Mastitis: don’t let it ruin your breastfeeding journey

Fever, chills, and radiating breast pain are just some of the symptoms of mastitis. About 20 percent of lactating women get mastitis, and to make matters worse, it’s most likely to happen in the first six months of breastfeeding — when you’re just starting to get the hang of being a mom and you’re completely sleep deprived. Luckily, with proper support, mastitis is easily curable.

What is mastitis?

Mastitis is a painful inflammation of the breast tissue, which is sometimes accompanied by an infection. Since it occurs most often in breastfeeding women, it can be difficult to distinguish mastitis from a blocked duct. But while a blocked duct can lead to mastitis, the two are quite different — more on this below.

What causes mastitis?

Mastitis is typically caused by a blocked duct or by bacteria getting into the breast (which is often precipitated by a cracked nipple). Blocked ducts occur for a number of reasons, including an irregular breastfeeding schedule or a wonky latch. This is why it happens so often in the immediate postpartum period when newborns’ sleep can be unpredictable and before you’ve gotten the hang of breastfeeding. And because your nipples are often raw during this stage, they can crack and allow bacteria in. Curiously, the biggest risk factor for mastitis is having had it before. So although every baby is different, if you had mastitis with one, you’re more likely to have it again. Mastitis can be extremely painful and causes many women to quit nursing altogether. This, however, can make the condition worse, as breastfeeding actually helps to clear it up.

What are the early signs of mastitis?

Nursing isn’t always comfortable, and run-of-the-mill clogs happen, so mastitis can be easy to miss at first. Pain in one of your breasts, a small lump, redness, or discomfort during nursing are early signs. But these can also be typical when your milk is coming in and you’re just adjusting to nursing. Feeling tired or a bit under the weather are other early signs, but given that you’re dealing with a newborn these are easy to overlook too. Unless you’ve had it before (and even then), it’s possible that you won’t realize you have mastitis until the symptoms become more acute.

Symptoms of mastitis

As if horrible breast pain weren’t enough, there are a number of other symptoms of mastitis including:

• Headache
• Itchiness
• A warm, red patch on the breast
• A hard lump in the breast
• Breast tenderness
• Pain during nursing
• Fever
• Chills
• Headache
• Aches and pains all over the body

I have symptoms of mastitis but I’m not breastfeeding

Although much more unlikely, it’s still possible to get mastitis even if you aren’t breastfeeding. Periductal mastitis, as it’s called, happens when the ducts under the nipple become infected and inflamed. The cause is unknown. The condition usually presents with a mass or hard lump in the breast, as well as discharge (bloody or otherwise); sometimes the nipple retracts (turns inward). This typically occurs in women;  smokers, those with diabetes, and people who are obese are at higher risk. In rare cases, men can also get mastitis. Treatment for periductal mastitis sometimes involves surgery to remove the affected duct, but is typically treated by draining the duct or with antibiotics.

Preventing mastitis

Mastitis prevention can be tricky. In one study, women using nipple cream (and weirdly, papaya-based ones in particular) were more likely to develop mastitis than those who used either a nipple cream without papaya or no nipple cream at all. Given how rough breastfeeding can be on your nipples, however, no one is suggesting that you give up nipple cream. One possible reason to fault the nipple cream, though, is when bacteria gets into the cream from your fingers. Make sure you’re practicing proper sanitation and hand washing. If you use reusable breast pads, replace them when wet, and wash them according to manufacturer guidelines to kill any bacteria. In the event that you develop thrush or mastitis, you should switch to disposable pads until the condition has cleared. 

Wearing tight and restrictive clothing on your chest can increase the risk of developing mastitis. Because breast size can increase dramatically while lactating, it’s a good idea to invest in some new bras (and try to avoid underwire). Other issues such as an improper latch can also increase your likelihood of the condition, so you might want to speak with a lactation consultant if you and baby are having trouble. When you’re weaning, cut down on feeds gradually instead of reducing them suddenly. And finally, always try to avoid engorgement by draining the breast at each feed. You can pump or hand express if your baby doesn’t drain you completely. 

Natural mastitis treatment

In its earliest stages, home treatment of mastitis is often sufficient. At the first sign of a clog, you can use hot compresses on your breast before each nursing session, hand express in a hot shower, or submerge the affected breast in a hot bath and gently massage the mastitis-affected area. And although it can be painful, it’s important that you continue breastfeeding or pumping. Your milk may taste saltier, which may put your child off of nursing on that side but keep trying. If you can’t get baby to drink, you’ll want to pump to ensure the breast is completely drained. By continuing to pump or nurse, you’re both working to clear the infection and maintain your supply. And don’t worry, drinking milk from the affected breast won’t harm your child in any way. You may also want to connect with a lactation consultant (LC), as they can help you find a less painful position to nurse in and teach you how to improve your baby’s latch going forward.

If none of that works, there are two other options: getting an ultrasound treatment on the mastitis-affected breast at a physiotherapy clinic (sound waves help break up the clogs) or enlisting your partner to try sucking it out (this is called the “big baby method”). But it’s important to act fast: mastitis symptoms can get worse extremely quickly.

When to see a doctor

If symptoms progress and you experience fever and/or flu-like symptoms, it’s important to see a doctor right away. In this case, mastitis treatment will involve antibiotics. Once you begin your round of oral antibiotics, mastitis symptoms should begin to clear within 24 hours. As with all antibiotics, however, it’s important that you complete the course prescribed even if you feel better right away. And, of course, continue nursing as it’s perfectly safe, even with the antibiotics (although you can confirm with your doctor, as some antibiotics may not be safe with breastfeeding).

Complications

If mastitis progresses untreated, abscesses can develop. Abscesses require immediate treatment, which can involve aspiration or surgical drainage. In rare cases, untreated mastitis may cause sepsis. Sepsis is the body’s extreme reaction to infection, and it can result in organ failure and even death. Signs can include: chills, fever, rapid and shallow breathing and confusion. If you think you may have sepsis, seek medical attention immediately — it’s a medical emergency. 

Many women aren’t aware that breastfeeding comes with many potential challenges. And mastitis has to be one of the worst things to go through in the postpartum period. While discomfort can be common during some stages of the breastfeeding process, pain shouldn’t be. Don’t hesitate to connect with a lactation consultant or a doctor if you have any concerns.