Mastitis. It's the dreaded breast infection that, at best can leave you shivery and aching with a burning hot boob that is agonising to feed from and, at worst, in hospital hooked up to an IV. Eeeeek!
There's no getting around it; mastitis is nasty. The correct management and treatment of the infection (and knowing how to prevent it occurring) is super important for breastfeeding mamas who want to stay well and avoid the burning boob for the duration of their breastfeeding journey.
What causes mastitis?
Mastitis is usually the result of a blocked milk duct that hasn't been cleared properly. This means that some of the milk caught behind the blockage is pushed into nearby breast tissue, causing the tissue to become inflamed. This can then result in an infection in the breast that requires antibiotics to be treated.
How do I know if I have mastitis?
The short answer? You'll feel awful! Many women will start to feel shivery and achy like they are getting a cold or the flu. You may not notice a distinct blockage immediately but your breast will soon become super sore, almost too tender to touch. It may also be swollen with red streaks and feel very hot to the touch. Mastitis can come on very, very quickly and leave you feeling like you've been hit by a truck, repeatedly.
If the early signs of mastitis are picked up, it can sometimes be eradicated without the need for antibiotics BUT this isn't always the case. If symptoms have been ongoing for more than a couple of hours without any improvement or if you're feeling extremely unwell, you will need to see a doctor ASAP. Experts also advise heading to your local hospital if you're unable to see a doctor as mastitis can become extremely serious in a short space of time and prompt treatment is essential.
Signs of Mastitis
- Breast swelling
- Skin redness
- Burning sensation
What should I do if I think I'm developing mastitis?
The most important thing to do if you believe you are developing mastitis is to keep feeding and/or pumping! It can be very, very tempting to stop feeding off the sore breast BUT doing so will only make the blockage worse and increase your chances of developing full blown mastitis.
It is super important to start treatment as soon as you notice symptoms. Sometimes, you may notice a lump or blockage but feel a-ok. It is still important to clear the blockage as soon as possible to prevent it becoming worse.
- Drain the breast as often as possible - Feeding and/or pumping is essential for clearing a blockage. Start each feed on the sore side as your baby will suck more effectively when hungry. Keep them on that side until the breast has emptied and feels softer. This can be tricky to achieve, especially with a younger baby and if you feel that your breast is still full, you may need to use a breast pump after feeding.
- Use heat and cold packs - There are ways you can help your breast to empty more effectively, including using heat and cold packs during and after feeds (we love the Lactivate Ice and Heat packs) . Applying heat to your breast just before you feed can encourage your letdown and milk flow while a cold pack applied to your sore spot or lump after/between feeding can relieve some of the inflammation and swelling.
- Gentle massage - Gentle massage can help to shift blockages and keep your milk moving. Experts recommend massaging the lump itself and gently 'pushing' towards the nipple while feeding. You can combine this with heat and can use your hand or LaVie Lactation Massager which uses gentle vibration to break up lumps, blockages and clogs.
- Changing feeding positions - Shifting feeding positions can sometimes help to shift blockages as it puts pressure on different parts of the breast tissue. Angling your bubs nose towards the lump or trying dangle feeding, where gravity helps in moving milk forwards can be helpful for stubborn blockages. See a demonstration of dangle feeding below.
- Check your nipples - Sometimes, blockages and mastitis can be caused by a nipple bleb or blister. These little white dots on the nipple are caused by a blocked nipple pore, the result of thickened milk getting trapped or skin growing over the pore. Often, if you can remove the bleb, the blockage will follow.
- Use your Haakaa - Your Haakaa breast pump can be an extremely useful tool for helping to clear blockages and blebs, especially when used in conjunction with Epsom Salts. All you need to do is fill your Haakaa with warm water, add 1 tbsp epsom salt and attach. The combination of heat, the salts and suction will work to remove the clog. You may have to repeat a couple of times, depending on the size of the clog.
- Rest, rest, rest - Your body needs rest. Easier said than done, we know! But if you can hop into bed with your baby, do it! The more time you can spend topless, lying down and feeding, the better chance you'll have of getting better. Do whatever you need to do to stay off your feet and call in as much help as you can so that you're able to focus on recovering.
- Seek medical advice - If you feel that your symptoms are not improving or feel extremely unwell, see your doctor or visit emergency as you may need antibiotics. Mastitis can progress very quickly and advanced cases can need aggressive treatment so it's always a good idea to seek medical advice.
How can I prevent mastitis from occurring?
Some women may breastfeed for months/years without a single incidence of mastitis, where as others may find that they develop it regularly (which is just not fair!). While there is no proven way to 100% prevent mastitis from occurring, there are various strategies that can help, especially if you seem to be prone to developing blockages and/or infections in your breast.
The most important thing to consider is whether your baby is latched well to the breast and transferring milk. A baby who isn't properly attached will struggle to drain the breast effectively which can lead to a multitude of issues, including blocked ducts and mastitis. If you've having trouble with your bubs attachment, it's important to seek help from a lactation consultant who will be able to support you in achieving successful breastfeeding.
If your baby is latching and feeding well, you've crossed the first hurdle! It's still important however to keep an eye on your boobs during and after a feed. If they feel unusually full (if, for example, your baby sleeps for longer than usual) or you notice any damage to your nipples (blebs, grazes or irritation from teething), make sure you treat it straight away. Hand expressing or gentle pumping combined with massage can help relieve any engorgement, and keeping grazes and blebs clear and clean can prevent them from developing further.
Some women also find that a lecithin supplement can help in preventing blockages and mastitis. Lecithin helps decrease the viscosity AKA stickiness of your milk meaning that it may not get 'stuck' as easily. Breastfeeding specific probiotics, like Qiara, have also been found to be helpful.
As with the majority of breastfeeding issues, speaking with and seeking support from an experienced lactation consultant/IBCLC is the best way to manage any problems you might be having.
For more information on mastitis and the products that can help treat and prevent it, check out our Mastitis & Blocked Duct Breastfeeding Concern Section.