Mastitis is the word no breastfeeding mother wants to hear.
Anyone who has suffered mastitis will know it’s an awful experience that can leave a mother in pain, feeling unwell, and very, very tired.
Breastfeeding when you have mastitis can become extremely painful and many mothers find it hard to continue.
Fortunately, with the right guidance and support, mastitis can be quickly overcome and you can be back on your breastfeeding journey in no time.
Let’s dive in and discover the facts about mastitis, it symptoms and treatments, and what it means for you and your little one.
What is mastitis?
Mastitis is inflammation of the mammary glands in the breast and surrounding tissue. The symptoms causing the inflammation might or might not be due to infection.
It can affect men, women, and even children, although commonly it affects breastfeeding women. In this instance, it’s also known as ‘lactation mastitis’.
Non-infective mastitis is when the inflammation is caused by stress on the breast tissue, such as blocked ducts.
If left long enough without immediate management it can lead to infective mastitis, where breast infection sets in within the breast tissue and causes inflammation.
Symptoms of mastitis can appear in one or both breasts, and can occur at any stage during a mother’s breastfeeding journey. Research shows it tends to appear after the milk has come in, during the first few weeks after birth.
Signs and symptoms of breast infections usually come on quite suddenly. If you have a blocked milk duct, you might feel, or see:
- A tender hard lump in your breast tissue
- That the lump is warm to touch
- A patch of redness on the overlying skin
- Intense pain in the affected area, especially when your let-down reflex occurs
- Very tired and run-down
- Nipple pain
- Breast engorgement
- Aching muscles
- Possible nausea
- Fever, with a temperature of 38.5C or more.
What are the causes of mastitis?
There are two main causes of mastitis:
- Milk stasis, when breastmilk is not moving freely through the milk ducts and causes a blocked duct
- Bacteria, most commonly Staphylococcus aureus.
Milk stasis most commonly causes mastitis as breast milk cannot be removed and a blockage in the milk ducts occurs.
These are the risk factors that can cause blockages:
- Your baby doesn’t attach optimally to your breast
- Your baby doesn’t drain your breast well (e.g. due to a tongue-tie)
- Breastfeeds are restricted (e.g. you feed according to a schedule)
- You have an oversupply
- You have a milk blister on your nipple at the milk duct opening.
If mastitis is reoccurring, your breastfeeding technique might need to be checked by someone who specializes in breastfeeding, such as a lactation consultant.
Can I keep breastfeeding if I have mastitis?
Yes, you definitely can.
Mothers are often told to stop breastfeeding straight away until they feel better. This advice is very unhelpful and can make mastitis even worse.
It’s perfectly safe, and important, to keep feeding your baby from the affected breast. Even if you have infective mastitis and need antibiotics, it’s still safe, and important, to keep feeding from the breast.
Reach out for help from a breastfeeding support service such as The Australian Breastfeeding Association or La Leche League. They will help you with breastfeeding positions.
How do you unclog a milk duct fast?
Blockages occur in your milk duct for different reasons and, if they are dealt with quickly, they can be resolved before infection kicks in.
As soon as you feel symptoms of mastitis such as a blockage, a red spot on your breast, or feeling unwell, try the following:
- Cancel plans and rest as much as possible, focusing on you and your little one
- Stay calm and relaxed to help your milk flow easily
- Use a warm compress on the affected side for a short time before the feed to help the milk flow
- Feed your baby on the affected side as much as possible to keep the milk flowing
- Make sure your little one is well latched so he can remove milk effectively
- With your thumb or finger, gently compress or massage the lump towards the nipple, to help move the milk through
- Consider changing breastfeeding position to focus on the trouble spot
- If you can’t breastfeed, use your hand or a pump to express so your breast is well emptied
- Use cold compresses, 20 minutes on and 20 mins off, between feeds to help with the pain and inflammation.
It’s best to continue feeding as much as possible to help reduce symptoms of mastitis, to keep your breast milk flowing, and to maintain your supply.
For more ideas about optimal breastfeeding, techniques speak with your healthcare provider or an Australian Breastfeeding Association (ABA) counselor or see an International Board Certified Lactation Consultant (IBCLC).
If your symptoms become worse and you find first-line treatment for mastitis doesn’t ease your discomfort, you’ll need to reach out to your health care provider or doctor for more help.
