Welcome to the kick your Expert led podcast, helping you explore and learn everything about getting pregnancy, birth, and becoming a parent.

On the podcast and our online pregnancy program grow My Baby, we share my experience of helping more than four thousand babies to be born.

And our experience of running a women's health clinic and parenting for boys.

We're here to help everyone to feel empowered in pregnancy and birth with real life, practical information.

Well, welcome everyone.

I'm Bridget Maloney and this is part two of our breastfeeding special with doctor KeVita.

Now I want you to go back and listen to part one.

It's got some basic tips and tricks and how to set yourself up for a good latch, and what some myths around breastfeeding are.

But perhaps you picked this episode up because you think you might have mass status, and that's completely fine to have a listen and then if you need some further explanation a few things that Cavita says, just go back and have it listen to part one or so.

So my sympathies go to you if you are that woman and you've picked this up because you think you've got mass artists, I hope things are going okay for you.

We'd love to hear feedback on this podcast, so yes, you can get into Spotify now and you can give comments straight up.

So yeah, we read every one of those and we try to incorporate that back into our podcast that we do for you.

All Right, everyone, let's get on to the episode and talk to doctor Caveta, breastfeeding medicine specialist perinatal GP and ib CLC with over eighteen years of medical experience.

Well, welcome back, doctor Cavita.

I'm so pleased that you've joined us again.

Thanks for having me.

Yeah, you're a last The last episode was so great and we've had such fabulous feedback from it.

So we're going to give people sort of like a concise masst titis because I know what people will do in the middle of the night.

They'll be searching through the catalog and going, oh my god, have doctor Patton Bridget ever done anything on mastatus and they'll pick this up.

So this is for the person that wants to know what mastatus is, why they got it, and what are they going to do to help them through the pain of mastitis.

So if we start I think we should really start at the basics and could you tell us what is mastitis?

Yeah, mastatus.

We had a new protocol that was really twenty twenty two and we it's revolutionized our understanding and management of mathtytis.

Mathoos is part of an inflammatory spectrum, so we actually now call it the mastitis spectrum, and it covers things from you know, blocked up painful lumps to the end of it being mastitis, and then further things like obsesses and you know, granulais mastitis and things like that.

So it's really important to understand that it is not just boom one thing, that there is a pathway that gets you towards tendency, towards mass types.

So yeah, that's because we used to.

Think it was an infection and people would go into their doctors and get antibiotics.

So is that just not there's no infection involvement anymore.

Yeah, So it's caused by information.

It's caused by milk stasis, so we're not removing that milk frequently enough and what happens then is you get a pressure effect.

So remember those lacksters like we were talking about, if they're over fooled with milk that causes the pressure effect on that tissue surrounding it, and that was swelling in that area.

So it's not actually within the lands of the tissue or the duck necessarily.

Where the problem is is actually in that surrounding tissue.

If that milk is not released or removed, we end up perpetuing that problem and that's swelling just increases.

So the way I explained it to effect patients is it's like a bruise.

So if you just the way you've got a bruise on your arms, if you had a bruise on your breast, would you you know, would you sit there on math large it bruis out of your arm?

No, you wouldn't dare And the same thing with the breast.

And I'd say this as someone who before twenty twenty two was doing it.

We were telling everybody to do it because that's what we thought it was based with it on not understanding the physiology and the anatomy of the breast as well as the doctor BETWEENA Mitchell and the ABM, they released this protocol and it's just made because it never made sense to me breast milk has antibacterial properties.

How is everyone getting this dirus so it just didn't make sense.

But regarding the antibiotics, with my patients, I always give them a script for the antibiotics so they have it on board because if you know mothers, mothers do not want to take anything.

They don't even want to.

I had somebody say they did want to drink tea because they're worried about how it affects their baby and they will not take the medication unless they are entire neat of it.

So, yes, they know it can affect the microbiome and all that, but the amount of the antibodic that goes into the breast milk is minimal, and if a mother feels that she needs to take it, take it okay, but know that that's not going to see of your problem.

You know, it has an anti infomba through effect as well, so that could be why it suddenly feels like it's settling down.

