Mastitis is an inflammation of breast tissue, which can both be painful and result in an infection.
It’s typical for breastfeeding women, but anyone can get mastitis.
What is mastitis?
Kala Shepherd, a certified nurse practitioner at Sanford Health in Chamberlain, South Dakota, said it’s important to tell the difference between an engorgement, when both breasts are full, and a clogged duct, when one breast is full.
“Engorgement can be when the breasts are full, or when you’re initially coming into your milk after having a baby, your breast can become engorged. If it’s not relieved, it can transition to a clogged duct in which milk is just sitting in the duct – which creates some inflammation,” she explained.
If engorgement is caught early, it’s more treatable and won’t require medication.
“Treatments would include expressing milk, massaging the breasts, taking things like ibuprofen and Tylenol, cool compresses can also help.
“If it doesn’t resolve from that standpoint, that’s where we’re getting into more of the mastitis component – where there is actually an infection probably developing in one of those glands or milk ducts,” Shepherd said.
What causes mastitis?
Mastitis is most common in the first three months of breastfeeding and can affect any breastfeeding woman.
Shepherd said there is a risk of recurrence with mastitis.
“If you’ve had mastitis before, you’re certainly more at risk of having it again from either being incompletely treated, or maybe you’re an overabundant milk supplier. Those women tend to be at higher risk because they’re not often completely emptying,” she said.
Shepherd said other risk factors for mastitis include:
- Weaning (switching a baby from breastmilk to whole foods and drinks) too rapidly
- Not expressing the milk
- Ineffective latch which can crack the nipple, allowing bacteria to get in
- Not breastfeeding or pumping enough
Mastitis symptoms and treatment
Shepherd explained when a clogged duct has progressed to mastitis, you will generally know because you feel very ill.
“When a patient has done all the supportive measures, like pumping, feeding, taking ibuprofen/Tylenol, and she’s now sick, that’s the point when it’s time to seek care,” she said.
“Fever, chills, malaise, nausea sometimes. We’ve also seen where the breast starts to feel warm to the touch. It’s generally unilateral (in one breast). At that point is when a woman really knows it’s time to seek treatment.”
Your provider might prescribe antibiotics that are safe to take while breastfeeding. You also might see a lactation consultant because mastitis treatment includes changing breastfeeding positions and emptying the affected breast.
If you are nursing in the same position repeatedly, you may not be emptying out all of the ducts from different areas of the breast. Shepherd said rotating the baby’s position can be helpful, especially if you tend to produce more milk on one side.
“That’s one of the first things we recommend if someone has a clogged duct: Start feeding on that side to have a better chance of emptying when the suck is a little more aggressive. Pumping a little bit at the end of the feeding can also help make sure you’re really fully emptying,” she said.
If a patient with mastitis is not breastfeeding, Shepherd recommends using a pump to clear out the ducts.
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