Mastitis | breastfedbabies
The first sign of mastitis can be that you have a temperature and you feel as if you are getting a cold or the flu. Then you might notice a sore tender area on your breast and if you check you may see a flushed red area on the breast. Sometimes you can feel a lumpy area and your breast may be swollen, painful or hot.
Mastitis can happen at any time, but it is more likely to happen two to three weeks after the birth. It is linked to blocked milk-collecting ducts, which are caused by a build up of milk in the breast. If there are blocked ducts, some of the milk can leak into the surrounding tissue and cause inflammation, and occasionally infection. This is what causes mastitis.
Mastitis can happen because the baby is feeding less for some reason, or because the feeding position is not good and the baby cannot drain all the segments of the breast effectively, or because of pressure from clothing or your bra.
- Try to avoid suddenly missing a feed or going a long time between feeds. If you need to change your routine, do it gradually.
- Make sure your breasts don’t become overfull.
- Avoid pressure on your breasts from clothing or your baby's fingers.
- Start self-help measures at the first sign of any red area on your breast.
Solving the problem
While you might not feel like breastfeeding with mastitis, it’s really important that you keep going. Removing the milk from the breast is essential to relieve the pressure and help clear the blockage. Stopping breastfeeding at this point may actually make the mastitis worse. There is no risk to your baby from breastfeeding while you have mastitis.
Make sure your baby is well positioned and attached when feeding. If you are in doubt, ask your midwife, health visitor or breastfeeding counsellor to watch you feeding and check your baby’s positioning is good.
If your breasts feel uncomfortably full, feed your baby more often or express a little milk between feeds. Feed from the side which is sore first, so that it is drained as thoroughly as possible. Warmth, either a warm compress or warm water poured gently over the breast, may help you feel more comfortable. Gentle massage and trying different feeding positions can also help.
You’ll probably need to rest and if you do not begin to feel better despite using these self-help measures (or if you feel suddenly worse), you may need to see your GP. Anti-inflammatory tablets or antibiotics may be prescribed by your doctor. This medication will not harm your baby. It’s important to keep draining the breast even if you are prescribed medication – it won’t work if you don’t do this. Most cases of mastitis don’t need antibiotics if self-help measures are started quickly. Taking antibiotics may also make you more prone to thrush, and may also make your baby restless and irritable for a few days, so it’s worth trying to resolve the problem without them if you can.
You will need to take some paracetamol to relieve pain and reduce your temperature. Make sure you do not take more than the recommended dose (two 500mg tablets four times a day and no more than 8 tablets in 24 hours). Ibuprofen can also be taken as it helps to reduce the inflammation. Take 400mg three times a day after food.
• Ibuprofen should not be taken by women who have asthma, stomach ulcers or are allergic to aspirin. Aspirin should not be taken by breastfeeding mothers.
• If your mastitis is not improving you will need to see your GP as you may need antibiotics. If so, you should be prescribed a 10-day course. You should feel some improvement within 12 –24 hours.
It is very important to finish the whole course of antibiotics. If your mastitis comes back after you have taken a full course of antibiotics, or is unusually severe, you may be asked to give a sample of milk. This will be tested to help the doctor choose the correct antibiotic for your treatment. Antibiotics may make the baby produce loose, runny motions and become irritable and restless, but the baby won’t be harmed and will get better when you finish the antibiotics. It is important not to stop breastfeeding during mastitis as this can make your mastitis much worse.
Unresolved mastitis can develop into a breast abscess, though this is rare. If your mastitis does not seem to be clearing up, contact your GP or the breastfeeding advisor at your local hospital. If an abscess has formed it may need to be drained or treated in hospital. These are relatively simple procedures.
You can find out more about how to prevent and manage mastitis from the following helpful booklets: