There is no simpler way to put it, mastitis is just plain nasty! If you’ve experienced it before, then you know it’s certainly something that you want to try to avoid having again! Mastitis is inflammation of the breast tissue that may or may not involve a bacterial infection. It occurs if milk stasis (meaning stationary or blocked milk) remains unresolved and the inflammatory response of the immune system continues to build. Having mastitis can be an absolutely miserable experience, but with the right approach, it can be cleared up quickly. It’s usually only in one breast, but it’s possible to have it in both breasts at the same time. In this blog we’ll look at the symptoms of mastitis, what causes it and how to overcome it.
How Do You Know if You Have Mastitis?
Those first few weeks to months after our babies are born can be exhausting. It is not uncommon to go without sleep and rest, and for a mother’s immune system to be on high alert. During this time we may fumble to learn how too breastfeed and we may not drain our breasts fully and milk ducts may become blocked. If these ducts remain blocked then they can become inflamed and our immune system kicks into defence mode to protect our breast tissue from infection. The result is typically swollen, tender breast tissue and fever like symptoms for Mum encouraging her to rest, allowing her body to repair and regain balance.
Breasts with mastitis present as:
- red
- hard
- sore
- hot
- swollen
You may also feel a lump, called a blocked duct, formed by the build-up of milk in your breast. If you have a blocked duct, the hard lump may feel rope-like because the duct, and its nearby ductules and alveoli, have become inflamed.
You may also have flu-like symptoms, such as:
- chills
- a headache
- a temperature of more than 38.5 degrees C
- exhaustion
- muscle pain (myalgia)
Up to one in four breastfeeding mums get mastitis, and some bottle-feeding mums do, too. Stay positive though, it’s important feedback from your body about your breast feeding and self-care. Many home treatments tend do the trick.
When Does Mastitis Occur?
You’re more likely to develop mastitis if you’re a first-time mum, though experienced breastfeeding mums can get it, too. Mastitis can happen at any point while you’re breastfeeding. But it’s most common in the first three months, particularly in the second or third week, when you’re getting used to breastfeeding.
Unfortunately, you can get mastitis more than once.
What Is Infective Mastitis?
Sometimes, milk stasis can become worse and develop into infective mastitis. This may happen if you’ve had cracked nipples. An infection can pass through the crack or fissure in your nipple into the lymphatic system of your breast.
What Causes Mastitis?
Here's three common reasons:
- Mastitis is most often caused when milk builds up in your breast because it’s being made faster than it’s being removed (milk stasis). Milk stasis most commonly happens when your baby isn’t taking enough milk from your breasts when she feeds. This may be because she isn’t latched on properly.
- A troublesome breast feeding technique that results in sufficient drainage of the breast. If your baby doesn’t latch on well on one breast, it can cause your nipple to be sore and make you reluctant to feed on the sore side. This can cause engorgement, milk stasis and then mastitis. If your baby favours one breast over the other, it may also lead to mastitis.
- The mother’s immune system is taxed resulting in the body being less capable of fighting off mild infections which result in an inflammatory response of the milk ducts.
What Causes Mastitis?
Here’s three common reasons:
- Mastitis is most often caused when milk builds up in your breast because it’s being made faster than it’s being removed (milk stasis). Milk stasis most commonly happens when your baby isn’t taking enough milk from your breasts when she feeds. This may be because she isn’t latched on properly.
- A troublesome breast feeding technique that results in sufficient drainage of the breast. If your baby doesn’t latch on well on one breast, it can cause your nipple to be sore and make you reluctant to feed on the sore side. This can cause engorgement, milk stasis and then mastitis. If your baby favours one breast over the other, it may also lead to mastitis.
- The mother’s immune system is taxed resulting in the body being less capable of fighting off mild infections which result in an inflammatory response of the milk ducts.
The following can also cause milk stasis and lead to mastitis:
In summary predisposing factors:
- Maternal stress
- Restrictive bra / clothing
- Poor positioning / attachment
- Damaged nipples- especially if colonised with Staphylococcus aureus
- Incomplete draining of the breast
- Unresolved engorgement
- Abrupt weaning
- Tongue tie
- Inadequate / inappropriate treatment of previous mastitis
- Scarring causing incomplete drainage
- Feeding to a strict routine, where there’s a long gap between feeds
- Overuse of a dummy or a bottle interfering with the time your baby spends at the breast and may affect how she attaches to your breast
How Can I Treat Mastitis?