It's not because it's actually managing the bacterial infection.

So the key things to know is that matthatists will always almost always be preceded by block ducks, and.

No, I want to know what that If you could describe what a block duck feels like for the first time parent.

Yeah, so what we used to stay is clogged duck.

But again we were under the misguided idea that it was actual clogs of milk within the ducks and they weren't able to get out an instructure.

This is not the case.

We know that a block duckt it's that tissue around it which may be blocking the dut.

So if you had a little narrow pathway and then you've got suddenly you know the traffics, you know, you can look at it as a traffic analogy, and then suddenly everything is pushing in that can't slow properly.

Now the traffic analogies doesn't work.

But it's basically the founding tissue around it has a lot and that's the blocked area that you're feeling.

It's not actually within the duct.

When we say a block duct, it's actually there's a blockage around the duct which is affecting the flow of milk from that alveol eye out through the nipple.

So in part one you talked about like fat, is that what the tissue is that's blocking or narrowing the duct.

Stron So it's kind of strong wal tissue.

Yeah, it could be fat, it could be any of those kind of things that I simplified it in that one.

But this strone wal tissue is just kind of the tissue that is in between that kind of area.

So that's the tissue exactly though.

That's exactly what we're talking about, and that's what causes the bruise.

It's like, you know, if we get a bruise, you know, you know there's muscle, there's stromal tissue as well, so again that you could get a bruise in your muscle in your arms.

Well, but the purpose of this discussion, it's the stromal tissue usually and we know this as well from ultrasounds.

So what I will do if the patient is is not so common now.

But in the early days when we were transferring into this protocol, you know, also to back myself because there aren't many of us practicing bus feeding medicine, and I didn't want to miss something A but B Also I wanted to be sure of what I was saying, so I would alteruly say that.

And there was never a collection there.

There was never you know, a bacterial if it was an abscess or a bacterial collection.

We will see two futages.

We see a different color, we see different things, and it wasn't that.

It was actually just in generalized inflammation.

And yeah, so the key thing for people to understand is that anything that causes pain in the breasts is usually due to inflammation of some sort.

Now, then we have to go down to what is the cause of that inflammation.

Is it the lack of removal from of milk from the breast or is it other things?

So let's for example, if you had nipple damage, you're going to have inflamation.

Let's say, like you know what, we're discussing the nekel damage on the nipple openings, if you've got cracknickles, anything like that.

Wherever there is a cut, your body will be desperately trying to heal it.

So it'll be sending you know, different stytokinds, different things like whatever it is to try and heal that tissue, and that can cause inflammation in that area too.

But the most common cause of my stylus is not removing that milk correctly.

How does that work in an oversupply?

Is it oversupply undersupply?

Like, you know, if you're not removing it because you've got milk coming out everywhere.

I don't know like, how do you get next stasis?

How do we get there?

Okay, So the reason we get there is usually because of these nets of you know, draining the breast, emptying the breast.

We end up making people think that they, oh no, my breast is well, oh no, I need to empty it.

Whereas what the breaths are usually doing in those first three to six weeks, if they are working it out themselves, they are incredible.

They're trying to regulate the flow themselves.

So when you're you know that first bit, when your breast become like rock halt, you know, that's all of that alveol, the congestion, you know, a demail, like all of this kind of thing.

As those those blands are debating right because your lacto sides aren't functional actually until after pregnant.

It's incredible.

So that's what all that swelling and hardness is.

And when that settles down, people panic and they think, oh no, I'm losing my milk supply because that's the myth pre dominant myths out there, because it's not really based on the science.

It's based on all of these people kind of miss bashing things together and coming up with what blacktation was you know for a while.

So that so what usually happens is these people will feel full and then they'll think, oh, no, I need to drain that, and then that just perpetuates the cycle, when instead what ideally would have happened is you feel full, Okay, if it's painful, put some ice on it.

It's still painful.

It takes some eyboprofen, keet that ice on it, and within three days that pain will reduce because the breast will have adjusted their supply and you won't get that milkstaces and help with that fast letdown that we were talking about.

