In tight engorged or edematous breasts, I have found short term use of a
nipple shield inside the breast pump flange to be effective for
initiating let-down.  When there is edema in the tissues you have
mechanical obstruction of milk flow PLUS reduced capillary blood flow
which can limit oxytocin crossing to the alveoli.  Alternating hot and
cold compresses are helpful.  Also, the MD should investigate MRSA
mastitis. 

-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of j.nicholls
Sent: Friday, June 22, 2007 2:11 AM
Subject: MASTITIS

Dear All

 

I have permission to post 

 

I am working with a mother who is now 12 days postpartum, she developed
mastitis bilaterally and was admitted to hospital. She was originally on
1 grm of iv flucloxacillin for 3 Days with no improvement.  Pencillin 2
grms was also added with some improvement. Her breast is still red and
tender, only a few drops of milk can be hand expressed. Her aerola feels
hard and difficult for the baby to latch. I have tried a shield which
did help the
baby to latch. But Mum is reluctant to keep using the shield.   I have
recommended 3 hrly feeds affected breast first, then switch to the other
breast. Hand express not pump because of the aerola odema. Ice after
each breastfeed and expressing. I don't know what else to suggest. She
is
exhausted and wanting to know how long the infection will last?   Can
you
give me any pointers that I can try  with this mother when she is
discharged in the community, I would like a mastitis protocol if anyone
would share with me.

 

Sincerely

June Nicholls

IBCLC           


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