Rest the mother, Not the Breast. This is the age-old mantra for mastitis.
It’s important to keep feeding your baby from the affected breast. Offering him the affected breast first encourages good milk drainage because he’s most hungry at the start of his feed. Although this may be painful and miserable for you if you stop feeding from your affected breast it will actually make the mastitis worse. If it’s too painful, try starting the feed on your unaffected breast, then switch to your affected breast after your let-down.
Here are some self-help methods you can try before seeing your doctor and taking antibiotics.
- Keep feeding your baby off the blocked breast.
- Breastfeed as often as your baby wants, aiming for eight to 12 breastfeeds a day.
- Make sure your baby is latched on properly and is feeding well.
- Express milk by hand or with a pump, after feeds, if you feel your baby hasn’t fed well. This can be useful if you have sore nipples.
- Try different breastfeeding positions, to see if they help your baby latch on better.
- Rest and drink plenty of fluids.
- Avoid wearing tight-fitting clothing or a bra until things improve.
- Have a hot shower. Run hot water onto your breast tissue and massage your breast in a downward motion towards your nipple. This will help to express away some of the excess milk pressure.
- Try massaging your breasts very gently while your baby is feeding to help the milk flow. Gently stroke from where your breast feels lumpy towards your nipple. Vigorous massage can make mastitis worse, though, as it pushes the leaked milk further into your breast tissue.
- Put a cold compress or gel pack on your breast after feeding to reduce swelling and soothe pain.
- Consider having your baby assessed by a chiropractor who is confident working with infants.
- Consider having your own spine assessed by a chiropractor.
- Keep up your supplementation of the B-complex vitamins (especially B1, B3 and B6). B6 may need to be increased considerably. Other important nutrients are vitamins C and E, selenium, zinc, manganese, calcium, and magnesium.
- Keep taking and eating Garlic, Evening Primrose, and fish oils.
- Useful ointments include St. John’s Wort, Poke Root, Calendula or Golden Seal.
- Drink Clivers tea to encourage lymphatic drainage or Feverfew tea.
- Avoid coffee, dairy food, refined carbohydrates, salt, and all animal foods containing chemicals. We certainly hope you are doing this already!
- Don’t worry if you notice increased surface blue veins in the breast, or if your nipples become darker.
- Use tissue salts. Calc Phos and Calc Sulph may also be beneficial.
- Homeopathics that may be beneficial for treatment of mastitis symptoms include:
- Belladonna 6c — for hot, red, swollen, throbbing breasts accompanied by a fever. This homeopathic is particularly useful on the first day when your milk comes in to ease engorged breasts.
- Bryonia 6c or 30c — for hot, hard, painful breasts that are sensitive to touch.
- Helonias 6c — for swollen breasts with extremely sensitive nipples.
- Silicea 6c or 30c — for cracked nipples.
If your baby isn’t feeding well and latching on properly, ask your midwife or child health nurse for help. She’ll be able to recommend a lactation consultant or infant feeding specialist. If attachment is an issue or if your baby. Learning to breastfeed can be challenging for both mother and baby and it can be harder again if a newborn has had some form of injury to the jaw or skull from the birth process. Sometimes newborns are unable to suckle properly because they are in pain, they may gulp and swallow unnecessary air in the process.
Was your birth long or complicated with the use of forceps or colic?
Was your baby born via caesarean?
Birth trauma is common with both caesarean births and births that requiring intervention and may result in nerve dysfunction. One simple way chiropractors encourage mothers to assess if their newborn has a vertebral subluxation (creating nerve irritation or poor nerve communication) is to compare how their baby feeds from one breast to the other.
Often a baby will feed well from one breast, but they will not want to attach properly onto the other side. Alternatively, a newborn baby may come off the breast frequently, on one particular breast. In both scenarios the baby is likely to have a combination of pressure and irritation to the nerves and vertebra of the neck or to the jaw or skull. The nerve and joint pressure that occurs may not only cause pain and discomfort for the baby but also impact the nerve messages relayed to the stomach and other digestive organs.
