Breast Pain After Antibiotics

Kathleen Tackett's picture

QUESTION

Dear Lactation Consultant,
I am a breastfeeding mother of a 5-week-old girl. For the first 2 weeks or so breastfeeding was going great. Then I developed mastitis in the right breast, and things have been bad since.

Although the course of antibiotics is complete, the right breast is still sore near the armpit area and seems to be producing way more milk than the left breast. I am afraid to pump it because I fear producing even more milk in that breast.

How can I get my supply in each breast to even out? Any suggestions will be greatly appreciated!

Thanks!
Barclay

ANSWER

Hi Barclay,
It sounds like your infection wasn't cleared up with the treatment you had. It could be that the antibiotic you were prescribed wasn't the right one for the particular strain of bacteria that caused the infection, or that you didn't take enough of it for long enough to completely clear it up.

It is not normal to still have soreness and engorgement after completing a course of antibiotics for mastitis. Another cause of symptoms like these after antibiotic treatment is a secondary fungal infection. This happens when the antibiotic kills off the 'good' bacteria that keep yeast from multiplying too quickly as well as the 'bad' bacteria that cause the infection. This is why many women will develop a vaginal yeast infection after a course of antibiotics. Yeast can also develop on mom's nipples and in her milk ducts, and that can cause swelling and pain, even after the initial infection is cleared up and the fever is gone.Check out the article "Information Sheet and Care Plan for Yeast Infections" and see if any of the symptoms sound familiar. You may need to be treated for yeast, especially if the soreness continues, the nipples become sore, or both breasts become involved.

You definitely need to let your doctor know if the pain continues. However, many doctors are not aware of the problems caused by intraductal yeast infections, and their response is to simply give you more antibiotics. This can create a cycle where you take antibiotics over and over, without ever treating the underlying problem. If you decide the problem isn't a yeast infection, then you can ask the doctor to culture your milk to try to figure out exactly what strain of bacteria is involved, so that he can be sure to prescribe the correct antibiotic. Don't be afraid to pump the full side if it makes you more comfortable. Express just enough milk to relieve the discomfort, and don't worry about overproduction. You can deal with that problem later if you have to, but at this point, reducing swelling and pain is more important than trying to even out your milk production. I wish you all the best,

-- Anne, IBCLC