Desert Storks

Breastfeeding-Dealing with Mastitis

Mastitis means inflammation of the breast. It can be caused by blocked milk ducts (non-infective mastitis) or a bacterial infection (infective mastitis). If a blocked milk duct is not cleared, flu-like symptoms such as fever, aches and pains will probably develop. Milk duct blockages cause milk to pool in the breast. This forms an ideal environment for bacteria growth and can lead to an infection.

Symptoms
Blocked milk ducts (‘non-infective mastitis’) can cause the breast, or parts of the breast, to become:

Tender or painful
Reddened
Hard.
When mastitis is caused by a bacterial infection (‘infective mastitis’):
The breast becomes red, swollen, hot and painful.
The skin may appear tight and shiny, and be streaked with red.
You feel very ill (‘fluey’) and have a high temperature (over 38 degrees Celsius)

How mastitis develops
Factors that predispose a woman to blocked milk ducts include:
Poor drainage of the breast – this can be caused by poor attachment of the baby at the breast or limiting the baby’s time at the breast.
Engorgement of the breast due to a missed feed or delaying a feed.
A tight or ill-fitting bra, or consistently lying in one position during sleep.
Holding the breast too tightly during feeding.
Trauma such as a kick from a toddler or pressure from a seatbelt.
Infective mastitis occurs when there is overgrowth of bacteria in the breast, which the body is unable to fight. Factors that predispose a woman to infective mastitis include:
Poor physical health
Nipple trauma caused by incorrect attachment of the baby during feeds
The use of nipple creams, which can harbour bacteria
An untreated blocked milk duct.
Preventing infective mastitis
To help prevent infective mastitis:
Mothers and midwives should thoroughly wash their hands before touching the breasts after a nappy change.
Make sure the baby is positioned and attached properly on the breast.
Avoid sudden long periods between feeds. Feed frequently.
Wear loose, comfortable clothing. Bras, if worn, should be properly fitted.
Avoid nipple creams, ointments and prolonged use of nipple pads.
Treatment
Measures that can help treat blocked milk ducts include:
The baby feeding well on the affected breast – offering the affected breast first can help.
The application of heat before a feed, gentle massage of the affected area during feeding, and cold packs after a feed for comfort.
A change in feeding position.
Frequent drainage of the breast through feeding and expressing.
If the blockage does not clear within 8 to 12 hours, see your doctor.

Treatment for infective mastitis should begin immediately. You should consult your doctor. Options include:
Continued breastfeeding to drain the breast
Antibiotics, for example flucloxacillin or cephalexin
Anti-inflammatory medication (such as ibuprofen) or analgesia (such as paracetamol), if necessary to relieve pain
Rest and adequate fluid intake
Heat before a feed and cold after
Varying the feeding position to increase breast drainage.
If you wish to stop breastfeeding, it is important to wait until the infection has cleared up. Rapid weaning may lead to a breast abscess.

Where to get help
A lactation consultant
The Australian Breastfeeding Association
Your midwife
Your doctor
Child health nurse
Things to remember
Mastitis is caused by a blocked milk duct or a bacterial infection.
Continued breastfeeding is the most important part of the treatment for mastitis.
See a doctor promptly if your breast is red, hot and tender, doesn’t clear up using the measures outlined above and you feel flu-like symptoms with a temperature.