This is something that occurs frequently with newborns and skilled chiropractors can use gentle paediatric techniques to help the body recreate balance and order in the skull and spine. Chiropractic adjustments in the early stages of neurological imprinting, safely and effectively address dysfunction and help restore natural, efficient suckling patterns for infants. The healthy functioning of your baby’s spine and nervous system will play an integral role in the overall health of your child. Chiropractic adjustments for the correction of poor nerve communication resulting from vertebral subluxations have been acknowledged as an effective therapeutic tool for infantile colic. While every infant’s case is individual and there are no guarantees, evidence suggests chiropractic typically has a 94% success rate with colic.(1) If you intuitively feel that something is not right with your baby, I urge you to have them assessed by a recommended chiropractic doctor. Healthy babies, free of nerve irritation, are happier babies.
Finally, your nervous system works intricately with your immune system. Chiropractic adjustments help to bring the immune system back into balance and support the body in fighting infections. Having your nervous system checked and spine adjusted can help to rebalance your immune system and allow your body to naturally move back into balance.
Traditional Methods of Managing Mastitis.
If you feel unwell, or if continuing to feed your baby is making no difference to the inflammation, see your doctor or seek help from a lactation consultant. She may recommend therapeutic ultrasound treatment to help open your milk ducts and promote circulation.
There’s no strong evidence that ultrasound treatment is effective, but some women find it helps relieve their symptoms. It’s done by specially trained women’s health physiotherapists and doesn’t take long, although you may need a few sessions, depending on how your mastitis responds to the treatment. Some physiotherapists may be able to visit you in your home for the treatment, for others you’ll need to attend a clinic.
Some women take painkillers to help with the pain, know these drugs will make your baby drowsy. Ibuprofen may help to reduce inflammation, as well as pain, or you can take paracetamol instead. If you’ve had mastitis for a few days, and it’s become infected, your doctor may prescribe antibiotics and these drugs will damage your baby’s gut microbiome so it’s important to try all these natural remedies before taking medications. Taking antibiotics however do no mean you have to stop breastfeeding.
What If It Doesn’t Clear Up?
If you still have symptoms or concerns after 1 or 2 days of trying to heal at home, or you have a fever that’s 38.3°C (101°F) or higher, or you are starting to feel worse - contact your doctor. You may need antibiotics to clear the infection.
If your mastitis doesn’t start to improve, it may develop into a breast abscess. This is a collection of pus within the breast that affects about three per cent of women who have mastitis that requires antibiotics. If you have an abscess, you’ll need immediate medical attention, and sometimes surgery, to drain it. The abscess may feel red and hot to the touch, and be noticeably swollen, and you may have a high temperature.
How Long Will Mastitis Last?
If you get onto mastitis early and it is diagnosed early, mastitis is easy and quick to treat, and it won’t be long before you feel better. Your temperate should drop after a few days and you should then start to feel better.
Should I Stop Breastfeeding If I Have Mastitis?
No, it’s important to continue breastfeeding when you have mastitis. Moving the milk will help you get better. Though it may be extremely painful at times, you need to let your baby feed as often as possible.
If it’s very painful to feed, try having a warm shower or putting warm face cloths on your breasts for several minutes before each feed. This should help your letdown reflex, and make feeding more bearable for you.
If your baby doesn’t finish a whole feed from your inflamed breast, or if it’s too painful to breastfeed, you can use a breast pump to express your milk. You can then give it to your baby in a cup or bottle.
Will Mastitis Affect My Baby?
Though you may be feeling unwell and uncomfortable, mastitis won’t affect your baby. It’s perfectly safe for her to feed from your affected breast, but the milk might taste a bit saltier than usual, and it may flow a bit more slowly.
Even if you have infective mastitis, and your baby swallows’ bacteria in the milk, it will be absorbed by her digestive system without harming her.
The Takeaway
There are several things you can do at the first signs of mastitis. So, go through the list above and hopefully some of these will help you feel better soon enough. Trust your body, it is always moving itself towards order and balance.
Yours in health,
Jennifer Barham-Floreani,
Bach. Chiropractic, Bach. App Clinical Science
Registered internationally, no longer practicing as a chiropractor in Australia.
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