Sounds like a Ductal Spasm. Not uncommon, especially in first time nursing
moms. (Although it can happen during any nursing situation.) Unlikely there is
actually "milk left" in the breast, as most milk is made during the feeding, and
only small amounts stored in the ducts. It may FEEL like milk is left, but usually
most of the milk already in the ducts is transferred to the baby during and
right after the let down. If the baby was only on the breast a minute or two,
there could be milk "left" but that is not what is causing the discomfort.
Ductal spasms occur (we believe) when a breast, usually which has not been
used before, starts to transfer milk and the some of the previously unused
ducts spasm at the first few weeks of usage. Some women, most commonly
those with Overactive Ejection, may feel strong almost "menstrual like"
contractions in the ducts of one or both breasts after a feed.
Warm compresses (especially warm, moist ones, if she has the time to get to
them) and perhaps some Tylenol or Motrin can do wonders for the discomfort.
Getting the compress onto the breast right after the feed is helpful, before the
spasm hits. Some feel that pre-Feed compresses are also helpful.
With most women, this problem resolves itself as the breast or breasts
get "used to" making and transferring milk.
However, be on the lookout for plugged ducts and/or mastitis. The
presentation of plugged ducts is different, as one can almost always feel the
plug, and massage, frequent nursing, warm compresses and making sure mom
has enough sodium in her diet should resolve the plug in a few days. If it is a
Plugged Duct, make sure her bra fits her properly. I, personally, found (as I
had OER and Ductal Spasms, and frequent Plugged Ducts with my children)
that going without a bra during the early morning hours was very helpful. (I
would leak so much I had to lie on a large towel.)
With Mastitis, she would would most likely experience pretty severe pain, rapid
onset, fever, nausea, headache, muscle pain, and flu like symptoms. (not
always ALL of these, but the presentation is usually rapid and severe.) She
may or may not have a palpable plug, as well. Fluid,Warm Compresses, REST,
frequent nursing, and, if not resolved or high fever occurs or mother appears
VERY sick, her doctor should be contacted for some Cloxicillan or Dicloxicillian
to treat the infection. If she is allergic to "Cillins" than Cephalpsporans can be
used. For most Mastitis, Amoxil is usually not helpful, and may even cause a
SuperInfection. (Although Augmentin can be helpful in some cases.) Mothers
with Mastitis need lots of rest, fluid, warm compresses, and often, some pain
medication. I have seen fevers as high as 105 F in grown women with Rapid
Onset Mastitis, so it needs to be carefully watched.
But, as this case sounds very much like simple Ductal Spasm. Just keep an eye
out for anything more severe.
Good luck.
Mary Jozwiak IBCLC, RLC, LLLL
Private Practice
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