Mastitis

Please find all the more detailed medical information below.  For now I just want to highlight a few things which are so crucial about mastitis that have helped many women I know (including myself!) and also some quick tips on how to prevent and quickly alleviate the symptoms of mastitis.

Mastitis is a breast infection usually caused by a plugged duct which is not emptied.  The milk which stays still can develop bacteria.  The infection can begin and progress quickly.  Mastitis hits like a truck so whatever we can do to prevent it we should do!  Here are some things you can do to keep mastitis at bay:

  • Feed on cue, around the clock, especially in those early days when your body is still regulating your milk production.
  • If you feel signs of engorgement which persist past day 5 post-partum please take action preemptively (see below) .
  • If you are going through the weaning process (from baby or pump) do it slowly to give your body enough time to adjust.

It is so important to keep your breasts healthy for you and for your baby :).  In those first few weeks when you are exhausted and getting used to the rhythm of motherhood tackling such a debilitating infection can take a toll on your body and even your emotional health.

Some common signs of mastitis are

  • Hard breast (engorgement) or lumps under the skin (plugged ducts)
  • Breast is very warm or hot to the touch
  • Red streaks on the breast
  • Fever
  • Flu-like symptoms

Here are a few things you can do if you suspect the onset of mastitis:

  • Nurse, nurse, nurse keep that milk moving!  Always start on the affected side.
  • If you are engorged try to hand express some of the milk.  You can also try bending over a large bowl of warm water and dipping your breasts in the water.  Gravity will help the milk flow out on its own.
  • If you feel lumps and suspect plugged ducts try to get the plug moving by nursing as much as possible while massaging the lump until it moves down and comes out.

If your fever gets high (101F or above) or you feel very ill call your Dr/OB/midwife  and let them know that you suspect mastitis.  They will prescribe you an antibiotic right away.

I hope none of you ever go through this as it is not at all pleasant!  If you do go through it make sure that you have someone to take care of you and to help you take care of your baby :).

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From the Mayo Clinic:

Mastitis is an infection of the breast tissue that results in breast pain, swelling, warmth and redness of the breast. If you have mastitis, you might also experience fever and chills. Mastitis most commonly affects women who are breast-feeding (lactation mastitis), although in rare circumstances this condition can occur outside of lactation.

In most cases, lactation mastitis occurs within the first three months after giving birth (postpartum), but it can happen later during breast-feeding. The condition can leave you feeling exhausted and rundown, making it difficult to care for your baby.

Sometimes mastitis leads a mother mistakenly to wean her baby before she intends to. But you can continue breast-feeding while you have mastitis.

Symptoms

With mastitis, signs and symptoms can appear suddenly and may include:

  • Breast tenderness or warmth to the touch
  • General malaise or feeling ill
  • Swelling of the breast
  • Pain or a burning sensation continuously or while breast-feeding
  • Skin redness, often in a wedge-shaped pattern
  • Fever of 101 F (38.3 C) or greater

Although mastitis usually occurs in the first several weeks of breast-feeding, it can happen anytime during breast-feeding. Lactation mastitis tends to affect only one breast — not both breasts.

When to see a doctor
In most cases, you’ll feel ill with flu-like symptoms for several hours before you recognize that there’s a sore red area on one of your breasts. As soon as you recognize this combination of signs and symptoms, it’s time to contact your doctor.

Your doctor will probably want to see you to confirm the diagnosis. Oral antibiotics are usually very effective in treating this condition. If you’ve had mastitis before, your doctor may prescribe antibiotics over the phone. If your signs and symptoms don’t improve after the first two days of taking antibiotics, see your doctor right away to make sure your condition isn’t the result of a more serious problem.

Causes

Mastitis occurs when bacteria enter your breast through a break or crack in the skin of your nipple or through the opening to the milk ducts in your nipple. Bacteria from your skin’s surface and baby’s mouth enter the milk duct and can multiply — leading to pain, redness and swelling of the breast as infection progresses.

