Monday, February 1, 2016

Sore Breast and Mastitis Treatment










When you have been away from your baby all day, you thought s/he was not nursing "that" much... but by the time you return home, your breasts are over-full, tight, and sore.

Time to give your breasts some TLC so that sore spot does not turn into mastitis!

A sore breast may have a sensitive, red, hard spot.  If those are the only symptoms, it is probably not yet mastitis.  Don't ignore it!  Treat it right away so it does not get worse or become mastitis!

Treatment for sore breast:

  • increase frequency of feeding with special emphasis on positioning of infant: place baby in several different positions, but most often in a position where his/her chin is over the inflamed area of your breast.  The motion of his/her chin as s/he nurses will work the ducts that drain the affected area, speeding improvement!
  • technique of breaking infant suction: always break the suction before removing your baby from the breast.
  • nipple hygiene: allow your nipples to air-dry after feeding and keep them dry (don't cover them in layers and layers of nursing pads, bras, clothing).  Bra-less with a loose t-shirt or pajama should be fine.
  • prevention of milk stasis: keep the milk flowing!  Nurse baby as often as you can.  Get in a hot shower and let the milk flow out.
  • complete emptying of breasts:  The breast is never truly "empty" but let baby nurse as long as he or she will.
  • massage breast and lymph glands, pressing lumps/hard/red spots towards the nipple, especially while in a hot shower.

Mastitis is more than just a sore breast.  It is an inflammation or infection of the breast, most often caused by stagnant milk remaining in the breast too long, plus a bacteria catalyst (usually staphylococcus) that starts growing in the sweet, warm, wet milk.  It is possible, however, to have mastitis at any stage of life.  Symptoms include: hot, red, inflamed area on one or both breasts, tenderness and pain in the inflamed area, illness, nausea, chills, and fever (over 100.4 degrees F).  With mastitis, you feel like you have the flu plus something wrong with your breast.

If you have recently given birth, you must rule out possible uterine or laceration infection.  Is our lower abdomen sore?  Is there any foul odor to your bleeding?  If so, contact your midwife or doctor right away.

If you are sure it is not an infection of the uterus or tear, you can try these treatment options for 12-18 hours. Extra treatment for mastitis:

  • Follow all recommendations for sore breast above.
  • Rest, except for caring for baby and self, resorting to bedrest if necessary,
  • Supplements, every 4 hours:
    • Vitamin C, 1000mg,
    • Grapefruit Seed Extract, 1 tablet/capsule, taken with food,
    • Garlic or garlic oil, 1-2 capsules,
    • Thyme, 1 capsule, or ½ teaspoon loose herb,
    • Water, 1 quart clear water every 4 waking hours (may add fresh-squeezed lemon juice or liquid chlorophyll). You might not think of water as a supplement, but when we are using it this way, it is a very powerful and effective supplement.
  • Apply hot compresses and use breast pump 1-2x a day after nursing baby until you have extracted all the milk from the breast.  Be sure to boil the flanges to sterilize them before use - you don't want to re-contaminate your breasts with bacteria.
  • Warm wet packs on breast, (a hand-towel is a nice size, but washcloths will work fine)
  • Raw, whole cabbage leaf covering breasts or tucked into bra,
  • Re-evaluate every 12 hours, or more often for worse cases.  If not dramatically improved in 24 hours, confer/consult/transfer care for possible antibiotic treatment.
  • Follow-up: As needed.
  • Referral to lactation counselor if mastitis re-occurs frequently.

If you are not significantly better in 24 hours, call your midwife or doctor or go to urgent care or the emergency room for antibiotics.  You don't want a breast infection to get out-of-control.  I am not a big cheerleader for use of antibiotics, but mastitis that will not dramatically improve in 24 hours with the following treatment is one case where I would recommend them!

Get well!

:) Deborah

Thursday, January 14, 2016

Statistics for my practice 2015





Statistics for my practice for 2015:

Total births: 30
            Homebirths: 26
                        Water birth: 15
                        Land birth: 11
            Hospital transports: 4 
                        Hospital spontaneous vaginal births: 4
                        Hospital forceps or vacuum births: 0
                        Hospital c-section births: 0
                                    Reasons for transport:
1. twin in footling breech presentation
2. high blood pressure
3. premature labor
4. high blood pressure and baby heart rate too low
Intact perineums: 18
First-time mothers: 5
Sets of twins: 1
Planned VBACs: 3
                        Successful VBAC: 3
                        Repeat c-section: 0

I know better than to feel proud about statistics. They can be great one year and bad the next. But 2015 was much better than 2014 for my practice. Praying for healthy mothers and babies again in 2016!

Monday, January 4, 2016

Cold Sores and Fever Blisters



Cold sores and fever blisters are much more likely when your immune system is down. :( "Cold sores" and "fever blisters" are caused by the Herpes Simplex Virus type 1. What should you do if you have a "cold sore" or "fever blister" while pregnant (or when your wife is pregnant)?
1.       Avoid spreading the virus
    1. Be sure to avoid any oral-genital sex when you (or your spouse) have any sign of the breakouts,
    2. when your baby is born practice careful handwashing,
    3. avoid kissing the baby if you have any sign of a break out. You don't want it to spread.
  1. Supplements/foods/treatments that help:
    1. L-lysine, start with 500mg per day at the first symptom and increase the amount by doubling the dose until you are taking 5000mg per day.
                                                               i.      Put some L-lysine from the capsule directly on the sores.
                                                             ii.      Foods that contain natural lysine and can help decrease the severity of the outbreak include: eggs, sour cream, yogurt, chicken and fish.
    1. Propolus, 3 capsules/3 times a day
    2. Zinc, 25mg after each meal and gradually increasing. Limit is 5000mg per day. (Increase gradually because it can cause nausea)
    3. Echinacea root and burdock root: place 1 tablespoon of each in a quart jar, fill jar with boiling water, cap, steep 8 hours, strain out herbs, store in fridge. Drink 1/4 cup 3 times a day for 10 days then stop. (Can be repeated 10 days on/10 days off.) There are reports that when repeated every 10 days for 6 months, outbreaks never return!!
    4. Heat lamp for 5 minutes, several times a day can help them go away faster
  1. Things that aggrivate cold sores should be avoided:
    1. Stress!
    2. Nuts, nut butters, seeds, chocolate :( and caffeine.