Identifying and Managing Mastitis

Breastfeeding is a joyful and a beautiful experience for every mother. It allows you and your child to bond and provides a sense of satisfaction of doing the best for your baby. But what if this overwhelming experience is interrupted by painful, inflamed breasts. This condition is termed as mastitis – it can be uncomfortable and agonizing for the mother.

Mastitis is an inflammation of the breast tissue, which may or may not involve an infection. The inflammation results in pain, swelling, redness, and warmth in one breast. It may also cause fever and chills. Mastitis occurs frequently in women who are breastfeeding (lactation mastitis), particularly during the first 6-12 weeks. It can also occur in men and women who aren’t breastfeeding.

Mastitis in nursing mothers may occur when the milk is trapped due to a blocked milk duct or problematic breastfeeding technique. Incomplete emptying of the breast can cause one of your milk ducts to become clogged. This blockage causes the milk to back up, and allows the bacteria to grow in stagnant milk, leading to breast infection.

Bacteria can enter your breasts from your skin’s and/or baby’s mouth, through a crack in the skin of the nipple region or a milk duct opening. Stagnant milk that is not emptied completely is a breeding ground for the bacteria.

How can I identify mastitis?

Usually, mastitis affects only one breast and the symptoms appear quickly. The characteristic symptom of mastitis is inflammation. Other symptoms include:

• Breast tenderness
• Warm to touch
• A lump in the breast
• Thickening of breast tissue
• Pain or burning sensation constantly or while breastfeeding
• Redness, often in a wedge-shaped pattern
• Fever of 101 F (38.3 C) or more
• Body aches
• Fatigue
• Abscess
• Headaches
• Nausea and vomiting
• Nipple discharge

You must seek medical help if these symptoms are getting worse. A detailed medical history would be taken and a physical examination would be done. If you are breastfeeding, a culture of your breast milk will help determine the best suited antibiotic, particularly in case of severe infection.

Your doctor may suggest a mammogram or ultrasound to rule out breast cancer and other breast conditions, especially if you are not breastfeeding. A biopsy may be recommended if the symptoms persist despite completing the course of antibiotics.

How to manage mastitis?

Breastfeeding is safe even if you have mastitis; it helps to clear the infection. The infection will not harm the baby. If you wean your baby abruptly, your symptoms may worsen. However, breastfeeding should be avoided if an abscess is present.

Your doctor may prescribe oral antibiotics for treating mastitis. Often the infection clears in 10 days but may last up to three weeks. Sometimes, mastitis does not require any medical treatment.

Here are some tips to relieve pain and inflammation:

• Apply a warm compress to the affected breast before and after feedings. A warm bath may also help.
• If heat is not effective, apply ice packs after feeding for some comfort and relief. Do not use ice packs before breastfeeding, as it can slow down the milk flow.
• Breastfeed every two hours or more frequently, so that the milk flows through the milk ducts. If required, use a breast pump between feedings.
• Gently massage in a circular motion, begin at the outside of the affected area and work towards the nipple.
• Have at least 10 glasses of water a day.
• Have well-balanced meals. Add about 500 extra calories a day while breastfeeding.
• Wear a supportive bra that doesn’t compress the breast.
• Rest as much as possible.

You may be referred to a lactation consultant for help. The consultant may recommend the following ways to adjust your breastfeeding techniques:

• Avoid prolonged overfilling of milk in your breast before breastfeeding.
• Ensure that your baby latches on correctly, as it can be difficult when the breast is engorged.
• Make sure that your breast is emptied completely while breastfeeding. Apply a warm compress to the breastfeeding or pumping, if you have trouble emptying.
• Breastfeed on the affected side first, when your baby is hungry and is sucking more strongly.
• Vary your breastfeeding positions.

Allow your nipples to dry out after breast feeding, and don’t wear tight-fitting bras or nursing pads that keep the nipples moist. These measures may help lower the chances of getting mastitis.

Although mastitis is a painful condition, it does not cause any long-term problems. Mastitis can be managed by some home measures and antibiotics (in case of severe conditions). During mastitis, you may produce less milk as your body fights off the infection. However, milk production increases once you start to feel better. Visit your healthcare provider after completing the treatment to make sure that the infection has gone away.