Yeah, and how interesting because most people would think, uh, and I think that was the treatment back then, was if you needed to put your breast on a breast pump to pump out the hardened block duck.

I still think of how many people that I would have said that to.

I would I was in there helping them, Yes.

In the shower in hot water.

Yeah, yeah, yeah.

And so it's it's one of those examples where the lack of it was assumed knowledge.

There's so much assumed knowledge in breastfeeding medicine that we need to debunk and start to really go back to first principles, you know, physiology, anatomy, function, and physics as well.

Physics actually comes into this, which is interesting because most doctors like myself aren't up to date on our fluid dynamics or our things are sympathized in the albola.

So we've talked about pumping being a risk for sort of creating or setting yourself up for a mass.

Datis spectrum symptom?

What about I'm already talking about the spectrum, So what about things such as I don't know how you hold the baby feeding positions or nipple shields, or is there anything else that you see us doing that you think, oh, well, you know, let's let's perhaps move that out of your feeding regime and let's concentrate on other things.

No, so there would never be a hard and past.

Well, there's a place for everything in breast fitting, and I wouldn't say there.

Let me just make sure I'm really arranging through all things.

There's no there's nothing that is going to create mass other than artificially creating an over supply, or if we damage that, we're not resolving and we're perpetuating because it will cause inflammation.

So those are the two mechanisms.

So, for example, if if you have damage and you're using a nipple shield, sure that can contribute.

If you are pumping and you are breastfeeding directly at the breast or with a nipple shield or with any other sublementary feeding device, that can impact it.

That again more because the pumping is creating and it if oh what a big one is if you have pump damage.

Okay, so if we are not using correct fitting pumps.

So if we have had a really a diagram which shows the way the shield the flag should fit over the nibble, it should the nipple should not be touching the side you will give.

That means it's too small.

And you should not be having the areola, which is the other colored bit, come into that pump because it will cause damage and the areola damage of it's bad.

Yeah all right, so you've mentioned that we've got new guidelines and it's just like recently we did an update on the bulk billing for the Genetic Screening Carrier and somebody commented, look, can you please tell GPS because they don't know it's bulk billed either.

And the information does flow through slowly sometimes doesn't it to your healthcare provider.

So how do you feel most healthcare providers go in diagnosing masst iitis using the new to twenty two guidelines.

So I think I think all my polleagues are amazing and they're doing their best for the abreast of everything.

The problem is that this is not until now actually we haven't had any official recognition by any medical colleges of lactation as a science.

We have recently the RCGP, which is one of these medical colleges in Australia and hyper part of we have a new Breastfeeding Medicine Breathinian Lactation Medicine Special Interest Group, which is the first time so now through that we are going to be able to push the proper guidelines, proper clinical care, proper education, collaboration with other specialties.

But up till now it's kind of just been, uh, we've been trying to educate people, we haven't had a systematic way of doing it.

There's also the Breastbinding as a network of Australian viewing the doctors as well, and that's for anybody who wants to be in the field.

But it's really only been if people have been interested in it and to be honest, even though we've got this this breathfeeding messine lactation at SIG, it's still it will it's not part of the curriculum yet.

So I'm doing lectures that you and s w and I've done it for pediatrics.

But again, if somebody wants us to come in, then we come in and do lectures.

But there's no obligation to put that in the curriculum because it's not seen as being necessary.

So that's our first challenge, and everybody needs to kind of push the colleges, push your MPs.

You know, I have been trying to get I want to get a postpartum care plan where we have six rebatable sessions and people can use that for flactation, for Sultan's phisios, whatever it is.

And you know, we have a care plan for if you into your knee.

You know you can if you've had the injury for a bit of time, not just because you've got one injury.

You can access pisio and things like that.

So we need something like that so that it's accepted in the medical system.

So right now, it's going to take time.

It takes time for when something is accepted in medicine, it takes seventeen years for it to become common practice.

So yeah, it's shocking.

Yeah, but with this one, where even fighting a harder battle because it's not considered it slowly starts to consider.

Even though it's a Board special Board certified speciality in subspecialty in America, it's still not considered that way in Australia.

And even I've spoken to obstitutions who have been like, oh well no, why do we need that, you know, not the majority.

