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What is mastitis and how can it be treated?

If a blocked duct is not treated in time, inflammation may occur in that part of the breast. This becomes painful and inflamed and one may develop a high fever. It can be accompanied by a cold, shivery feeling or by a bad headache and general body pain. Mothers often think they have the "flu", but have no sore throat.

The symptoms are caused by inflammation rather than an infection. In most cases the inflammation is in the tissue between the milk lobes and not in the milk ducts. As the milk itself is not affected, it is not necessary to stop breastfeeding.

The following treatment can be useful to relieve the condition:

• Continue to breastfeed your baby. It is perfectly safe, even if you need antibiotics. It is a common myth that it is unhealthy for the baby to breastfeed when the mother has a breast infection. This is definitely not true.
• It is most important to feed the baby frequently on the affected side to keep the ducts and lobes as clear as possible. Start feeds on the affected side for at least 24 hours or until the condition has cleared.
• Apply heat to the affected side e.g. with warm cloths or in a bath.
• Express on the second side to relieve any discomfort if necessary.
• Apply cold packs or cabbage leaves over the affected area to relief pain.
• Drink plenty of clear fluids and get plenty of rest.
• If you have a fever consult your doctor, antibiotics may be prescribed.
• The pain can be relieved and the fever and inflammation reduced by taking a safe painkiller four-hourly for 24 hours. Please consult your pharmacist.
• Vary your feeding positions.
• Should your doctor advise you to stop breastfeeding temporarily, or should feeding be too painful, it is imperative to empty the breasts frequently by expressing the milk manually or with a breast pump.

There is much that you can do to prevent mastitis from re-occurring:

• It is accepted practice to have a double length course of antibiotics when mastitis is diagnosed.
• Avoid sudden long stretches between breastfeeds. Do not delay or miss feeds, but if you do, or if the baby breastfeeds poorly, hand express or pump to soften the breasts and relieve fullness.
• Treat damaged nipples as soon as they occur.
• A poorly fitting bra, or a bra that constricts (such as an under-wire bra) may contribute to blocked ducts, which can lead to infection.
• The best way to avoid mastitis is to get plenty of rest and eat a healthy, balanced diet while you're nursing. The more run down you are, the more susceptible to infection you become.
• To avoid the getting mastitis should the symptoms reoccur, keep the breast empty by the methods mentioned above and if no fever sets in you are unlikely to need antibiotics.

If you have recurrent breast infections, some of the following might be a factor:

• Cigarette smoking can contribute to lowered resistance to infection. In addition, it can inhibit let-down. This may result in repeated breast infections as milk “pools” in the breast.
• An overabundant milk supply can prevent baby from completely emptying the breast. Allow baby to finish the first breast before offering the second breast. If your breasts feel uncomfortably full, express just enough to relieve the fullness.
• If either nipple is sore, cracked or bleeding, this can be a point of entry for infection. If sore nipples are a recurrent problem, seek help from a lactation consultant or breastfeeding expert.
• Nipple shields can slow the milk flow and encourage infection. Use of dummies and bottle feeding can affect how baby sucks and contribute to nipple soreness, which can develop into mastitis.
• Another area to check when researching recurrent breast infections is your sleeping position. It may help if you vary your position. If a breast is under pressure for too long, the ducts in that area may not be able to allow the milk to flow freely.