With Fiona Grouber, Women’s & Pelvic Health Physiotherapist and First Time Mum
Can you tell us a little bit more about yourself, your own breastfeeding journey, and Pelvic Wellness?
Hi, I’m Fiona, a Women’s & Pelvic Health Physiotherapist, a new mum, and Owner of Pelvic Wellness, based in Melbourne.
Over two months ago, I became a mother with the birth of my gorgeous daughter, Zara. It has been such a special and beautiful journey so far, however, not without its challenges.
My breastfeeding journey began in the hospital where I was introduced to nipple shields due to difficult and painful latching. At this point, I was complementing my breastfeeding with formula top-ups as there was concern regarding Zara’s insufficient weight gain. By two weeks postpartum, with the support of my Maternal & Child Health Nurse, I was able to wean off the shields and transition to exclusively breastfeeding. More recently, I reached out to a Lactation Consultant who dramatically improved my feeding experience following issues of lactose overload and a fast let-down. While I knew breastfeeding wouldn’t be easy, I never realised how difficult it could be! I would highly recommend reaching out to various healthcare professionals for support with feeding as it really is unchartered territory for you and your baby!
Professionally, I work as a maternity ward physiotherapist supporting new mums during their acute recovery phase. I also see women privately through my business, Pelvic Wellness, treating pelvic floor issues (such as incontinence, constipation and sexual pain), pregnancy aches and pains and postpartum recovery. My business came to fruition after realising there was a lack of women’s health clinical services in my local community. I feel extremely fortunate to be able to work with women during such momentous life stages.
What is one of the most common challenges you see new mums experience with breastfeeding?
From a physiotherapy point of view, the most common breastfeeding challenge my patients experience is Mastitis. It refers to the inflammation of the breast tissue and often begins with a block milk duct. When the duct becomes engorged, the milk may push out into the surrounding tissues and cause an inflammatory reaction, and potentially become infective.
The breast is usually red, hot and painful, sometimes with firm lumps. It is often associated with flu-like symptoms such as aching, whole-body chills and a fever. Mastitis is quite common affecting 3-20% of breastfeeding mothers.
What are some preventative measures and ways to manage these problems that new mums can adopt?
Here are my top tips to manage Mastitis:
- Rest: Prioritise looking after yourself and accept help from others where available. Resting will help support your immune system.
- Heat & Ice: Apply heat before feeds and ice afterwards, for approximately 10-15 minutes. The Bare Mum Breast Care Duo is a fantastic option here, with the gel pads offering both warming and cooling effects and they sit comfortably in the paired bralette.
- Medication: Use anti-inflammatory medication (for e.g. ibuprofen) to help reduce inflammation and decrease the likelihood the engorgement becomes infective. Evidence shows that taking antibiotics prophylactically is not effective in preventing mastitis. Speak to your GP or Pharmacist for advice that is specific to you.
- Massage: Lymphatic breast massage should be light and gentle, similar to if you are ‘stroking a cat’ with massage towards the underarm, rather than the nipple. Avoid deep pressure as this can lead to increased inflammation and breast tissue injury. Perform massage once to twice daily as needed. Your Women’s Health Physiotherapist can help ensure you are using the correct technique.
- Clothing: Avoid wearing a tight bra, especially those with underwire.
- Feeding: Keep your feeding routine relatively regular. Sudden changes like a missed or hurried feed can lead to engorgement.
- Therapeutic Ultrasound (TUS): TUS transmits sound waves at a specific dose that helps with reducing swelling and discomfort, while assisting with drainage of the breast ducts. See a Women’s Health Physiotherapist for ultrasound treatment and an individualised management plan.
Amir L.H. (2014). ABM clinical protocol #4: Mastitis. Breastfeed Medicine. 9(5):239-43. doi:10.1089/bfm.2014.9984
Mitchell, K.B. et al. (2022). Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum. Breastfeeding Medicine. 17(5): 360- 376.