My Breastfeeding Story
So what is the true definition of mastitis?
The amazing Dr. Katrina Mitchell, has been a pioneer and advocate for treatment of breastfeeding issues, and has come up with new scientifically proven treatments and definitions for mastitis. She has found that mastitis is not just one complication, but a spectrum of issues, that can result from inflammation of breast tissue. This can be “ductal narrowing, inflammatory mastitis, bacterial mastitis, phlegm, abscess, galactocele, and subacute mastitis” (Mitchell et al, 2022.). But what does this mean to the common lay person? Basically, anything that looks or feels out of the norm probably is a part of the mastitis spectrum disorders. However, that DOES NOT mean it needs to be treated with antibiotics as a first line of defense.
The “New Academy of Breast-feeding Medicine Mastitis Spectrum Protocol 2022” now states what breastfeeding women should do in response to breastfeeding inflammatory issues:
🔥 Breast rest - NO MASSAGE, Don’t overfeed or over pump, down regulate production
🔥 Advil - 800 mg every 8 hours x 48 hours
🔥 Ice - 10 minutes every 30 minutes or as needed
🔥 Tylenol - 1000 mg every 8 hours x 48 hours
This is all such important information to start spreading like wild fire around our breastfeeding populations! It could prevent so much trauma, stress, and pain.
This all hits home to me, because like most new mothers, I had an intense road to breastfeeding my first child. First, I learned that it is the opposite of “natural” to breastfeed. My son had a tongue tie that caused extreme pain, bleeding, scabbing; and inefficient transfer of milk while nursing. It seemed that no one knew this was the issue, so I was told in the hospital after his delivery, to pump after every feed, to feed him after he tried nursing. So for the first 10 days, my days/nights looked like this: attempting to painfully nurse for 60 minutes, then pump for 20 minutes, then feed him what I pumped. Sleep for 20-30 minutes, then start all over again. So basically I did not sleep EVER and was an emotional wreck, and felt like a failure.
When I eventually got in touch with the lovely clinicians at Daraluz, they were the first to diagnose my son with a tongue tie. After going back and forth a million times, we finally decided to get it fixed. And amazingly, we had immediate changes in my son’s ability to nurse! All of a sudden it didn’t hurt to nurse, he could latch, and transfer milk successfully. I was so relieved, and exhausted, that I started sobbing, because I did not understand that nursing didn’t have to be painful.
Although nursing got better, I felt external pressures to pump so that I could start building a storage for when I returned to work at 3 months. So I continued to pump a few times a day. And at 1 month, all of a sudden, I noticed my right breast got extremely hard and painful, and stopped being able to express milk via my pump. Reading online, I learned that I needed to pump/nurse/massage/take hot showers. So I did all of that! And it would feel better after I nursed, but it eventually got worse and worse. Until I developed a raging case of mastitis, where I had streaks across my breast, a fever, couldn’t get out of bed, and required antibiotics to be able to care for my new child.
After this, I lived with constant issues of what we couldn’t figure out: did I have thrush? Constant clogged ducts? Constant mastitis? My breast would get so large and engorged, my son would refuse to latch, and a pump would not even be able to pull any milk out - basically, my life was a living hell. Every day, I would set a goal of trying to make it 1 more day of nursing.
But finally, at 3 months, I got referred to Dr. Katrina Mitchell, an oncologist, who had a passion for treating breastfeeding issues. All of my LC’s and CNP’s at Daraluz didn’t know what to do with me anymore for with constant “clogged ducts”. So I made the appointment, not knowing what to expect.
Meeting with Dr. Mitchell was life changing; she explained that everything I was doing was making my issues worse! I ended up having to go on a series of different antibiotics, and eventually IV antibiotics, to help get rid of my subacute mastitis. But most importantly, she said that I was no longer allowed to pump. That the pressure mechanism of pumping is actually very different than that of a babies’ suck; that it had created inflammation/damage to my breast tissue.
I was able to manage my symptoms with self ultrasound, lymph massage, inflammation management, and no pumping - until my son was 8 months. But it never got easy, and I constantly was battling nipple blebs and engorgements from all of previous breast trauma. And, finally, enough was enough, and I couldn’t go on living life this way. So, I made the decision to wean my son, which turns out, he was a lot happier without me forcing him to nurse all of the time. I relied heavily on the generosity of my breastfeeding community to supply donor milk and also used formula over the next few months. And we were all SO much happier. No one could have told me that I would be so much happier not breast feeding. But as new mothers, we have to choose our own journey and it takes time to learn our lessons, so I had to get to this decision the my own way.
What I learned is: breast feeding is hard. And sometimes you need a team to help— lactation consultants, CNM’s, physical therapists, doctors, friends, and community. As well, I learned that formula is ok, and that I should have probably switched earlier for my own sanity. I have no idea why I was stuck in this breastfeeding only mentality, but I was, and I regret the stress it created in my life. I also regret that I thought pumping was also supposed be natural and good for me. We are force-fed so much about parenthood, that it’s difficult to weed out what’s true and what isn’t.
When I got pregnant with my second child, I immediately got PTSD about future breastfeeding issues, and my good friend, a CNP, made we call a postpartum counselor. When I got in and told her of my struggles, she assured me that the second time would be different because I was armed with experience and knowledge this time. After working with her, I made the resolution that I would try and if things got hard/stressful; then I would say I gave it my best shot and switch to formula. And I would be ok with that!
After my second baby was born, it was a different experience! She latched much easier, and it was significantly less painful because she did not have a tongue tie. As well, I did not even bring a pump into my house, and swore not to. When my milk came in and I got painfully engorged, my CNM friend talked me off the ledge, reminding me that it wasn’t physically milk in my breasts, it was the inflammation causing the engorgement. So I went to my trusty treatments of ice, ibuprofen and just nursing at baby request. And guess what? Within a few days, my inflammation calmed down; and I was able to nurse my baby with zero issues until we were ready to organically wean around 14 months. How anticlimactic is that?
I recognize that I had some different environmental influences the second time, thanks to the pandemic. I stayed home with my daughter until 6 months, and that was so amazing. When we opened our practice, I was able to schedule nursing breaks to go home. And then eventually started substituting nursing sessions with formula. So by 14 months, my daughter showed me she was ready to be finished. All in all, it was such a beautiful healing process, and I am so grateful to everything I had learned from my first experience. I actually got to enjoy it this time around, and I had zero shame in using formula, and making this experience my own, rather than having outrageous expectations for myself.
I unexpectedly am sharing this with all of you, in the hopes that it makes someone feel better, if they’re having issues. And also, to show that through my personal journey, I have developed a passion for treating and bringing my new treatment knowledge into my practice. I am grateful for my continued relationship with Dr. Katrina Mitchell, and her kindness in letting me reach out to her with patient questions and support. She is truly passionate about researching breastfeeding issues and supporting anyone and everyone who she crosses paths with. Her knowledge has also been transferred to many clinicians around town, including the practitioners at Daraluz, before she moved back to California. But Albuquerque was beyond lucky to have her innovative and trailblazing teachings, and it has made a difference in the care we now give.
At Method Physical Therapy, we have vowed to get anyone with mastitis type symptoms in within 24 hours of you reaching out to us. We do this because we know it can feel lonely and scary when something comes up that can jeopardize your health or your babies nutrition.
So if you are feeling defeated, scared, or worried about your breastfeeding journey - please know you are not alone and that there is a beautiful community here to support you.
-Genevieve Richter
Mitchell, Katrina B., et al. “Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022.” Breastfeeding Medicine, vol. 17, no. 5, 2022, pp. 360–376., https://doi.org/10.1089/bfm.2022.29207.kbm.