PTP - I need some ideas on how to help a mom and hope your collected wisdom will point me in the right direction. A mother of a 9 month old contacted me about her struggle with recurring mastitis and plugged ducts. The trouble didn't start until the baby was 7 months old. Mom doesn't work, nurses on demand, number of feedings has decreased slightly and gradually. Baby started solids at 6-7 months, no signs of allergies or contact dermatitis for either mom or baby. Nursed first baby for 15 months without incident. Has managed some over supply issues throughout both courses of lactation. Currently on second round of antibiotics, also taking lecithin, Ibuprofen for inflammation, and probiotics. She woke up today with a hard area on the right side upper quadrant. The mastitis and plugged ducts have moved from one breast to the other and occurs in different areas. She doesn't go longer that 3 hours between feedings during the day but has one long stretch at night (6-7hrs). Given the gradual organic decline in milk at 9 months, I don't think the mastitis or plugged ducts is due to being engorged. Mom knows about tricks for draining the breast well. She can often pump 4oz within an hour of nursing. Also no signs of thrush or bleb. Where do I go from here? What questions should I ask? 
Thank you in advance!!
Wendy Jordan, BS, IBCLC
www.seacoastlactation.com
 		 	   		  
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