Mastitis: Signs, symptoms and treatment options

Mastitis is an infection of the breastfeeding mother’s breast tissue. Typically, this infection is caused by a bacteria entering to the milk duct through a break or crack in the nipples. It can also occur if the plugged or blocked milk duct isn’t treated accordingly.

It usually affects only one breast at a time but if a mom has had it before, there is a big chance that she will have it again. This problem is most common in the first two to three weeks of breastfeeding but can occur in any stages of lactation.

What is mastitis

Mastitis means an infection of the breast tissue that usually happens during the time of breastfeeding. It will occur when bacteria (from the baby’s mouth), enter a milk duct of your breast, through a crack in the nipple.

Early signs of Mastitis

The early signs and symptoms of mastitis may come as a swollen area on your breast that feels hot and it would be painful when you touch the affected area.

You’ll notice that your nipple is starting to become red, however, it would be difficult to detect if you have a darker skin tone.

In addition, the early sign of mastitis can be a wedge-shaped lump on your breast. You might also feel a burning sensation that can be constant or only during breastfeeding.

Causes of Mastitis

Mastitis is caused by milk that has been stuck in the breast. Other mastitis causes to consider are the following:

• Bacteria in your breast

Bacteria from your skin’s surface and your baby’s mouth can enter your milk ducts via a fissure in your nipple’s skin or a milk duct hole. Stagnant milk in an unemptied breast serves as a growing ground for microorganisms.

• Blocked milk duct

One of your milk ducts can become plugged if a breast does not entirely empty at feedings. Milk backs up due to the blockage, resulting in breast infection.

Mastitis is most frequent in the first six to twelve weeks after starting to breastfeed. However, Mastitis can affect both men and women who aren’t breastfeeding. If you have any of the following, you’re more likely to acquire mastitis:

• Diabetes or any autoimmune disease
• Eczema or other similar skin conditions
• Nipple piercing
• Breast implant
• Plucked or shaved chest hair causing nicks in the skin
• Tobacco addiction

Signs and symptoms of mastitis

Mastitis is pretty obvious when it occurs. This is because there is a significant change in breast appearance and considerable pain is felt on the affected breast/s. Thus, some early signs of Mastitis can come so suddenly. 

Here are some of the signs and symptoms of mastitis:

1. Hard, swollen breasts
2. Warm, reddened, and tender breasts
3. Presence of red streaks over the breast
4. Fever and chills (of 38.5 degrees or higher)
5. Fatigue and flu-like body aches
6. Headaches
7. Expressed milk may look gelatin-like or stringy
8. Milk may also include mucous pus or blood
9. Milk may taste saltier due to the increased sodium
10. Nausea or vomiting
11. Pus coming out of the nipple
12. Pain when breastfeeding

Mastitis treatment

While it is a scary thing to experience mastitis, mothers should not fret. Mastitis is a very curable infection and will not affect breast milk or breast tissue. This infection can be treated by the following mastitis treatments:

1. Antibiotics

The most commonly prescribed medication for mastitis is antibiotics. Safe for both the breastfeeding mommy and baby, antibiotics like Augmentin or amoxicillin can help kill the mastitis-causing bacteria and eliminate pus from inside the breast tissue.

It is recommended that moms with mastitis go for between 10-14 days of the course of antibiotics. Take note that it should be prescribed by a doctor.

2. Pain relievers

Ibuprofen or panadol helps to reduce numerous symptoms of mastitis such as fever, swelling, and pain. Take fever medication (antipyretics) if you have a fever.

Just like antibiotics, it is important to note that any medicine should only be taken when prescribed by the doctor.

3. Drainage via an incision

If the swelling of the breasts won’t go away immediately, the doctor can make a small incision on the breast in order to manually drain the pus. This treatment is very effective and provides almost instant relief.

4. Supportive measures

Mastitis-infected mothers should get a lot of bed rest, especially when they are experiencing fever and fatigue. A warm compress with breast massage helps get the swelling down while encouraging milk letdown.

Do also increase fluid intake and get adequate nutrition. If possible do also get help around the house during this stressful period.

Can you breastfeed with Mastitis? 

Even with this infection, mommies should never decrease or stop breastfeeding. It may be uncomfortable or painful, but it is the only way to prevent plugged ducts and relieve engorgement of the breast.

