How to Prevent and Survive Mastitis

So many things are more difficult now that I am a parent to three children. Like when my three-year-old dashes to the bathroom with just enough time to spare before peeing his pants, mowing over my two-year-old in the process, and I’m in the living room with my boob hanging out for a tiny baby who just had an incredible blowout. Or when we’re racing out the door to get my oldest preschool on time (ha!) and he slams the brakes on the whole process by insisting he needs his magic wand and a Buzz Lightyear toy, (“Not THAT one, Mom … the other one!”) which of course I can’t find, and the baby is protesting loudly after being unceremoniously plopped into the carseat, and my nose is running due to a lingering cold and my daughter wants to be picked up and then my phone starts ringing. And cooking. Who can cook anymore? 

But in this completely mad circus—this beautiful, raw, emotional, tender and perfectly precious circus—having mastitis for the fifth time really brought things to a new level. It’s like … (and I’m trying say it without being utterly doom and gloom), it’s like a kick in the teeth, like you’re drowning and someone hands you a baby (says comedian Jim Gaffigan, father of five), only now you are unbelievably ill. It is a serious test of your fortitude as a parent. 

So this month I thought I’d visit with you about it, not as a doctor but as a mama, and as a frequent sufferer of clogged ducts over the course of three breastfeeding journeys in four years. 

HOW TO PREVENT MASTITIS

Clogged ducts are common in the life of a breastfeeding person, and unless you’re incredibly lucky, you’ll probably have to handle one or two. Fortunately there are things you can do that, when applied quickly and with diligence, can generally stop things from really going to hell in a handbasket. Not everyone gets mastitis, and some never even have clogged ducts!

***Disclaimer (and I’m so sorry to tell you this): There are some clogs that simply aren’t going anywhere; there are some clogs, like the one I dealt with recently, that are so enormous and angry that mastitis is all but inevitable in someone who is prone to it, like me. So while these strategies are tried-and-true and vetted by the lactation geniuses at Willow, they are by no means foolproof and cannot with certainty steer you around a bout with the worst fever of your life. I’m so sorry. 

Recognize the signs of a clogged duct. Basically it’s a localized soreness in the breast that is tender to the touch. Sometimes it’s accompanied by redness and sometimes you can feel a hard ball of tissue close to the surface of the skin, but in either case, once you realize it’s there you’ll need to jump into action. 

Take some lecithin right away. Lecithin is an inexpensive and widely available supplement that is thought to reduce the stickiness of milk passing through the breast. Once you notice a blocked milk duct, start yourself on a regimen of 1200mg 3-4 times per day. I also take it daily to help prevent recurrence.

Don’t wear restrictive clothes. A clogged breast needs to be free and easy. Wear a soft nursing bra or better yet, go completely without.

Keep the breast empty. Feed the baby every two hours and pump out the remaining milk after each session, every time, even at night, until the clog is gone. It’s a real pain in the buns but this advice from one of Willow’s lactation consultants has saved me from illness so many times! 

Massage. While baby is sucking or the pump is working its magic, gently massage and compress the sore area (ouch, I know) to help the clog break down. Some people swear by pressing a vibrating electric toothbrush to the area, or by working a wide-tooth comb around it while standing in the shower. Use a little soap for lubrication and run the comb from the top to bottom of the breast.

Enlist the power of gravity. At feeding time, lay baby on their back and position yourself above them, on all fours, while they go to work. My friend calls this “dangle feeding” and laughs a lot about how funny it looks, but hey, it works!

HOW TO SURVIVE MASTITIS

Despite your best efforts to remove the clog, sometimes an infection sets in anyway (remember my disclaimer?) and mastitis becomes a reality. In the interest of truth I’ll tell you: this is really, really, really awful. My stomach drops just thinking about it. Fielding this level of illness as a parent can bring you to your knees, but I promise you will get on the other side of it. Promise.

First thing, call the midwives. Pick up the phone the moment you start feeling shaky or feverish, and they will call in an antibiotic for immediate pickup at your pharmacy. Seriously, don’t resist the medicine. One of my worst mistakes during my first bout with mastitis was to think I could approach it holistically and get around having to take antibiotics … and wow, that was memorably idiotic. I know antibiotics can be a drag, but it’s much, much, much worse to attempt to go without. 

Second thing, call in the troops. Get someone over to your house to help right away. You might soon be longing for bed. 

Walk straight into the shower. When you have mastitis, heat is your friend. Using warm compresses on the sore breast can really help loosen the clog and relieve some discomfort, but for me, getting in the hottest shower I can stand is even more effective. Cover the nipple with your hand and aim that hot water directly at the breast. You can also use hot towels or a heating pad.

Put yourself to bed and stay there. It’s probably silly to even say as much, because you’ll likely already have a profound desire to sleep. The fever that accompanies mastitis can get nasty, and rest plus ibuprofen/acetaminophen is really the only way to get through it. Still, I know what you’re thinking, and yes, it will seem impossible to check out when you’ve got little humans to care for. So if you are in the regrettable position of having no available help (been there), turn on the TV, put the toddler in an extra absorbent overnight diaper, and make the couch your home until someone comes to give you a hand.

Continue with your clog-busting routine, even though you’d really rather not. Feed the baby lots and lots, pump out the extra milk each time, apply heat, massage if you can stand it, try some “dangle feeding”, take your lecithin, don’t forget to eat, and don’t neglect your other breast in the process.

I firmly believe in exposing real-world parenting, and like I said, you may never feel so wretched in your life. But it’ll pass (maybe it’ll never come!), and afterwards, you might never be more thankful for your health. Here’s to never doing THAT again! Please, universe, please?

Shelley DeWees is a three-time Willow client who spends her days chasing her preschooler son and toddler daughter around her home in South St Paul. Her most recent addition, another boy, arrived just this past July! Shelley also loves going to workout classes and is an avid reader. She’s really tired of having mastitis.