Breastfeeding is a beautiful and natural way to nurture and strengthen the bond between a mother and her baby, offering numerous benefits for both, including enhanced nutrition, immune protection, and emotional connection. However, breastfeeding can be challenging, and one of the most prevalent issues for breastfeeding and pumping mothers is mastitis.
In this comprehensive blog, we will explore everything you need to know about breastfeeding and mastitis, providing valuable tips and effective remedies to ensure a smooth and enjoyable breastfeeding experience.
What is mastitis?
Mastitis is a common condition among breastfeeding women, especially in the early months of breastfeeding. It occurs when the breast tissue becomes swollen and inflamed due to infection or inflammation caused by bacteria entering milk ducts through cracked or sore nipples. Inflammation results in breast pain, swelling, redness and warmth often accompanied by fever and flu-like symptoms. Mastitis often arises when the breasts are not emptied regularly, or when a milk duct becomes blocked and inflamed.1
Dealing with mastitis can be tough for breastfeeding mothers, both physically and emotionally. It can disrupt breastfeeding routines, decrease milk supply, and lead to feelings of frustration and exhaustion.
Causes of mastitis
The primary causes of mastitis include:
- Engorgement: When the breasts are not adequately emptied during breastfeeding or pumping, milk can accumulate, leading to engorgement. It can cause milk stasis, making it easier for bacteria to enter the breast tissue
- Cracked or sore nipples: Damaged nipples, often due to improper latching during breastfeeding or pumping, create openings for bacteria to enter the breast tissue, leading to infection and inflammation
- Blocked milk ducts: If milk remains stagnant in the breast due to infrequent or inadequate milk removal, it can increase the risk of infection
- Bacterial infection: Mastitis is often caused by bacteria entering the breast tissue through cracked or sore nipples
- Frequency of breastfeeds: Missing or delaying breastfeeding sessions can cause milk to build up in the breast, increasing the likelihood of mastitis
- Weaning process: During the weaning process, when a woman gradually stops breastfeeding, there may be irregular milk removal, which can contribute to mastitis
- Milk blebs or blisters: Milk blebs, also known as milk blisters, can block the nipple pores, leading to milk stasis and increased risk of infection
Signs and symptoms of mastitis
The symptoms of mastitis include:
- Swelling, redness, and warmth in the affected breast
- Breast tenderness and pain, especially during breastfeeding or pumping
- A firm or lumpy area in the breast
- Fever and chills
- Fatigue and body aches
- Skin redness in a wedge-shaped pattern
- Flu-like symptoms, such as high temperature and malaise
- Nipple discharge (may contain pus)
- Lymph node enlargement in the armpit on the affected side
Risk factors for developing mastitis
Several risk factors can increase the likelihood of developing mastitis. These include:
- Previous bout of mastitis while breastfeeding: Having had mastitis before increases the risk of experiencing it again in subsequent breastfeeding periods
- Sore or cracked nipples: Damaged nipples can provide an entry point for bacteria, contributing to mastitis
- Wearing a tight-fitting bra or pressure on the breast: Restrictive clothing or pressure on the breast, such as from a seatbelt or heavy bag, can impede milk flow and drainage, increasing the risk of mastitis
- Improper nursing technique: Incorrect positioning and latching during breastfeeding can lead to insufficient milk removal and, consequently, mastitis development
- Poor nutrition: Inadequate nutrition can result in decreased milk production, leading to engorgement and blocked milk ducts, which are common precursors to mastitis during breastfeeding
The diagnosis of mastitis is primarily based on clinical evaluation and a thorough medical history. A healthcare provider will inquire about the patient's symptoms, breastfeeding practices, and any previous history of mastitis.
During the physical examination, the healthcare provider will carefully assess the breasts for any signs of inflammation, such as redness, warmth, swelling, and tenderness. They may also palpate the breast to check for any areas that feel firm or have lumps.
In certain situations, additional tests, such as a breast milk culture or imaging studies like ultrasound or mammogram, may be recommended, especially if there is a history of recurrent mastitis or to rule out other breast conditions with similar symptoms. A timely and accurate diagnosis is essential to initiate the appropriate treatment and alleviate the symptoms effectively.
Importance of mastitis prevention
Preventing mastitis is crucial for the well-being of both mother and baby. Mastitis can disrupt breastfeeding patterns, leading to inadequate milk transfer and potential early weaning. It can also cause severe pain and discomfort for the mother, making breastfeeding a challenging and stressful experience. By focusing on mastitis prevention, you can ensure a successful and enjoyable breastfeeding journey, promote a healthy bond with your baby, and avoid unnecessary pain and complications.