I speak to them, oh yeah yeah, and they're just like, no, it's another thing.

This wasn't older.

Yeah person.

But again, I was so shocked and I was like down for like a week, being like, oh my gosh, I'm going to as was two years ago.

But I feel like the trend is turning.

The tide is turning, but it will come from people seeking information and saying it.

So if you hear this and you're given different advice, just say, have you heard of the twenty twenty two Mastidas protocol?

Because they're saying to do other things and I see people coming in but that being like, oh no, I was told to do this, and I'm like yeah, and I think it's also important to say I was doing those things too before we have the new protocol.

Well, that's what a new guideline is.

Everybody adopts their practice eventually to the new guidelines.

And we might put a link in the show notes to those guidelines because I know we'll get some motivated people who will want to read it.

And I love that that you're championing the six visits postpartum.

And I just want to point out the other day I was looking through our like you know, the medicare billing rates and our obstricans.

They both bill the post natal visit and our post natal visits are about thirty to forty minutes with the obstetrician and about thirty to forty minutes with the midwife, and all up, the government pays us all them forty two dollars thirty five.

I mean, that is so wrong.

You know, you can't even get a plumber to come to your house for that, Like, you know, I just think there's something wrong where people say, oh, you know, I only had a six week check with my obstrition and it was about ten minutes.

I'm thinking, well, that's because you know it's bad.

But perhaps their rebates need to be better for it to.

Be a Oh, they definitely do even internal practice.

You know they're taking away.

There's a mental health consultation.

We do the two seven one three, and you know, I like that one because it's we're focusing on mental health and it shows the importance of mental health as separate to your physical symptomes.

But even that is now, no, just put it all as one thing, and we don't have a proper postpartum IEM.

Not that's ridiculous, Yeah it is.

It's the GPS that the ninety percent of the issue is postpartum, whether it's feeding or or for the mom.

And the thing is the mom gets ignored.

I make my patience.

I fult build them, but I make them book in a point of themselves because I'm like, you need to understand from get go that your health is important and we need to look after both of you.

You can't just look after one or the other.

You have to understand them both as a as a unit, unit to the unity, back to the unit.

So I want to go back to the masstatas spectrum.

So let's say someone has and what I'd like to do is just go through the symptoms in that spectrum and what someone would notice, and then we'll later talk about the treatment because they might be a bit the same.

But so if you could start with the lump in your breast, is that the first symptom.

Yeah, that is often the first symptoms.

Sometimes it can even be hardness of the rest.

You can just feel suddenly, you know, once your breast have already started to regulate something and feel a bit of hardness.

Okay, have a think about it and we'll walk.

Secondly, what you should do.

But then you might notice the painless lump.

Okay, that's the next time.

Then that lump might become painful.

Okay, Then you might notice that it's actually really painful in that particular area.

But you may not have any redness, you may not have any swelling, you may not have any further pain.

When it kind of goes to that mass dive.

As part of the spectrum, you will notice possibly redness, and in different colors in my life kind of color.

You might know the shininess.

You may not see redness in the same way.

You still will see red, but it just won't look as florid as on the fair skift.

And you may notice that it will be very tender, very very tender to put anything on it.

That is also one of the hallmark features.

Now, if you get fevers, the evidence actually says that within twenty four hours that fever will come down, given my kind of thing, and you may not follow up the patient.

And I'm still scared of abscessorce because I've been a doctor for a long time and I've seen abscesses due to bad management.

I will generally say, look at the fevers, take the antibiotics.

But the evidence doesn't say that you need to do that, you know, and I'm being slow the terms on that.

But the thing is, parents know usually by this will take place over five to ten days usually, and you can bring so you have many, many opportunities to reverse that kind of pattern if you know about it.

If you don't know about it, it just goes from painless, lamp painful love, locked out, mass dives.

And what about abscess?

What is that is that part of the spectrum.

It is it's the far end of the spectrum where if you can have repeated some people have a predisposition and it will be there will be a bacterial collection that is very It's a lot more rare than we've realized, than what we've previously thought.