It can be difficult even for your doctor to tell if your mastitis has become infective. Treatment with antibiotics will be required to kill harmful bacteria, and your doctor is the best person to see for help.
For some women, mastitis can be so severe a doctor might recommend hospital admission to help reduce serious symptoms if normal methods don’t help.
It’s important to see a doctor or healthcare provider if you have any of the following signs of infection:
- Flu-like symptoms (e.g. muscle aches, fever, chills, fatigue)
- Sore or cracked nipples with signs of infection (e.g. your nipple might be red and hot to touch, and thick, yellow pus might be present)
- Presence of pus or blood in your breastmilk
- Sudden and severe symptoms
- A lump in your breast has not cleared within 24 hours.
What can happen if mastitis is left untreated?
Although uncommon, if left untreated, mastitis can turn into a breast abscess that will cause further pain and illness for a mother.
Breast abscesses need to be drained by a trained doctor, usually under local anesthetic, in hospital.
Rarely, inflammatory breast cancer can have symptoms similar to mastitis. If your symptoms aren’t relieved by mastitis treatment, speak with your doctor.
How to prevent mastitis from occurring
Unfortunately, mastitis can reoccur and it’s important to focus on prevention to avoid painful bouts of mastitis.
You can focus on the following tips:
- Avoid skipping some feeds
- Continue breastfeeding your baby on demand
- Avoid giving your baby other forms of nutrition in the first 6 months (exclusive breastfeeding)
- Make sure you’re attaching and positioning your baby well at the breast so the ducts can be drained effectively
- Offer your baby both breasts equally, alternating the side you start on, to drain the ducts equally
- Avoid becoming overfull or expressing excessively, so as not to create an overproduction of milk
- Keep a close eye on your nipples when breastfeeding to ensure the skin or surrounding area don’t become damaged and increase the risk of bacteria infecting the ducts
- Avoid tight, restrictive clothing around the breast area to reduce the risk of creating a blockage that causes mastitis
- Rest whenever possible to ensure you do not become overtired and stressed.
Can probiotics help with mastitis?
The use of probiotics for the prevention and treatment of mastitis and breast pain is widespread amongst many health professionals, from doctors to IBCLCs.
At this stage, there’s insufficient evidence about the use of probiotics for the treatment or prevention of mastitis. Although some studies were promising, the evidence wasn’t significant enough to recommend the use of probiotics.
If you’d like to take probiotics, that’s totally up to you. Bear in mind, each individual strain of probiotics has its own function in the body.
You can also consider dietary measures to boost your immune system.
Drink plenty of water, and make sure your diet contains a range of healthy foods, including lean protein, vegetables (in a variety of colors), green leafy salads, good fats (coconut oil, olive oil, avocado, egg, fish, etc), nuts and seeds.
Check out Healthy Breakfast – 13 Delicious and Healthy Breakfast Ideas for some tips to start your day on a healthy note.
Can mastitis dry up milk supply?
The pain, stress, and inflammation of mastitis can have an impact on a mother’s supply.
Interruption to the feeding process and ineffective milk removal can indicate to the body the breasts are too full and therefore should slow down production.
With the right support, though, this can be a temporary problem, and quickly fixed.
Seek the support of a lactation consultant to help you maintain your milk supply rather than suffer in silence.
Does mastitis affect baby?
Babies might also be a bit fussier with breastfeeds from the affected breast. This can be because:
- The milk tastes saltier
- Milk supply drops
- It might be more difficult for your baby to get the milk out.
Even if you’ve been prescribed antibiotics to help kill bacteria and infection in your milk ducts, you can still feed your baby, as the antibiotics are safe.
Demand feeding your baby at the breast whenever he needs to be fed keeps the breast milk flowing to meet your little one’s needs. Be sure to read Baby Hunger Cues | How To Tell Your Baby Is Hungry.
Women’s bodies and breasts are pretty amazing and can usually balance out well when there’s a problem on one side. The other breast can boost supply while the affected breast recovers, to make sure there is plenty of breast milk for your baby.
Once the mastitis resolves, your baby might want to feed more frequently; this will help boost your supply back up again, meeting your baby’s needs perfectly.
If you find your supply is struggling to get back to where it was before the mastitis, speak with the ABA or a lactation consultant, or call your doctor for more ideas.