Breast Pain in Nursing Mama - Who Diagnoses Mastitis, etc.?

[lizzywednesday]

UPDATE: Just reached my OB and they've called in some antibiotics to my pharmacy. I may despise antibiotics, but I'd like to ensure this is treated ASAP.

Thank you everyone for your suggestions and resource links. You are wonderful.

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OK, so I've been working out what I thought was a bleb and clog on my left side for a few days now. HOWEVER, I woke up last night in screaming pain in the left breast, aches and chills. I tried taking my temp this morning and got two readings 10 degrees apart - the first was a fever of 107.3. (We have a temporal thermometer from Walgreens, so IDK if that makes any difference.)

My nipple has been cracked and I did pump some milk on my in-office day that was a little pink-tinged. Per Kellymom, I'm supposed to go to the doc about this for antibiotics, http://www.kellymom.com/bf/concerns/mom/mastitis.html, but I didn't have any more symptoms until today.

DD is almost 8 months old, so she's not only teething but also going through a bit of a nursing strike (she nurses, but mostly nips & then she gets bored and pulls off really roughly before she starts playing with the nipple) and it just hurts really badly today.

I went to the gyno Thursday for my annual and she didn't say anything about mastitis because she was tracking it like a normal complication of weaning. (And it wasn't hot to the touch on Thursday, just tender and a little painful while nursing.)

So, if I do call an urgent care center, what do I tell them so I'm diagnosed properly? I seriously feel like I've been hit by a truck and it's crazy painful to nurse on the affected side. I've got a hot compress on my left breast and I pumped earlier to relieve some of the pressure (which worked fairly well until I picked DD up from the floor and the pain returned) but I still feel awful.

Thanks in advance for any advice you can give.

[infomama]

I went to my OB.

[doberbrat]

I'd call your ob and if you dont get satisfactory answersr/care then call your primary care doc.

do it now b/c mastitis can turn into a breast abscess.

feel better

[marge234]

I'd call your ob and if you dont get satisfactory answersr/care then call your primary care doc.

do it now b/c mastitis can turn into a breast abscess.

feel better

:yeahthat: Gyno should be willing to call in an Rx for you. GL.

[luckytwenty]

I'd call the OB. I've had mastitis before (sounds like what you have--only my fever wasn't quite that high, more like 101 or 102) and she actually just called in an Rx for a strong antibiotic. Within 24 hours, I was a lot better and eventually the symptoms were gone completely. Usually fever + flu symptoms + a lump/soreness in one spot is mastitis, not that I'm a doctor or anything.

[lizzywednesday]

OK, I called the ob and left a message on the on-call line because, like everything I end up needing on a weekend, the office is closed.

The other option was the "if this is a medical emergency press 9" ...is it an emergency? Could it get worse than a breast abscess?

I mean, yes, I'm in pain & I feel like crap, but that's not my definition of "medical emergency." Should I expand my definition?

[infomama]

The other option was the "if this is a medical emergency press 9" ...is it an emergency? Could it get worse than a breast abscess?

I mean, yes, I'm in pain & I feel like crap, but that's not my definition of "medical emergency." Should I expand my definition?
I don't think this is a true medical emergency. Wait 20 minutes and if they don't call you back have the docs paged again.

[lizzywednesday]

I don't think this is a true medical emergency. Wait 20 minutes and if they don't call you back have the docs paged again.

Thanks.

[lalasmama]

OK, I called the ob and left a message on the on-call line because, like everything I end up needing on a weekend, the office is closed.

The other option was the "if this is a medical emergency press 9" ...is it an emergency? Could it get worse than a breast abscess?

I mean, yes, I'm in pain & I feel like crap, but that's not my definition of "medical emergency." Should I expand my definition?

I wouldn't consider it a medical emergency (sorry!). For an OB office, a medical emergency is going to be premature labor, heavy bleeding, etc.

If they don't call back in an hour or two, you could do an urgent care or walk-in clinic. However, if you go to UC or a walk-in clinic, you may want to take a print out of something about mastitis. As a medical assistant in a OB/GYN office, I was shocked that a doctor came to me to "help" him diagnose mastitis, because he had very little breastfeeding knowledge (and he knew that I was a doula, and likely knew more!). A recent study showed that most doctors dealing with breastfeeding couples only feel confident in treating breastfeeding issues that they had dealt with in their personal lives... which is an interesting thought/idea if you end up with a childless doctor who isn't interested in lactation! Obviously, this is just my long-winded way of saying "help the doctor out, have a list of symptoms (and treatment, if you can find it) for mastitis from a reputable source when you go into the urgent care, and it will go smoother for everyone!"

[lizzywednesday]

I wouldn't consider it a medical emergency (sorry!). For an OB office, a medical emergency is going to be premature labor, heavy bleeding, etc.

If they don't call back in an hour or two, you could do an urgent care or walk-in clinic. However, if you go to UC or a walk-in clinic, you may want to take a print out of something about mastitis. As a medical assistant in a OB/GYN office, I was shocked that a doctor came to me to "help" him diagnose mastitis, because he had very little breastfeeding knowledge (and he knew that I was a doula, and likely knew more!). A recent study showed that most doctors dealing with breastfeeding couples only feel confident in treating breastfeeding issues that they had dealt with in their personal lives... which is an interesting thought/idea if you end up with a childless doctor who isn't interested in lactation! Obviously, this is just my long-winded way of saying "help the doctor out, have a list of symptoms (and treatment, if you can find it) for mastitis from a reputable source when you go into the urgent care, and it will go smoother for everyone!"

Thank you very very much.

Would a printout from Kellymom be good enough? Or should I try to find something at La Leche League?

[marit]

Is there an urgent care clinic you can go to?

It sounds like the infection is pretty progressed by now, I wouldn't wait too long before the first antibiotic pill.

The good news is even the first antibiotic pill will make you feel much better...

[lizzywednesday]

Is there an urgent care clinic you can go to?

It sounds like the infection is pretty progressed by now, I wouldn't wait too long before the first antibiotic pill.

The good news is even the first antibiotic pill will make you feel much better...

I'm trying to find one.

[Octobermommy]

I would press 9, unless the message you left will be returned shortly. Do you know how the weekend phone situation works? You need the antibiotics now, you do not want this turning in to an abcess and possible surgery.

[lizzywednesday]

I would press 9, unless the message you left will be returned shortly. Do you know how the weekend phone situation works? You need the antibiotics now, you do not want this turning in to an abcess and possible surgery.

I'm new at the practice, so, no, I have no idea when the messages will be checked and returned.

[lalasmama]

Thank you very very much.

Would a printout from Kellymom be good enough? Or should I try to find something at La Leche League?

I'd do Mayo Clinic (http://www.mayoclinic.com/health/mastitis/DS00678/DSECTION=symptoms ) or HealthLine ( http://www.healthline.com/channel/mastitis_symptoms ). Some offices use KellyMom (ours does!), and some don't.... and LLL isn't a "medical" site (despite their knowledge!)... However, having the Mayo clinic and LLL together should work!

[infomama]

No answering service to page the doctor?? Go to the urgent care. You could be waiting all weekend. Did they give you an info packet outlining how they handle after hours needs?

[lizzywednesday]

No answering service to page the doctor?? Go to the urgent care. You could be waiting all weekend. Did they give you an info packet outlining how they handle after hours needs?

I managed to get in touch with the on-call OB and have been on antibiotics for 24 hours.

I feel almost back to normal.

[infomama]

I managed to get in touch with the on-call OB and have been on antibiotics for 24 hours.

I feel almost back to normal.
I was thinking about you this evening. Glad to hear you are on the mend!!