So there are many people that I have and again they come to me because they do this and they're like, it's so bad, and I'm like, it must be an abcess, and I go looking for it and it's not.

The Usually if you have an abscess, you will have had repeat episodes of mass diypes.

It is when it is not being resolved correct way, which means we have to change the f ending factor.

And I'm a bit confused.

I've never seen an abscess.

Is it something that's internal to the breast and the skin you can't see it, or is it something that is sore and open.

It can be both, but most likely it's going to be internal.

Yeah, that we shouldn't get too much of a focus on that.

Yeah yeah, yeah, yeah, so because that's just going to terrify everyone.

But again, if we manage it early, we won't get to the point of nasto.

But however, if it's you think it's pretty simple.

In Australia, we're lucky that these things are not build that we can get not to sound and make sure that there's not a collection that needs to be drained or anything like that.

Great, all right, So now let's talk about the treatment on that spectrum.

So somebody has just hard breasts or they've founder like a bit of a lumpy bit, let's start there and then we'll work our way up.

So if you have had said sudden onset of these things, because there is breath cancer Awareness month as well, so we can do it.

We'll do one little thing on that right at the end.

But let's say you've noticed a bit of hardness in the breath and then you've noticed a lump.

The first thing you're going to do, even at the hardness, because it's uncomfortable even there, is you're going to put ice on.

And did you have to hear about how they used to have cabbages in maternity?

So it's so clever.

I love all these old wise kind of tailed But the caventer has a really high water content.

So if you put that in a freezer and you take out a leaf, you've essentially got an ice pack.

Right, So they were doing the right treatment anyway for this endoragement and this kind of inflammation.

The natural weight that an ice pack is going to be more effective.

So you can get those little ice packs where you can section them and you pop it on that area.

No massaging, no draining, just treat the breast.

No heat and no heat.

No heat, no no, no, no, yes, he heat is out.

Okay, heat heat.

We know heat exacerbates inflammation.

So you always think about it.

If I had a bruise on a leg, on my arm, what would I do?

You'd put ice, You would never put heat on it.

So you put that ice on it.

And if it's still really painful, you can take eyebroprofen.

If it's still persisting at that point, see your doctor and make sure you that there's nothing else going on and go from there.

Yeah, and what about our physio at work has done a whole lactation physio lactation course and so she offers ultrasound.

What do you think about that.

I think there's a place for it, but we've got to fix the cause of it.

So if we get it early at first sight of symptoms, we don't need the lpersound.

We don't need the lasers.

And that's generally my principle with everything in breastleedings.

And if we get it early, we don't we don't need all the external things.

You don't need the lanyline.

You don't need the nipple creas, you don't need the silver cups.

You don't need anything other than yourself body, some knowledge and support.

Those are the things that you actually need.

Few pillows helps, A good baby carrier also helps.

But yeah, so the ultrasound it can be great.

Let's say, what often happens is patients get nervous in the middle of the night.

They're like, ah, it feels too and gorged.

I'm just gonna drain it.

You know.

The other thing that we haven't discussed at all here is when you tell a mom that she's making too much milk.

You were both moms, right, I would be I remember, I would be like, you're insane and you're danger between my baby and step away, right until that's the thing you're you know, we're so driven to just be the beat.

Make more milk, make more milk, make more milk, And that's an instinctive response.

So it sometimes takes people a bit of time, but they start to see the difference when they practice this.

If they put the eye on, you will see an improvement.

But if it let's say, you know, you panic in the night and then you pump it's just going to make it worse.

It takes three to five days everything with the breast to get better.

That you should notice a decrease in that kind of redness in the pain, the redness that you often see the mastatus.

We all thought it was, you know, bacterial infection is actually just hyperreemia.

And again Katrina, until there was a whole section on this, it's actually just the same of like you know, book, you did something and you've got redness, it's the same thing.

So redness doesn't always we need antibiotics.

Get it on board.

So if you paddic at two way in and you think you have a fever, take it.

It's not going to cause harm.

Yes, I know it just wraps the microbio, but so little bits into the breast milk and it's it's not an issue.

I have no problem with people taking it, but just know that it's not going to solve the problem.

That's the key thing.

