Breastfeeding is not easy by any stretch. Throw into the mix obstacles like engorgement, milk blisters and mastitis, and things get a little more than complicated.
1 in 5 breastfeeding mothers in Australia experience mastitis and although it really isn’t a pleasant experience (to say the least!), there are things you can do to help ease breast pain and reduce discomfort [1].
Plus, it’s important to know exactly what the symptoms are so that you can be aware of any signs of infection.
In this article, we’re going to explore mastitis in breastfeeding women, how you can help treat it, and when you should seek help from your GP.
What is mastitis?
Mastitis is a painful inflammation of breast tissue that is often hot, swollen, painful and sometimes red. In women of colour, mastitis can make the breast appear darker in colour [2].
It usually only occurs in one breast, but can sometimes affect both [3]. Mastitis is most common in women who are breastfeeding but women who are not breastfeeding and men can get it, too, because they have milk ducts.
Sometimes, breastfeeding women with mastitis may also develop an infection, which leaves symptoms of generally feeling unwell, nausea, vomiting, and a fever.
What are the signs and symptoms of mastitis?
Mastitis signs and symptoms typically come on quickly, sometimes as quickly as overnight [4]. The main symptoms of mastitis are (which can affect one or both breasts):
- Pain
- A swollen or sore breast
- Red breasts
- Changes in breast colour in Black women
- A “wedge-shaped” breast lump or hard area [5]
- Hot-to-touch area on the breast
- A burning sensation or pain
- Headache
- General flu-like symptoms
As mentioned previously, you can also develop a breast infection with mastitis. Signs to look out for include all of the above, in addition to:
- Feeling feverish
- Nausea and vomiting
- Fatigue
- Body aches
- Sore or cracked nipples
- You have pus or blood in your breast milk
What does mastitis feel like?
It can be difficult to know exactly what is causing your pain and discomfort, especially for new mothers as the entire experience of caring for a newborn might have your body feeling generally off or malaise (lack of sleep doesn’t help anyone!).
For the majority of breastfeeding women, mastitis feels hot to the touch, swollen and painful. As previously mentioned, these symptoms can come on quickly.
You might also feel like you’re coming down with the flu and get a sudden onset of tiredness, feeling achy and feverish — and generally run down.
If you do feel like this, take it as a sign to slow down and rest. Get your loved ones to take over as much as they can so you can rest and take it easy!
What causes mastitis?
Mastitis usually occurs in the first 3 months of breastfeeding and has a few potential causes. The main causes of mastitis are:
- Improper latch
- A long break between breastfeeds
- A build-up of milk
- Damage to the nipple (including a nipple piercing or eczema)
- Blocked milk ducts
- If you abruptly stop breastfeeding, which can cause engorgement and lead to mastitis
- Breast implants
- Skin nicks from plucking or shaving hairs from around your nipples
- Smoking
What are the treatments for mastitis?
When it comes to treatments for mastitis, there are a few ways to tackle it. For some people, mastitis goes away on its own with the help of a few at-home remedies, but others may need to take antibiotics.
In any case, there are certain things you can do to ease your pain. Some helpful mastitis treatments include:
- Ensure proper latch positioning, get help with this from a lactation consultant if you need to
- Continue to feed as best as you can, even if it is uncomfortable
- Rest (preferably with your baby)
- Make sure you drink plenty of water to avoid dehydration
- Gently massage the affected breast
- Avoid restrictive clothing — who wants to wear restrictive clothing after giving birth anyway? We’re championing comfort above all else over here
- You can also use a warm cloth compress to relieve discomfort or even take a warm shower
- A cold compress might also feel good and relieve pain, just make sure you’ve wrapped a tea towel around your ice pack or frozen veg
What are some mastitis prevention tips?
Many health conditions and complications that come from breastfeeding are hard to prevent altogether but don’t worry, there are a number of things you can do to help prevent mastitis, including:
- Make sure you have a proper latch and your baby is feeding properly — if you hadn't already noticed, this really is key when it comes to avoiding and treating mastitis
- Breastfeed often, particularly if your breasts feel full
- Avoid breastfeeding breaks for too long, pump in between feeds if you feel you need to
- Avoid pressure from tight-fitting bras or clothing that might affect milk flow
What can be mistaken for mastitis?
Since lots of breastfeeding issues have similar signs and symptoms, it’s easy to mistake or misdiagnose. Mastitis is often mistaken for a blocked milk duct because plugged ducts can turn into mastitis — though it doesn't always happen.
Can mastitis go away on its own?
Sometimes mastitis can go away on its own, even in cases of infection. If so, it should clear within 10 days [6]. However, you may be required antibiotics to clear the infection.
If your breast infection or mastitis hasn’t cleared during this time or with the help of antibiotics, your GP may send off a milk sample to a lab to help find out if you have a bacterial infection.
Is it safe to continue breastfeeding when you have mastitis?
Yes, you can continue to breastfeed when you have mastitis, even if you have a breast infection. In fact, it’s actually encouraged to continue breastfeeding to avoid any milk build-up.
It won’t cause any harm to your baby, but your milk may taste a little more salty to them. If you’re taking antibiotics prescribed by your doctor, it’s still safe to breastfeed. These antibiotics are completely safe for your baby.
Can you get mastitis more than once?
If there’s one thing worse than getting mastitis, it's getting recurrent mastitis. This study found that approximately 1 in 6 women experienced more than one episode of mastitis [7].
We understand how miserable this can be when you’re supposed to be focusing on precious time spent with your little one.
That's why it’s always best to seek the help of your doctor or a lactation consultant to establish the best breastfeeding technique for you and your baby to avoid any recurrent bouts of mastitis.
Getting to the root cause of why you're getting mastitis will help prevent it from recurring.
What are the complications of mastitis?
Getting a breast infection from mastitis is never ideal and if left untreated can cause a breast abscess. A breast abscess typically requires surgical drainage.
If this abscess is left untreated, it can cause issues in the future with feeding and you may be unable to feed the baby from that breast in future.
When to seek help for mastitis
Always seek help if you are worried or have any questions for your healthcare professional.
However, it’s especially vital to get help if:
- You have streaks across your breasts that are swollen and hot to touch. This isn’t as visible for women of colour so keep an eye out for any changes in colour and your breasts getting darker.
- If your temperature goes above 38.4°C or you feel feverish.
- Your nipples appear infected (this might be cracks or pus).
- If you have pus or blood in your breast milk.
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