Michelle, something is not hitting me right about the
mother of a 4.5 month old on her 6th bout of mastitis.
<<The mastitis seems to come when the baby feeds
erratically (its her style!), but her plentiful milk
supply ends up backing up, and voila, another
infection.>>  Outside of teething bouts and the
occasional sniffle, 4 month olds aren’t usually so
erratic in their nursing routines as to be the culprit
with recurrent mastitis.  Is it possible mom’s routine
is erratic?  Or, is something consistently happening
to interfere with milk production and/or breast
emptying?

Sounds to me like a breastfeeding management issue.
Has mom kept a nursing journal?  Are there issues with
pacifiers etc?  Separation?  What happens at night?
Baby happy?  Healthy diapers?  How often does the baby
go to the breast?  How well is the baby emptying the
breast?  Does mom report plugs between bouts that come
& go?  How much dairy are we talking?  Is the baby
nursing both sides or is she nursing the same side
several times before going to the other?  How’s the
latch – everyone comfy?  Is this baby comfort nursing
or does this baby seem to be trying to make nursing
work?

What does mom think is making baby’s nursing erratic?

Does mom have help with her special needs 6yo while
she tackles her breastfeeding crisis?  This seems to
be another red flag. Lots of stress, and a practical
challenge.

I’d go over the breastfeeding management with a fine
tooth comb first.  There's a clue in that plentiful
milk supply.

Susan Johnson  MFA, IBCLC
Salt Lake City, USA

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