The problem being solved is seeing perhaps a lactation consultant to help get your position and latch right.

Is that is that what.

You're actually the main problem is the understanding if you've got if you're removing the milk correctly, or if you are over pumping.

Most of the time we've blocked up amistas, we will see a pump involved.

Yeah, all right, So I'm going to ask about the people that get recurring mastatis, what would you suggest for them?

For them the same the same protocol we've got to use ice cyberprofen anti inflammation is that is the way we're going.

But speak to your doctor if it keeps happening.

For me, my kind of way I practice is if it happens twice, I will do an office sound just to make sure that we're not missing anything.

But to be honest, when I think I get a particular type of patient as well, like they're already tuned into half the information.

They just want confirmation, So I don't really get ones that progress further than that.

But it is really important as well for people to know if you notice a hard lump that doesn't seem to go away, a peace sized lump, anything like that, you need to speak to your GP, get a mammogram, you know, make sure that we there is no content indications for mammograms.

Just because you're breastfeeding, really really important because it Breastfeeding Awareness month, but also just really really important anyway to never neglect breast to help including awareness about breast cancer too.

Thanks for mentioning that I recently found what I thought was a lump, and Pat doesn't often say anything in a hurry, but because ah, I get that one checked out and it was really stressful, and I went to have my mamogram and it's all clear.

But the relief that you get from an all clear, it's really worth doing.

So yeah, I'm really glad that you mentioned that as particularly because it's bastfeeding month.

That's great.

But also just if you get the all clear, that you still feel nervous, don't accept the answers there as well.

Truck those instincts get further imaging.

We now have different guidelines as well, so because sometimes we can't always see it with a usually under forty, you know, we need a breast upter sound, so we might need a mammogram.

We now have breast MRI, which I don't know if people are aware of, So if you suspect it, speak to your doctor.

Doctors don't want to miss things either, so they can send you on to your breast surgeons and they can give you the best advice, the best imaging and go from there.

Don't sleep on this, advocate for yourself.

Yeah, and always check yourself for mums.

Yeah.

In my case, my lump has gone, so I feel I feel like I'm fine.

Good, good.

Yeah, it's so stressful.

I think talking about it normalizes the fact that you know, before, before I was in medicine, you don't know like that, Like it feels like how do you know?

So you're not supposed to know.

You go to your doctor.

They're used to feeling brisks, and even if they're not, they can image it and then we can get more answers for you.

You don't want to be sitting there being like if only I had gone in when I thought that.

That's the key thing.

Kiviti.

You've mentioned the microbiome a couple of times.

Does you mean gut microbiome?

Is there a microbiome or on your nipple or what do you mean by.

That microbiome microprahrame.

If we have a respiratory microbiome, we have nasal microbiomes, they have an oral microbiome.

It just means the living organisms in a particular area.

And of course the big one is the gut, which we now know is eighty percent of our immune system.

It's incredible.

Yeah.

So the reason I mentioned microbiome is because microbiome it's a bit of a fixation out there in the community at the moment.

But again, like everything, we've got half information in out there, So the microbiome is hugely important.

But there are lots of natural ways of improving your microbiome.

It doesn't always have to be an expensive supplement because those supplements are super expensive.

In terms of the breast.

Then like, do we have to work on the microbiome?

Is that a part of mastitis?

Yeah, so there's this is something where it's part of you'll see this in the protocol.

It's called the disbiosis.

So if we treat with antibodies, we can affect the microbiome of the breast.

But then again this is something that your doctor should really be be talking to you about.

But what we need is there are always organisms.

So just like on our skin, you know, we have Canada, we have you know, strep organisms.

We have all sorts of different organisms that are on our skin, and the same thing for the nipples in the breast, and different types of skin will encourage different types of organisms.

So you didn't ask this question.

But nipple thrush is another one that you know, I think hopefully it's out of fashion now, but again the evidence doesn't support it.

You know, we've had everybody that had painful red breasts was told the typical thing we were told, even in medical school is that somebody finds that even a tirt too painful to treat them for the nippleed thrush.

And again I don't mind people being treated for things if they need it, but it's an arduous treatment.

