Dear wise ones,

I'd like to ask some advice about a mother who is pregnant with her second
child. With her first baby she had a terrible time with mastitis for 11
weeks which ended up in her being hospitalized and being given medication to
stop lactation. I was in contact with her in the first week because she had
problems with latching on the 'mastitic' side and as a result developed
cracked nipples. We managed to correct the latch and the nipple problems
went away fairly rapidly (i.e. matter of a few days) but she the developed
mastitis. My next step was to get a LC in and she spent some weeks with
intense supervision under the guidence of two LC, sometimes daily, until the
hospitalisation. Six months after weaning she underwent some breast research
in the same hospital (echo + mammogram) - but nothing untoward found,
although it was noted she had a lot of breast tissue in the mastitic breast.
Breastfeeding on the other side was never a problem and her daughter was
very adept at bf on both sides according to the two LC's.

We are now talking together about ways to reduce the chance of mastitis with
the second baby. My thoughts (appart from the frequent feeds with excellent
latch) were to drain the breasts as much as possible once a day with a
double sided electric pump. My own experience with mastitis and oversupply
in the first four months was that this was actually a very good remedy that
did not influence the supply too much but meant that every morning I could
pump off the excess at the first feed and empty my two 'milk dams' (as my
husband referred to them!). The rest of the day I was very comfortable and
the mastitis was at bay. At about four months I no longer needed to do this
(little mouth had grown a bit etc).

Would you recomment this? I found it very helpful and have discussed it with
the mother who is also very open to doing this. She has a daughter who will
be around 18 months with the birth of the second so she can profit from the
pumped milk! This maybe a cultural thing but it is something I would find
difficult to suggest to every mother in my area because bf must under no
circumstances disturb that gentle balance of having to go the extra mile
:-(. Luckily this mother is keen to do anything to maintain a breastfeeding
relationship this time round!

groetjes

Sara Bernard
The Netherlands

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