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Date: | Sat, 12 Jun 2010 14:45:16 -0700 |
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I have seen this lowered output following mastitis so frequently that
I would call it a "norm." Early onset mastitis, that does not follow
a nipple wound, is common in the women I've seen with oversupply
syndrome.
Did mom's description (she could feel it almost coming up toward the
skin) sound like near abscess to you? It did to me. If not, it was
pretty close. So you may be right regarding involution of a portion of
lactating tissue.
I have seen the reduction in milk supply following mastitis take
several weeks to come back up. The area can stay tender for a month or
more in some moms (they say it "feels bruised"). Many women have told
me that their milk supply never seemed to return to previous levels.
Also, based solely on clinical observation and subjective evaluation
from moms -- return of supply appears to be related to the extent of
the mastitis. Small area of infection fairly quick return; large area
(usually involving an entire quadrant of the breast) supply does not
return to previous levels. (Good idea for a research project.)
Personally, If she developed the mastitis from milk status due to
overproduction, I'd use caution with anything that increases supply
(beyond stimulation and milk removal). She could develop mastitis on
the "good" side.
Your idea to have the baby start on the affected side first would only
work if the tissue has not involuted and the baby cooperates.
Otherwise she may want to let the baby fill up on the good side and
finish on the affected side. She will be lopsided and that side could
potentially involute completely. Just inform her of her options,
risks, and let her decide what works best for her and baby.
I remind moms that women have 2 breasts because we occasionally have
twins. If one side "dries up" she should be able to meet the baby's
needs on the good side.
I had a mom with only 1 breast (mastectomy) exclusively breastfeed
twins for 6 months and went on to breastfeed them for a year. She was
an ample producer but was "forever feeding babies" during the first
few months to make sure they both got enough.
Marie Davis RN IBCLC
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