Post by Angel J. Miller, MSN, CNM
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.
Mastitis is often caused by Staphylococcus areus and Escherichia coli bacteria. It is an unwelcome guest, especially to first time moms who have a difficult enough time trying to establish a breastfeeding routine with their baby. It is also unwelcome to those of you who have already experienced cracked nipples, have thin or sensitive skin, engorgement or a weakened immune system. Mastitis is often preceded by engorgement, plugged milk ducts or cracked and bleeding nipples.
Mastitis needs to be differentiated from a plugged or blocked duct, because the plugged or blocked duct does not need treatment with antibiotics, whereas mastitis often, but not always, does require treatment with antibiotics. A blocked or plugged duct presents as a painful, swollen, firm mass in the breast. The skin overlying the blocked duct is often red, similar to what happens during mastitis, but less intense. Mastitis is usually associated with fever and more intense pain as well. However, it is not always easy to distinguish between a mild mastitis and a severe blocked duct. A blocked duct, can progress to mastitis.
Symptoms of mastitis include:
• A red, sore spot or “hot spot” on your breast
• Breast tenderness or warmth to the touch
• Swelling of the breast
• General malaise or feeling ill
• Overall, flu-like symptoms
• Fever of 101 degrees F or 38.3 C or greater
• Red lines following the troubled milk duct’s path
Because many healthcare providers will prescribe antibiotics, it is up to the mother to find, in addition to the antibiotics, other remedies and comfort measures to help shorten the episode of mastitis, ease the pain and help to continue to breastfeed your baby.
Self-care remedies. Resting, continuing breast-feeding and drinking extra fluids can help your body overcome the breast infection. If you are prescribed an antibiotic, the course of therapy will usually be ten to fourteen days of antibiotics. Even though you may feel better after 48 to 72 hours of taking the antibiotics, be sure to finish the antibiotic regimen to ensure your breast infection is resolved.
To relieve your pain and discomfort:
•Be sure to maintain your breastfeeding routine-Yes; you can still breastfeed your baby with a breast infection. It is safe for you and for your baby. It is also recommended by the La Leche League to continue breastfeeding on the affected breast through mastitis to help shorten the episode of the infection and avoid abscesses. Mastitis need never be the reason to discontinue breastfeeding your baby.
- Avoid prolonged engorgement before breastfeeding your baby. You need to reduce the fullness as much as possible at each feeding to ease the inflammation and expel any milk plugs that may be present. Some babies may be reluctant to breastfeed on the infected breast because of elevated sodium content in the milk. If your baby cannot be persuaded to nurse, you need to express milk to keep her breast soft.
• Use different positions to breastfeed your baby; sometimes the same position causes pressure points on a certain area of the breast, thus causing a plugged duct which can lead to mastitis. Be sure you are in a good and comfortable position before your baby latches on!
• Drink plenty of fluids! Did I mention this before? This is important enough to repeat!
• If it is too painful to breastfeed on the affected breast and/or your breast is too sore to have babe latch on, you can pump and hand expressing your milk
• If you have difficulty emptying a portion of your breast, apply warm compresses to your breasts, take a warm shower, or kneel in your tub filled with warm water and submerge your breasts before breastfeeding your baby or pumping
• Wear a good supportive bra
• While waiting for the antibiotics to take effect, take a mild pain reliever such as acetaminophen (Tylenol, others) or ibuprofen (Motrin, Advil, others)
Prevention: reduce your chances of getting mastitis by fully draining the milk from your breast while breastfeeding. Allow your baby to completely empty one breast before switching to the other breast during feeding. If your baby nurses only a few minutes on the second breast, or not at all, start breastfeeding on that breast at your next feeding.
Alternate the breast you offer first at each feeding, and change the position you use to breastfeed from one feeding to the next. Make sure your babe latches on properly before each feeding. If your baby is not latched on properly, break the suction with your finger. If baby fusses a few seconds, that is okay. This is better than you developing cracked nipples that can lead to mastitis.
Finally, do not let your baby use you as a pacifier. Babies enjoy sucking and often find comfort in suckling at the breast even when they are not hungry.
Breastfeeding your baby is the most fulfilling action in the mother-infant bonding process. It should be pain free and fulfilling.
Angel J. Miller, MSN, CNM
- Oversupply of Breast Milk-What to Do (9monthsin9monthsout.com)