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Breast feeding with mastitis signs and symptoms
It can be an incredibly painful experience with symptoms ranging from burning hot, sore breasts complete with a razor-blade stabbing sensation in the nipples to fever, chills and all-over body ache. The best cure is prevention so if you can recognise the signs early and act quickly, you’re on the right track.
If early mastitis is fast becoming a problem for you, head to your GP immediately (let the receptionist know that you’ve got mastitis when you make an appointment). You’ll need antibiotics to treat the infection and you must prioritise rest till your symptoms subside.
Mastitis is inflammation of the breast due to nipple damage (cracked or damaged nipples make it easier for bacteria to get in) or blocked milk ducts. Think of your milk ducts as cobwebs or highways – they are an interlaced series of ducts that need to be open and clear.
for the milk to flow freely from the breast to the nipple. If they get clogged, you may notice a lump or an area of engorgement that can be uncomfortable but may go down when you next feed. If it doesn’t subside and starts to feel hot and look red, you can presume that your breast is inflamed and you’re at risk of an infection. In this case, swift treatment is most effective.
New evidence released in 2022 claims that the traditional methods of frequent feeding, expressing if your baby doesn’t drain the breast and vigorous massage is actually doing more harm than good. Instead of placing extra pressure on the inflamed area and encouraging more milk production, you essentially want to give your breasts a break. Recommended treatment includes:
Feed your baby on demand by following their cues. Increased feeding, feeding solely from the affected breast, firm massage or pumping to drain the breast isn’t recommended because it can stimulate hyperlactation (too much milk) which is a significant risk factor for swelling and inflammation. If you are particularly uncomfortable, a small amount of hand expressing to relieve pressure should be fine. Avoid using a breast pump or nipple shields as both can result in inadequate milk extraction from the breast, therefore contributing to further swelling in the breast.
Regular ibuprofen every eight hours will reduce inflammation and pain, and regular paracetamol will assist with pain management.
→ Using ice Applying ice can provide symptomatic relief (frozen peas wrapped in a tea towel work well). → Practising lymphatic drainage This is only recommended for very engorged and swollen breasts. Use gentle and very light strokes from the breast towards the armpit to help release pressure (no firm massage is required). → Taking care of yourself Make sure you stay hydrated by drinking at least 2litres of water throughout the day. Eat well and prioritise immune-boosting foods that nourish and nurture you. And most importantly: rest, rest, rest. That’s an order!
If your symptoms continue to worsen you will need to see your GP as soon as possible. Mastitis is quick to develop and if bacteria is present, it requires oral antibiotics to treat. In severe cases, you may need to be hospitalised and treated with IV antibiotics. You can expect your baby to develop an upset tummy in response to the antibiotics — they may be more colicky for a few days and may develop diarrhea. Keep an eye out for thrush, too.
Some women are more susceptible to mastitis but for anyone currently breastfeeding, active prevention is always a good option. This looks like:
Lactation Consultants of Australia and New Zealand | lcanz.org Australian Breastfeeding Association | breastfeeding.asn.au ABM Protocols | bfmed.org/protocols
Maternal & Child Health Line 24 hour – 13 22 29
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