What is Mastitis?

Mastitis can be defined as a breast inflammation (or swelling) occurring typically in just one breast that comes with a fever over 100.4 F. It can include body aches and chills (general malaise), and acute pain in the breast tissue. It affects about %10 of all breastfeeding women, although in some populations the rates are as high as %30.

The way mastitis looks:

If the mother’s skin is light, the mother’s breast will often have streaking red marks on the exterior of the breast, and it will be hot and uncomfortable to the touch. If the mother’s skin is darker you might see a redder tone in the area of inflammation, a flushed look, or streaking and the rest of the same symptoms as above. Many mothers can feel a knot or thick wedge of swollen tissue in the breast that is under the area of redness.

(We’d like to thank the mother that donated this picture to us!)

Some questions to ask yourself if you have recently been diagnosed with mastitis:

• Have I had a blocked duct recently?
• How is my diet? Am I feeding myself well?
• Has my baby been biting me? Any teething behaviors?
• Am I carrying anything heavy on one side or another? A bag, a purse, a baby carrier?
• Has my pump been rubbing or is the fit right for my breast?
• Has anyone in my family been sick recently?
• What positions am I nursing in, do I need to switch it up more regularly?
• What sort of bra am I wearing? Remember, no under-wire bras when you are nursing!
• Am I nursing frequently enough?
• Have I had any type of nipple trauma lately?
• Is the spot under where my toddler rests their head?
• Am I  stressed out about something?
• Have I had any nipple damage lately?
• How is my fatigue level? Am I trying to do too much?

By asking these questions, you can help isolate what has contributed to your breast infection. Some women get them repeatedly, and some women have them only once. By ruling out what might have happened right before you received the diagnoses, you may be able to take steps to prevent reoccurrance.

It is important to change positions when nursing with mastitis! If you try sitting more upright or less (depending on your natural position), lying down or something new, you might help with the blocked ducts or mastitis. Some mothers get on all fours and hang their breast over their baby and nurse in a sort of “Dangle” position. Your baby will probably think it’s fun, and it will certainly help to use gravity to get your breast drained. The objective is to unclog the blockage, and get your breast really empty.

You may have heard that when trying to promote emptiness in the breast during  a blocked duct or mastitis, the best way to do this is to orient baby’s chin towards the mass.

According to a small study done with women who were attempting different types of breast massage to clear their blockage, a different approach worked better, with less discomfort (Cambell 2006, pg 304),

“Clinicians stopped recommending massage from behind the plug, but instead suggested massaging in front of the lump of milk toward the nipple, as if “trying to clear a pathway.” The woman begins her kneading close to the nipple, pushing toward it. “

You can try the massage by itself, or during nursing. It makes sense that during nursing would be the  most effective.

A few things to do if you think you have mastitis:

• Contact your healthcare provider; breast abscesses can form from untreated mastitis. Those really hurt!
• If you are prescribed antibiotics, take the whole dose and don’t stop taking them early.
• Keep breastfeeding, don’t wean!
• Nurse frequently, varying your position.
• Use breast massage while nursing, to help clear your blockage and empty your breast.
• Consider alternating cold/hot compresses to reduce the discomfort.
• Have someone give you a hand with your baby or housework.
• Try and get some rest.
• Take a bath!
• Yes, it is safe to nurse when you have a breast infection! It will not hurt your child.
• If it is absolutely too painful to nurse, please pump every time you nurse on the unaffected side.
• If you have been prescribed antibiotics for the infection, think about the fact that they make you vulnerable to yeast growth, and use some kind of probiotic in your diet.
• If you already have the breast abscess, protect the wound from your child’s mouth. Your baby can directly introduce normal oral bacteria into a place where they are normally tolerated (inside your breast), which may make it harder for you to heal. Change the position so that your baby’s mouth doesn’t touch the drainage in place.
• For a mother who is getting repeated mastitis, the supplement Lecithin is a possible suggestion.  Lecithin acts to break down fat molecules ( an emulsifier), it is present in your body normally, but some mothers have more/less than others. Some women having allergies to soy (lecithin supplements are associated with soy) so it would be wise to talk about any supplement with your Dr before you take it.

References:

Cambell, Suzanne IBCLC. Recurrent Plugged Ducts J Hum Lact August 2006 22: 340-343

Riordan, Janice RN, EdD. A Descriptive Study of Lactation Mastitis in Long-Term Breastfeeding Women. J Hum Lact June 1990 vol. 6 no. 253-58

Spencer, JP. Management of Mastitis in Breastfeeding Women. Am Fam Physician. 2008 Sep 15;78(6):727-31

(C) Serena Meyer, IBCLC. all rights reserved. No portion may be copied or used without expressed permission from the author.