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Dear Lactation Consultant:
I am expecting my second child any day
now and although I successfully breastfed my first for one year, my
one major problem was chronic mastitis. There were no lactation
services in my local area but I have since moved and there will be
help available this time, yet I am still very nervous. Last time my
doctor kept giving me antibiotics, which after a while were not
even working and I am afraid they may have had an effect on my son
as well. I really do not want a repeat of this situation this time.
What do you think I should do to prevent a repeat?
Lynn Rice
Saskatchewan, Canada
Dear Lynn:
Take a deep breath and be thankful you are
now living in an area where you will be able to get lactation
assistance. It can mean all the difference to you and you should
try not to worry.
I have a few questions to ask you that
might shed some light as to why you had recurring mastitis:
What was your milk supply like? Did you
have a very fast flow? Did the baby appear to choke on your milk,
particularly shortly after the let-down occurred? You could have
had an overactive milk ejection reflex and/or an oversupply, either
of which might be responsible for mastitis. If you have more milk
than the baby can handle you might find yourself with an
overabundance of milk that either gets plugged in spots or fills an
entire area, often leading to engorgement and then mastitis.
If you slept on your side or stomach you
could have irritated your breasts to the point where if they were
already prone to mastitis, this could trigger it. Also, a too tight
bra, one with underwire, or one that just fits you in an
uncomfortable fashion could also be the culprit.
These are just a few of the more obvious
causes of mastitis. I would recommend you have the name and number
of an experienced lactation consultant available for when your milk
comes in and make sure she makes house calls. It is difficult
enough to get out with a new baby when it’s your first, but
with a second, I would definitely want someone to come to your
home. She can show you the best positions to use on the chair,
sofa, bed, etc you will be using for optimal comfort so you can
avoid problems. She can show you the different positions we
recommend when a woman has an overactive letdown or oversupply if
these are indeed your issues. Positions such as the Dancer
(Australian) or side-lying will slow down the flow and make it
easier for baby to control it as well.
Nursing on one side at each feeding may
also help tremendously.
If you can’t get help, you can
always contact me, but I know there are consultants in your part of
Canada. Good luck. --Leslye
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