What is mastitis and how to deal with it?

Signs and symptoms of mastitis, or inflammation of the mammary gland, can appear suddenly and can always come back. Keeping your body warm and avoiding cold/drafts and making sure your breasts are properly drained/pumped can help keep mastitis at bay.

What may be the symptoms:

• Breasts become tender

• Breast swelling

• Thickening of the breast tissue or you may feel clear lumps when touching the breast

• Constant pain or burning sensation while breastfeeding

• Redness of the skin in the problem area

• Feeling like you're going to get sick, symptoms like the flu or a cold. You may sweat a lot or feel chills and may have a fever of 38.3 C and above.

Reasons

Milk left in the breasts is the main cause of mastitis, or inflammation of the mammary gland. If the baby does not take to the breast or the breasts are not completely empty and milk accumulates in the breast the milk duct can become blocked.

Another cause of mastitis is bacteria that have easy access from the surface of your skin, and bacteria from the baby's mouth can enter the milk ducts through cracks in the skin of the nipple or through the opening of the milk duct. Stagnant milk in the breast, which is not emptied, provides a favourable breeding ground for bacteria.

Risk factors for mastitis include:

• Previous mastitis during breastfeeding

• Sore or cracked nipples (although mastitis can develop without a broken, split nipple)

• When using a seat belt (by this we mean prolonged use for many hours) or carrying a heavy bag, wearing a tight bra or putting pressure on the breast, which can restrict the flow of milk.

• Insufficient breast care

• Tiredness or stress [for the mother]

• Poor nutrition

• Smoking

Complications

Mastitis/inflammation of the breast that is not treated adequately or is due to a blocked duct can cause pus (abscess) to form in the breast. An abscess usually requires surgical intervention. To avoid this complication, talk to your doctor as soon as you develop signs or symptoms of mastitis/breast inflammation. The doctor may prescribe a course of antibiotics.

Prevention

In order to get breastfeeding and techniques right at the very beginning, it is worth consulting with a lactation consultant who will talk about and show various breastfeeding techniques, which can be of invaluable help to you.

Tips with which you can already start dealing with mastitis at home (techniques that I use for my clients):

• Place a chilled cabbage leaf (i.e. from the fridge) on the chest and change it after every feed.

• Take a shower at least 3-4 times a day and massage your breasts in circular motions from the top of the neck down to the nipple.

• Take a pain killer such as Paracetamol or Ibuprofen every six hours for the first three days (as per NHS advice, do not take aspirin while breastfeeding).

• Avoid wearing a standard bra, for example make a bra out of a large muslin/gauze cloth so that the cabbage leaves can be on the chest. The picture shows a gauze bra, where the gauze is large enough to extend around the body, crossed in front of the chest and tied it at the back of the neck.

• Make sure that the breasts are empty of milk (breasts must be completely soft to the touch) and I recommend getting a good electric breast pump to use for pumping between feedings. If you use a breast pump, I recommend massaging the breast at the same time to get all the milk properly. Feel free to ask me more information about the breast pumps, which one I recommend and how to use it.

• During breastfeeding, empty the milk from the breasts completely, starting with the problem breast.

• Before switching to the other breast during breastfeeding, let the baby feed from one breast until completely empty. Change the breastfeeding position every time a new meal begins.

• Make sure the baby has a good latch/nurse technique.

• Drink plenty of liquids and rest as much as possible.

• If you are a smoker, I recommend that you consult with your doctor about the most effective way to quit smoking.

Please don't hesitate to contact me about any of the topics covered here, or specific breastfeeding techniques.

NB: In case of mastitis, honey should not be applied to the breasts, because honey and nuts are the biggest source of allergies in babies. Even if you wash your breasts repeatedly, the honey has been absorbed into the nipples and breast, and an allergic reaction can have very sad consequences.

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