While breastmilk is a complete form of nutrition that naturally contains the vitamins and minerals a newborn needs, breastfeeding can come with challenges as well as benefits.

One of the most common conditions which can occur for mothers who choose to breastfeed is mastitis.

Ahead of World Breastfeeding Awareness Week on 1st – 7th August, Eilis Mackie, Lead for Lactation and Infant Feeding at The Portland Hospital, shares her expertise and advice for mothers about mastitis.

What is mastitis?

Mastitis is an inflammation of breast tissue, usually caused by an infection. It is a common condition which mainly affects women who are breastfeeding.

The inflammation results in breast pain, swelling, warmth and redness. Some people might also experience flu-like symptoms.

Mastitis is very treatable and unlikely to cause further complications, however, it is important to know which signs and symptoms to look out for and when to seek treatment.

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Who does it affect and what are the risk factors?

Mastitis most commonly affects women who are breastfeeding (lactation mastitis).  It often happens during the first 6-12 weeks of breastfeeding.  However, mastitis can also occur in women who are not breastfeeding and in men – although this is far more uncommon.

Mastitis is typically caused by bacteria that enters your breast through a milk duct opening or a crack in the nipple.  Bacteria can come from the skin or from your baby’s mouth.

An infection is more likely to happen if milk is trapped in the breast as the milk provides a good environment for bacteria to grow.  Sometimes a milk duct can get blocked, causing milk to back up in the breast and lead to trapped milk in the breast.

You may also be at higher risk of developing mastitis if you:

  • Have sore or cracked nipples: this can increase the chances of bacteria entering the breast. If you find that your nipples start to crack, it’s important to get help from your midwife or medical expert as soon as possible as they can help advise what’s best to do.
  • Wear a tight-fitting bra or put pressure on your breasts: this can restrict milk flow
  • Use only one position to breastfeed: using different positions can help make sure you completely drain the breast and prevent trapped milk.

Preventing Mastitis:

To help avoid complications such as mastitis, consider meeting with a lactation specialist.

A lactation specialist can provide expert tips and provide invaluable advice for proper breastfeeding techniques.

You can help prevent your chances of developing mastitis by avoiding the risk factors outlined in the section above.  Additionally, here are some breastfeeding techniques which might also help lower your risk of mastitis:

  • Your baby should latch onto the nipple with his or her mouth open wide covering the nipple
  • Allow your baby to empty one breast before switching to the other breast when possible
  • If you need to stop feeding, break the suction using your finger
  • Change the position you use to breast-feed from one feeding to the next.
  • Air your nipples out when possible

Signs and symptoms of mastitis:

Signs and symptoms of mastitis can appear suddenly and include the following:

  • Breast tenderness or warmth to the touch
  • Breast inflammation
  • Redness on the breast and nipple, often appearing in a wedge shape
  • Pain and discomfort when breastfeeding
  • Thickening of breast tissue, or a breast lump
  • Generally feeling ill and rundown
  • Running a high temperature
  • Nipple discharge which may be white or contain slight traces of blood

If you have any of the symptoms above, speak to your midwife, lactation consultant or doctor for advice and they will be able to help.

Treatment:

Sometimes mastitis goes away on its own.  However, if you notice you have symptoms of mastitis, and you don’t start feeling better 24 hours or you feel they are getting worse, it is important you seek medical advice.

The most common treatment for mastitis is taking antibiotics to help clear up the infection.  You should start to feel better within a few days of taking medication, but always make sure to take the full course of antibiotics your doctor prescribes to prevent antibiotic resistance.

To alleviate symptoms, you can take over-the-counter pain relief medication such as ibuprofen and paracetamol.  Warm baths or showers will also help reduce the pain and having plenty of rest and fluids will also speed up recovery.

We advise women to continue breastfeeding when they have mastitis unless told otherwise by their doctor.  Your breast milk may contain traces of antibiotic; however, it is not bad for your baby and it is completely safe to continue nursing. In fact, if you stop breastfeeding the existing bacteria could further spread in the milk that is left in your breast, potentially prolonging the infection.

If left without treatment, the infection can cause an abscess to develop, forming a mass of pus in your breast.  Abscesses are usually painful and normally require surgical draining.

Mastitis is very treatable, particularly if you seek medical advice early on, so it is always best to speak to your GP or a lactation specialist early on.

Article by Eilis Mackie, Lead for Lactation and Infant Feeding at The Portland Hospital, part of HCA UK.

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