Mastitis: When Your Breast is Sick

Your baby sleeps all night.  Yay!  But getting to sleep all night for the first time after your baby’s birth can come with a few negatives.  First is the strike of fear that sends you running from your bed to the baby’s to check that she is alright.  Then are the painful, engorged breasts that have too much milk for the baby’s first feeding that morning. And what can then follow that engorgement is an inflamed breast and even mastitis.

How Mastitis Develops

Mastitis begins when breastmilk is forced out of the alveoli into the surrounding tissue when it is compressed (tight bra) or overfilled (baby sleeping all night).  The milk is irritating to the surrounding tissues causing inflammation.  The inflamed tissues cause the ducts (tubes that drain the alveoli and then lead the milk out the nipple) to swell closed. These plugged ducts trap the milk which can become infected.  The best strategy for clearing the infection is emptying the alveoli of milk.  This can be very difficult unfortunately because the ducts are swollen so women can experience engorgement that does not respond to nursing or pumping alone.

Anti-inflammatory treatments are generally necessary to allow the milk to empty. 

1. Try putting wet wash cloths in the freezer and placing the frozen clothes on the inflamed part of the breast 4-5 times a day.
2. Ibuprofen 600 mg every 6 hours is a big help in reducing the swelling.
3. Homeopathic remedy arnica is good to help reduce swelling.

Fighting the infection can also decrease the inflammation and allow the milk to flow.

1. Natural immune boosters like Echinacea, Vitamin C and Zinc can assist your body in killing the bacteria.
2. Applying heat can bring more circulation to the unhappy area of the breast and that can help speed the fight against the infection.
3. Antibiotics work by killing bacteria but studies have shown that mastitis usually resolves with or without them. It is now believed that antibiotics have additional anti-inflammatory effects that might be the bigger help in the cure of mastitis.  Call your obstetrician for a prescription.  Most commonly Dicloxacillin is prescribed as it works primarily against the bacteria that commonly causes mastitis, Staph Aureus, and has very few side effects like many broad spectrum antibiotics.  Keflex is usually the next best choice for mastitis or when Dicloxacillin does not work.

Preventative measures especially for women with repetitive plugged ducts and/or mastitis.

1. Avoid engorgement as much as possible-as the baby begins to sleep through the night or wean from the breast, it may be necessary to use the pump to just drain the breast enough to prevent engorgement until milk supply decreases.
2. Avoid breast compression-underwire bras are compressive to breasts.
3. Try lecithin supplement, the usual recommended dosage for recurrent plugged ducts is 3600-4800 mg lecithin per day, or 1 capsule (1200 milligram) 3-4 times per day.
4. Acupuncture has been shown to decrease plugged ducts.
5. Sometimes what you might think is repetitive plugged ducts is an unresolved mastitis. Check in with a lactation consultant or a physician to be sure that mastitis is cured to avoid the formation of an abscess.

Moms don’t have any extra time to be sick.  We are WAY too busy.  Work to recognize the early signs of inflammation in your breast and to avoid situations where mastitis might develop. For more information about breastfeeding, attend the Womens Wellness of New Jersey Breastfeeding Class. After you have your baby, stop by our Free Lactation Circle offered each week in the Womens Wellness of New Jersey classroom.  Email [email protected] for more information on our programs.