlth/pub...practice_guide
..pdf
which says nothing about mastitis milk ever being unsafe, and reinforces
the necessity to continue feeding. Mothers continue to nurse even with a
frank abscess, which is a collection of pus. If you want to squeeze as
much pus as you can out first, then nurse, that would be fine too.

thebestfedbaby says:
"Our mother's generation used to experience breast abscesses a lot, not
because they were anatomically different, but because mothers then were
encouraged to put babies on a rigid schedule (leading to plugged ducts),
and were then told NOT to nurse their babies because the milk was
infected and would make them sick. Nowadays, every doctor knows that the
milk from an infected breast will not harm the baby in any way, because
antibodies in the milk protect him from infection."

Not to mention that the bacteria quite likely came from the baby's mouth
in the first place.

In my opinion, the onus of evidence is always on the person recommending
pumping & dumping (or weaning), not the person recommending
breastfeeding. I reckon that switching to pumping-only (especially if
you're tired and not a good pump responder) is more likely to lead to
abscess, not less. Have you asked your doctor for her source of
information?

Lara

Cathy Weeks wrote:

I did have a very bad cold, and I suspect my resistance was down.

That's just adding insult to injury, isn't it? I hope you feel better
soon. I used to get blocked ducts when I was underslept or sick - I
wondered if it had something to do with not eating well at those times,
too. Have you tried adding lecithin?

Lara

"Cheryl S." wrote in message ...
"Cathy Weeks" wrote in message
m...
1. About 7 years ago, I had my nipples pierced. snip
The pus, which is thicker than milk
didn't come out the holes in the end of the nipple, rather
it came out the hole in the side of my nipple, which is bigger,
and more easily allows the pus to come out. snip

Maybe these larger holes allowed bacteria to get in easier, and that's
what caused the mastitis?

Why now? Kivi has been breastfeeding for 2 years now.

Cathy Weeks
Mommy to Kivi Alexis 12/01