Dr. Misti Virmani breaks down some common issues general practitioners may see in moms who are breastfeeding. The symptoms may seem familiar but the cause might not be what you think.
A lot of the common questions that I get from physicians who take care of moms is what to do when they come in with the problem. The question is really what is the problem about? So is it a breastfeeding problem or is it another problem with mom?
And if you’re talking about breastfeeding problems, some of the most common are going to be pain with breastfeeding. That could be anything from engorgement in the first couple of days postpartum. So usually around day three to eight, averaging around day five, you see some engorgement. And that means the breast is really full of milk and mom’s not emptying it quite completely. And so she can feel a lot of tension in her breast and it can be very tender when she walks or if her breasts move. She could have a plugged duct, which could cause localized pain in a specific area.
Sometimes plugged ducts can turn into mastitis, which is an infection in that plugged duct area. Mastitis is characterized by having fever.
So when moms come in and they’re just having some breast pain, but no fever or no generalized symptoms, that’s usually something that can be taken care of without antibiotics and without systemic treatment, but maybe some pain medication and teaching her how to empty her breast more completely with heat compresses, massage — sometimes you can use vibratory therapy on the affected area because the plug is usually composed of fats in the milk that plug up in the smaller portions of the duct. And vibration, like with the end of a toothbrush, even, or if she has — well, this might be awkward — but a vibrating massager would potentially help break up some of the fat in there to help move things along so that the breast can empty. Because the key to taking care of a lot of these problems is to empty the breast.
If she starts developing fever, she’s having “B” symptoms that look a lot like the flu, actually. So generalized aches, myalgias, headache, sometimes even nausea and vomiting associated with breastfeeding and pain in her breast, usually in a very specific area — that is mastitis. Even if you don’t see redness over the breast, because the symptoms can come on very quickly. You need to get antibiotics started as soon as possible. There are several that work. Doxycycline is a very easy choice. Clindamycin works, Bactrim works, Augmentin works. So you have a range of choices in which antibiotic might be useful for treating that.