Mastitis

Mastitis is an infection in the breast which can occurs with breastfeeding. Women will experience pain in their breast (usually one, not both), fever and general feeling of unwell similar to the flu. The breast that is affected is usually, hard, sore to touch with redness. This can occur at any stage of breastfeeding but most common in the 2nd or 3rd weeks postpartum. It is painful. It usually occurs in up to 10% of breast feeding women.

Causes

The most common cause of mastitis in due to milk not expressed out from the breast, often called engorgement. This can be due to the baby not sucking hard enough, blockage of mild ducts, over production of milk. Other causes include cracked nipples

Up to 50% of women will have recurrent infections.

 

Treatment

Often you can treat simple mastitis with over-the-counter relief medications such as ibuprofen and Tylenol. And cool compresses and regularly emptying the milk with hand or pump expression. You may also need an antibiotic which will be left up to your healthcare provider.

 

Tips to reduce mastitis

  • Breast feed with in the first 1 hour if the infant is showing signs of readiness.
  • Prevent engorgement, express milk to prevent staisis
  • breastfeed exclusively for 4 months or, if possible, 6 months
  • Empty breast completely with each feed
  • If you do have mastitis continue to breastfeed, unless contraindicated by your healthcare provider
  • Apply cold towel or ice. This will help decrease swelling and pain. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel, and place it on your breast for 15 to 20 minutes every hour as directed
  • Gently massage your breast before and during breastfeeding to help drain your milk
  • Use different positions to breastfeed: Change the position of your baby during feedings.
  • Get more rest until your fever is gone and your breast is not sore. Do not sleep on your stomach until your infection is gone.

 

  • Breast care:
    • Keep your nipples clean and dry between feedings.
    • Check them for cracks, blisters, or other irritated areas.
    • Wash your hands before and after you breastfeed your baby or pump your breasts.
    • Wear a nursing bra that supports your breasts but is not too tight

 

  • Correct positioning of infant
    • for effective suckling infant must create a teat (1/3 nipple and 2/3 breast tissue)
    • infant’s chin should touch breast
    • if areola large, more should be visible above infant’s upper lip than below it
    • cheeks should be rounded
    • with proper attachment infant will be relaxed without difficulty breathing

 

When to call your healthcare provider 

Women who have mastitis symptoms should always inform their healthcare provider so that an official diagnosis can be made and they can rule out other things that may be occurring.

 

References:

  1. Committee on Health Care for Underserved Women, American College of Obstetricians and Gynecologists. (2007). ACOG committee opinion no. 361: breastfeeding: maternal and infant aspects. Obstet Gynecol, 109, 479-480.
  2. Dixon JM, Khan LR. Treatment of breast infection. BMJ 2011; 342:d396.