Treatment options for mastitis
If mastitis occurs, early treatment is essential to prevent complications. Treatment options may include:
- Antibiotics: In cases of bacterial mastitis, antibiotics are typically prescribed to fight the infection. It is important to complete the full course of antibiotics as directed by your healthcare provider
- Self-care measures to relieve symptoms: Applying warm compresses, massaging the breast, and taking over-the-counter pain relievers like ibuprofen can help alleviate pain and discomfort
- Continuing to breastfeed or pump during treatment: Contrary to popular belief, breastfeeding or pumping milk frequently is essential to maintain milk production and prevent further complications
Tips for mastitis prevention
- Establishing a good latch and proper positioning: Achieving a proper latch and positioning during breastfeeding is key to preventing mastitis. Ensure your baby's mouth covers a significant portion of the areola, with their lips flanged outwards. Seek guidance from a lactation consultant if you're having difficulties
- Ensuring complete emptying of the breast during feeds: Allow your baby to nurse on one breast until they have finished or become less interested before offering the other breast. This ensures proper drainage and reduces the risk of engorgement and blocked milk ducts
- Maintaining good breast hygiene: Keep your breasts clean by washing them with warm water daily. Avoid using harsh soaps or lotions that can dry out the skin and cause nipple cracking. After feeding, allow your nipples to air dry before covering them
- Avoiding restrictive clothing and tight bras: Opt for loose-fitting clothing and bras that provide proper support without compressing the breasts. Restrictive clothing and tight bras can impede milk flow and increase the risk of clogged ducts
- Managing engorgement: When the breasts become overly full and firm, it can increase the likelihood of mastitis. Apply warm compresses or take a warm shower before nursing to encourage milk flow and alleviate engorgement2
- Pain relief: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain and reduce inflammation associated with mastitis. Always follow the recommended dosage and consult your healthcare provider if you have any concerns or medical conditions that may interact with these medications3
- Using breast compresses and warm showers: Applying warm compresses to the affected breast and taking warm showers can help alleviate discomfort and promote milk flow. Gentle massaging of the breast while in the shower can also aid in milk duct drainage
- Rest and hydration: Getting plenty of rest and staying well-hydrated can support your body's healing process and improve overall well-being
When should I seek medical help if I suspect mastitis?
You should see a doctor in the following situations related to mastitis:
- Lack of improvement after home treatment: If your symptoms do not improve within 12 to 24 hours after trying home remedies such as warm compresses, proper breast drainage, and rest, it's essential to seek medical attention
- Symptoms persist after antibiotics: If you have been prescribed antibiotics for mastitis and your symptoms do not improve within 48 hours of starting the treatment, it's crucial to consult a healthcare provider
- Mastitis without breastfeeding: If you develop mastitis despite not breastfeeding or pumping milk, it may indicate an underlying issue. A medical evaluation is necessary to determine the cause and provide appropriate treatment
Can I continue breastfeeding if I have mastitis?
Yes, it is generally safe and recommended to continue breastfeeding if you have mastitis. Frequent breastfeeding or pumping helps maintain milk supply and promotes proper drainage of the affected breast. Frequent breastfeeding or pumping can help alleviate symptoms and promote healing by ensuring adequate milk drainage.
Will antibiotics for mastitis harm my baby through breast milk?
Generally, antibiotics prescribed for mastitis are considered safe for breastfeeding mothers and their babies. Healthcare providers typically prescribe antibiotics that are compatible with breastfeeding to ensure your baby's safety.
Mastitis can be a challenging ordeal for breastfeeding mothers, but by being aware, taking preventive actions, and promptly identifying the initial symptoms of mastitis, you can significantly reduce the likelihood of encountering mastitis. Remember to focus on establishing a good latch, maintaining proper breast hygiene, managing engorgement, and seeking medical help promptly when needed. Seek support from lactation consultants, healthcare professionals, and breastfeeding support groups to ensure a successful and joyful breastfeeding journey.
- Amir, Lisa H. “ABM Clinical Protocol #4: Mastitis, Revised March 2014.” Breastfeeding Medicine, vol. 9, no. 5, June 2014, pp. 239–43. PubMed Central, https://doi.org/10.1089/bfm.2014.9984.
- Zakarija-Grkovic, Irena, and Fiona Stewart. “Treatments for Breast Engorgement during Lactation.” The Cochrane Database of Systematic Reviews, vol. 9, no. 9, Sept. 2020, p. CD006946. PubMed, https://doi.org/10.1002/14651858.CD006946.pub4.
- Pevzner, Miri, and Arik Dahan. “Mastitis While Breastfeeding: Prevention, the Importance of Proper Treatment, and Potential Complications.” Journal of Clinical Medicine, vol. 9, no. 8, July 2020, p. 2328. PubMed Central, https://doi.org/10.3390/jcm9082328.