Risk factors

Things that put you at increased risk of mastitis include:

  • Sore or cracked nipples, although mastitis can develop without broken skin
  • A previous bout of mastitis while breast-feeding — if you’ve experienced mastitis in the past, you’re more likely to experience it again
  • Using only one position to breast-feed, which may not fully drain your breast
  • Wearing a tight fitting bra, which may restrict milk flow

Complications

Complications that may arise from mastitis include:

  • Recurrence. Once you’ve had mastitis, you’re more likely to get it again, either breast-feeding the same infant or a future child. Delayed or inadequate treatment is usually to blame for mastitis recurrence.
  • Milk stasis. When the milk isn’t completely drained from your breast during breast-feeding, milk stasis can occur. This causes increased pressure on the ducts and leakage of milk into surrounding breast tissue, which can lead to pain and inflammation.
  • Abscess. When mastitis is inadequately treated, or if it’s related to milk stasis, a collection of pus (abscess) can develop in your breast. An abscess usually requires surgical drainage. To avoid this complication, talk to your doctor as soon as you develop signs or symptoms of mastitis.

Treatments

Mastitis treatment usually involves:

  • Antibiotics. Treating mastitis usually requires a 10- to 14-day course of antibiotics. You may feel well again 24 to 48 hours after starting antibiotics, but it’s important to take the entire course of medication to minimize your chance of recurrence.
  • Self-care remedies. Resting, continuing breast-feeding and drinking extra fluids can help your body overcome the breast infection. Empty the milk from your affected breast frequently. If your baby refuses to nurse on the affected breast, use a breast pump or hand express the milk to empty your breast.
  • Adjustments to your breast-feeding technique. Making sure that you fully empty your breasts during breast-feeding and that your infant latches on correctly are key to avoiding bouts of mastitis. Your doctor may review your breast-feeding technique with you or may refer you to a lactation consultant for help and ongoing support.

If your mastitis doesn’t clear up after taking antibiotics, check back with your doctor. A rare form of breast cancer — inflammatory breast cancer — can also cause redness and swelling that could initially be confused with mastitis. Your doctor may recommend a diagnostic mammogram, and you may need a biopsy to make sure you don’t have breast cancer.

If you have mastitis, it’s safe to continue breast-feeding. Continuing breast-feeding offers the added benefit of helping clear the infection in your breast.

Remedies

To relieve your discomfort:

  • Maintain your breast-feeding routine.
  • Get as much rest as possible.
  • Avoid prolonged engorgement before breast-feeding.
  • Use varied positions to breast-feed.
  • Drink plenty of fluids.
  • If you have trouble emptying a portion of your breast, apply warm compresses to the breast or take a warm shower before breast-feeding or pumping milk.
  • Wear a supportive bra.
  • While waiting for the antibiotics to take effect, take a mild pain reliever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others).

If breast-feeding on the infected breast is too painful or your infant refuses to nurse on that breast, try pumping or hand-expressing milk.

Prevention

To get your breast-feeding relationship with your infant off to its best possible start — and to avoid complications such as mastitis — consider making an appointment with a lactation consultant. A lactation consultant can give you tips and provide invaluable advice for proper breast-feeding technique.

Minimize your chances of getting mastitis by fully draining the milk from your breasts while breast-feeding. Allow your baby to completely empty one breast before switching to the other breast during feeding. If your baby nurses for only a few minutes on the second breast — or not at all — start breast-feeding on that breast the next time you feed your baby.

Alternate the breast you offer first at each breast-feeding, and change the position you use to breast-feed from one feeding to the next. Make sure your baby latches on properly during feedings. Finally, don’t let your baby use your breast as a pacifier. Babies enjoy sucking and often find comfort in suckling at the breast even when they’re not hungry.

 

If you need breastfeeding help, please contact your local support group, La Leche League or Nursing Mothers Counsel. You can also email me at melisa@ilovebreastfeeding.com.

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