You know, you have to take.

You know, you have to put a gel on your breast, you have to treat baby.

Sometimes you have to take an oral medication and it's and the big issue I have is that doesn't fix the problem.

So yes, a segue away from it, Yes, there is a breast microbiome.

The microbiome contains lots of organisms that are supposed to be there, so we don't want to alter it.

And so if we feel like we've altered it because we've taken antibiotics, do we have to do anything to increase our microbiome.

It will self correct.

It will self correct as long as you have a healthy, balanced diet, good habits, it will self correct.

That's the amazing thing, you know, I get.

Should I go and buy a probiotic and give it to the baby?

And you know what the third most prominent part of breast milk is, No, it's something it's something called human milk Oligo psacharices, So these are little sugars that feed our gut microbiome.

So it's the third most prominent part of more than your fat's more like you know, it's not more than your fats, but it's more than one particular fact.

Let's say.

So, it's so important that the design of breast milk.

Again, that incredible design makes so much of this so that we can and encourage the growth of certain species.

So certain species are really good for immune heal.

So what they need to know is you don't need to buy something from out there.

Your microbiome coming from your breast milk and it is fast period than anything you can buy.

Let's say somebody has mastadis and they're worried about what to do in terms of feeding their baby.

Do they not feed off that breast or do they continue feeding?

What's your advice there?

Your feed is normal, so you don't want to try and feed to drain.

You know, you see people saying dangle, feed to try and release it, all these kind of things.

You don't want to do anything different to what you be doing.

Feed as normal as what baby needs.

You cannot empty a human breast.

There is always residual milk in it.

It's a ductless system.

It's not a system like dairy cows, so it cannot be it cannot be empty like that.

But things not to do.

No heat, no massaging, no trying to drain it, no trying to massage towards the nipple, and definitely no trying to feed to drain the law.

No gentle massage even because that adds to inflammation.

The things you can do ice hyberprofen you can if you must.

If you're really uncomfortable, you can do gentle memphatic massage, which is just like gentle skin pressure.

Nothing else, not VPN.

You're not massage and you go away from the nipples towards the armpit.

But that's the most of it.

And see your doctor if you're concerned.

Wow, thank you so much, Covet.

That is a great sort of one oh one masstitis.

And again going back to your whole thing of it.

It's a team approach, like you need to be supported through this, so you're getting support from your partner if you have one, or a mother if if my all mother in law, I'll only be a mother in law if if you need and their good support and finding a good gp and perhaps the elactation consultant like you know, reach out to your contacts, because I don't think anyone should go through mass artists alone.

No breastfeeding medisin doctor as well.

So that's what I mean.

There's not many around though, are they.

We're growing, We're growing.

There's I think there's many, but we're not connected yet.

So there's there's quite a few that are interested.

And in the next two years, like watching space, it's going to change.

I'm people are interested.

You know, we're not accepting the status quo and how ignore it's been.

So I mean, I think the big long term things are going to take a while, but you know, we're making small moves and things like what you're doing so important.

You're doing the same things, you know, like you're just keeping people informed and answering those questions that they have because we just don't know this.

And until I came on to doing social things.

I had no idea what was bothering people because you just don't have You only have your small appointment windows to work things out.

So yeah, thanks for all the amazing stuff that you've done.

Oh that you are so kind, You're so kind.

All right, Kavita, thank you so much for your time, and I hope we keep in contact over the years.

I'd love to see what happens with breastfeeding medicine.

We'd love to get a breastfeeding medicine at our clinic.

That would be amazing.

Alright, everyone, I hope you got a lot from that episode.

We've got a few things that we need to put in the show notes, so if we've mentioned something, just go and have look in your show notes s and see if they're there so you can click on them and have a read up as well.

All Right, until next week, everyone by for now.

Hey, even though doctor Pat is well a doctor and we get lots of other doctors and other experts on our podcast, I just need to remind you that this podcast is for informational purposes only.

We share lots of medical insights and experience, but everything we talk about is general in nature and may not apply to your specific situation.

Please always consult with your own healthcare provider for your individual medical advice.

When you grow your baby yeah,