How Jessie recovered from mastitis
Disclaimer: the case below is an amalgam of multiple cases that have presented to me, and is not derived from any specific or identifiable mother-baby pair who have seen me as patients. Needless to say, all names are fictional.
Jessie’s breast is inflamed
Jessie first noticed she had a problem around 2 o’clock, in the dead of the night, when their 12-week-old woke up grunting and grizzling for a breastfeed. Jessie leaned over and gathered the baby up from the bassinet without getting out of bed, then lay back wearily against the headboard. Her left breast was sore and her fingers found a rather large, hot and tender lump. It must have been four or five centimetres wide. She winced as she brought Lily on.
Apparently she’d knocked something when she switched on the night light because her wife Nell in the other room called out sleepily through the wall.
“All ok hon?”
“Yeah all good.”
Jessie absent-mindedly stroked Lily’s silky hair as the little one swallowed greedily from her breast. Soon Lily was slowing down, and flutter-sucking as she drowsed back into sleep.
But by the time Jessie and the baby were starting the day, well after Nell had left and gone into the city for work, Jessie wasn’t feeling great. The lump burnt fiercely under a vivid red patch of skin, and she felt nauseous and achy as if she was coming down with a cold or flu (or heaven forbid, covid). She just wanted to lie right back down again on the bed but there was little Lily, grizzling from the bassinet when she wasn’t flashing hopeful smiles at her mother, wanting to be picked up. Soon she'd be crying loudly.
Jessie shot a warning text through to Nell, though she knew Nell had an important seminar running all day.
"feeling crap. mastitis"
Nell shot a quick text back with three frowny face emojis – the meeting hadn’t started.
"oh no. keep me posted"
Jessie knew what to do. Afterall, they had a fridge magnet on hand in case this situation arose!
Nell makes sure Jessie has help and is able to rest
Nell had obviously been sending out SOS messages to their friends in the morning tea break, after receiving another miserable text from Jessie. Jane arrived in the middle of the day to check on Jessie and the baby. Jane was a tall, large-bodied grey-haired woman, the CEO of a national non-profit organisation, who lived reasonably close by and was luckily working from home that day.
“What say you go to bed darling, and I’ll take Lily out for a walk for 45 minutes,” Jane suggested kindly after Jessie let her in. Jessie sat down and fed the baby from the painful side, just for five minutes, then handed Lily and the carrier over, gratefully disappearing into the bedroom to lie down.
She rested miserably, focussing on her breath and visualising a white light surrounding her and especially her aching breast, filling her with love and healing. After a while she picked up her phone and scrolled through her socials, then dipped in and out of a book.
Lily was red-faced and screaming when Jane brought her back in. Jess could hear them coming down the street and dragged her aching body off the bed to meet them at the door. The baby snuffled and hiccoughed and sobbed miserably as Jessie cuddled her and put her back on the affected breast on the sofa in the living room.
“Oh my poor little angel!” she murmured.
Once Lily was settled, Jessie looked at Jane.
“What happened?” Jessie tried not to sound accusing but her head was aching, and the baby never screamed like that. Jane laughed good-naturedly. She had three grown-up children now and a couple of grandchildren. She knew that babies survived and thrived despite the occasional screaming bout. She also knew how important a new mother's attunement and vigilance was.
“Mostly she was happy, I swear, looking out from the side of the carrier. But then she snapped as I was walking back, just as we came into the street. I knew you’d hear us and think I was torturing her!!!”
Jessie laughed weakly.
“I’m mostly worried about you though,” Jane said warmly. She went into the kitchen while Jessie was feeding and rustled up a salad roll and a cup of tea.
When Nell arrived home late afternoon, Jane had barely eaten a quarter of the roll. It sat there, soggy now, on a plate on the bedside table. Both baby and Jane had fallen asleep on the bed.
“Jane was so lovely but I couldn’t eat it ….” Jessie muttered, her voice trailing off, looking at the soggy roll then down at the baby who was tucked up against her side on the bed.
Nell takes over as best she can but they make sure the baby is still coming onto the affected breast frequently and flexibly
“Soup?” asked Nell, kissing Jessie and giving a hug and rub of the shoulders. Jessie nodded faintly. Soon Nell had Lily strapped into the carrier. Lily wriggled and groaned but soon settled happily enough to watch the action in the kitchen from that snuggled-up place. In a while, Jess walked slowly out into the lounge-room and lay down on the carpet, tears sliding down her cheeks. Honestly, she felt so bad. She couldn’t remember when she’d last been so sick! Nell came back in with a thermometer.
“39 degrees Celsius. No wonder you’re crook!”
Throughout the evening Nell worked hard at entertaining the baby, who came on and off Jessie’s breast. Lily would sometimes take Nell’s breast, too, even though Nell hadn’t particularly tried to make any milk – it was just nice sometimes, a way of comforting the baby. But tonight, the parents knew that Jessie's inflamed breast needed Lily has much as possible.
Jessie preferenced the left side which had the mastitis, but offered the right whenever it felt too full. Sometimes Nell lay down on the carpet beside them both, calmly stroking the hair of these two whom she loved so much. She felt that a big part of her role as the non-birthing non-breastfeeding parent was to remain calm and loving, even when everything seemed to be falling apart for Jess.
Finally Jessie took some ibuprofen, dragged herself into the bathroom for a shower and went to bed. Nell slept in the family bed even though she had to work the next day, and got up with Jessie and the baby during the night just be of support - to bring in a glass of water, to hold the baby while Jess went to the toilet, to stroke Jessie’s hair. Jess offered the affected breast the first two times the baby woke, but worried about the ‘good’ breast on the third wake, so she offered that one first to make sure it didn’t develop a mastitis.
The lump looks even worse the next day and Jessie still feels miserable
The lump was somewhat bigger and redder when Jessie woke the second day, and Nell worked from home. The baby wasn’t very happy inside the house but Jessie went out and lay down on a sofa on the deck, or on a picnic rug under the trees when the sun wasn’t too hot. Jessie and Lily got through the day with Nell coming in and out and taking Lily for short (but, as Nell insisted, extremely exciting!) walks.
Jessie persisted in putting Lily on the inflamed breast as often as Lily was interested. Sometimes the baby pushed off as if to say: what? Not again? Other times she took it, even just for a short while, and Jessie knew that was good – all those dilations of the milk ducts opening up against the high pressures inside the lump, to relieve the fluid and inflammation!
By the fourth day, the lump is smaller and not so tender and Jessie is recovering well
Jessie had three days of feeling really quite unwell and sometimes feverish. Finally, four days after the lump took over her life, Jessie was starting to feel better. The lump was still there, but not as angry and painful. The fevers had gone.
By the end of the week the lump too had disappeared, and life for Jessie, Nell and their little Lily went back to normal.
("Whatever normal life is once you’ve had a baby!" as they would say.)
Recommended resources
PBL Foundations
How do you know if you have mastitis and how common is it?
Why your letdowns help prevent or heal breast inflammation
When might you need antibiotics for mastitis?
Why lymphatic drainage and therapeutic massage don't help with breast inflammation
Ellie, who is breastfeeding four-week-old Harry, develops breast inflammation. Part 1
PBL Intermediate
Five ways to help prevent breast inflammation when you're lactating
A closer look at breast inflammation, fever, and use of anti-inflammatory medications
Probiotics (including Qiara) don't help prevent or treat breast inflammation
PBL Advanced
Why advice to NOT change patterns of breastfeeding when a woman has mastitis risks worsened outcomes