Mastitis at 3 weeks is a clue there might have been sub-optimal
breastfeeding up to that point.  Combine an initial good supply with
poor drainage, poor suckling, poor L & P, infrequent nursing -- if any
of these were going on before the mastitis presented, it/they may have
contributed to her supply tanking, with the mastitis simply being the
final straw.

I think the best thing she can do to avoid problems with #2 is to be
absolutely diligent about early and often, skin-to-skin, cue feeding,
and biological nurturing from the moment of birth.

As LLL has long said, mastitis is often an indication the mother is
trying to do too much.  She will also have an older child to care for
this time around which may make it harder to prioritize her own rest
and recovery.  She should be encouraged to plan ahead for the early
weeks so that her older child's needs will be met while she herself
rests as much as possible.

I'd probably suggest lecithin supplements as well, given her history.

Margaret
LLLL, IBCLC
Longmont, CO


On Thu, Nov 18, 2010 at 4:34 PM,  <[log in to unmask]> wrote:
> I have a doula/lactation client who developed mastitis 3 weeks after her first birth. She took antibiotics for it. Her supply completely tanked, despite continued nursing and extra pumping, and she never got it back. Everything had been going well with nursing until that point. I've never seen anyone have such an extreme bodily response to mastitis. Now she is expecting again and wants to avoid the same problem from happening again with this baby. Is there anything she can do prenatally and/or postpartum? Any supplements you would recommend?
> Thanks so much in advance,
> Julie Rosen, LLLL, IBCLC, CD, PCD, LCCE
> Teaneck, NJ
> Sent from my Verizon Wireless BlackBerry

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