Cher,
This is a special interest if mine, bc I was that mother. I had massive O/S and while I only had a total of 3 bouts of mastitis with my 2 son, I had 6 with my daughter in her first 6 months. She was the one with the undiagnosed TT, so I would query the skill of the individual who did not find a tie. But, in either case, what I learned was that inflammation underlies chronic mastitis and I was not diagnosed w celiac disease until I was nursing my 3rd. I learned a lot of skills to manage O/S that we all know, but were only bandaid. My O/S came immediately under control pretty much the minute I eliminated gluten from my diet, thus beginning to heal the inflammation. I see this all the time in my practice..when we identify the foods causing maternal inflammation, we see the plugs and mastitis resolve almost immediately. I was lucky that my PCP is a homeopath my mastitis always resolved within hours of tx, so I never took an abx for mastitis and never exposed myself or my babies to further gut damage. It is terribly worrisome that a mother who already has a compromised immune system is further ravaging her gut with these meds when a holistic approach has proven itself hundreds of times in my practice over the past almost 2 decades.
Jennifer Tow, BFA, MA, IBCLC, RLC, OMT
Intuitive Parenting Network, LLC
Holistic Lactation Consultant, Holistic Health Coach (focus in nutrition), founder Holistic Lactation Institute
Date: Sun, 31 Dec 2017 11:45:32 -0600
From: Cher Sealy <[log in to unmask]>
Subject: Chronic Mastitis w/Common Variable Immune Deficiency
Happy New Year! I have been contacted by another IBCLC who is asking for
help for a mom with a history of chronic mastitis. The mom has given
permission to post. Baby is 3 1/2 months old. Mom works outside the home
full time. She has had 6 bouts of mastitis. First was 2 weeks postpartum.
Mom also has a health concern - common variable immune deficiency. Her
body no longer makes the necessary immunoglobulins needed to fight off
common viruses and colds and bacteria. She has low levels of IgG and IgA
and gets Gamma globulin (IgG) infusions (Gammagard) once/month. Her doctor
told her that she is likely to continue getting mastitis as long as she
continues to breastfeed.
Mastitis typically with 102-103 deg fever with redness and warmth over
affected area with tender hard lumps. Antibiotic treatments included 4
rounds of Keflex, 1 round of IV vancomycin. Doctor tried 250 mg of
azithromycin on Monday, Wednesday, and Friday as a preventive effort . A
week or two later another round of mastitis (her most recent) Mom put on
Clindamycin 3x day for 2 weeks.
Baby has been sleeping through the night since 6 weeks, but mom has
continued to wake up around 2- 3am to pump until just recently. She states
she wakes up in pain every morning around 5:00 am and "breasts feel like
they are about to burst." Her typical schedule is 6:00 wake up and pump (13
oz). 8:00 pump prior to starting work (3 oz) 11:30-12:30 pump (7 oz)
4:30 pump (6-7 oz). 7:30 Direct breastfeed at home. 10:00 Pump to empty
breasts before bed (4-5 oz).
Two side notes: Mom has been checked for inflammatory breast cancer. Baby
has been checked for tongue tie.
After receiving this request for help, I suggested that information be
shared with this mom about reducing supply and also suggested trying
cloxacillin/dicloxacillin for next round of mastitis.
Any suggestions would be greatly appreciated by this mother!
Cher Sealy, RN, BSN, IBCLC
Private Practice Lactation Consultant
Montgomery, AL
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