Aim to nurse every two hours

If you are concerned about the health of your baby, express a few drops of milk out from the infected breast before suckling. When actual breastfeeding is not possible, pump the breasts to completely drain them of milk. Here are some tips in nursing your baby with mastitis. 

1. Before nursing

Use heat and gentle massage before breastfeeding. Use a warm compress and take a very warm shower, as heat helps to improve milk flow. When the shower, apply soap to your breasts and a wide-tooth comb.

Comb your breast gently toward the nipple with the wide-tooth comb to improve circulation.

You may see the affected part turning red; this means that this method is working. Combing improves blood circulation and helps the milk flow out more easily. Loosen your bra and wear comfortable clothing that will not restrict your milk supply.

2. While nursing

Nurse on the affected breast first. If it’s too painful then nurse from the affected breast immediately after the let-down. Find a good position to feed and make sure you have a good latch.

Ensure the position you choose allows you to massage your affected area. Massage gently but firmly from the plugged area toward the nipple. Do also nurse while leaning over the baby (dangle feeding) to maximize the use of gravity and the baby’s suckling to help.

3. After nursing

Use a cold compress or cold cabbage leaves between feedings for any inflammation.

Troubles you might experience with breastfeeding while having Mastitis

Breastfeeding is no easy task but if it means giving your baby the much nutrition they need, would you even sacrifice it? If you’re feeling some kind of pain while breastfeeding, this could be one of them.

• Breastfeeding with mastitis hurts even with a good latch

Breastfeeding’s initial pain and discomfort are typical for many of us. Sometimes we go into nursing completely unaware that it can be painful, leaving us surprised and uncertain. Don’t worry, it’s normal!

Breasts must also “toughen up,”, particularly for first-time mothers who have never nursed. This could explain why, after a while, the pain from breastfeeding subsides over the next few weeks. Putting up with the pain can be the best option, especially if it just lasts a few seconds before dissipating.

• Sore nipples breastfeeding

Breastfeeding mothers frequently experience sore nipples. Prevention is achievable, and therapy is determined by the underlying cause. The following are the most typical causes:

• your baby is unable to latch well
• Baby still adapting to this new skill
• chafing
• Thrush

• Breastfeeding pain lumps

While breastfeeding, you may discover a bump on one or both breasts. These lumps could be caused by a variety of factors. The cause of a lump when breastfeeding affects the treatment.

Lumps can sometimes disappear on their own or with home treatment. In some cases, it’s necessary to see a doctor for medical attention.

Some causes might include:

• Engorgement
• Mastitis
• Abscess
• Blocked milk duct
• Swollen lymph node
• Cyst
• Breast Cancer

Make an appointment with your doctor if you have any of the following symptoms:

• the lump’s surrounding region is red, and it grows in size
• a high fever or flu-like symptoms appear
• you’re in a lot of pain or discomfort

Breastfeeding pain relief home remedies

Here’s how to prevent sore nipples from breastfeeding as well as other breastfeeding pain you may experience.

• Check the latch

An infant may have difficulty latching for a variety of reasons. An overly shallow latch is a common issue. A shallow latch creates too much suction on the nipples, which causes pain. When nursing, your baby’s lips should be around most or all of your areola.

• Your baby might have tongue-tie

If your kid has a tongue-tie, you may develop persistently sore nipples. A tongue-tie can only be diagnosed and treated by a doctor or a qualified lactation consultant. They may recommend surgery, or they may be able to teach you how to work around it and still obtain a good latch.

• Practice breastfeeding positions

The way you sit and hold your baby during breastfeeding has an impact on how comfortable you and your baby are. Breastfeeding can be done in a variety of ways. You can ask a lactation expert for advice, or go through books and research. There are definitely a lot of tips online like this.

Your baby’s face should be parallel to your breast (horizontally or vertically) and their tummy should be in contact with your body in a healthy grip.

• Treat engorgement

When the breasts become excessively full of milk, engorgement occurs. This happens if you wait too long between nursing sessions or if you’re still in the early stages of breastfeeding and your supply is still adjusting to your baby’s needs.

Breasts that are engorged can be painful. They can also make latching on to the breast more challenging for your infant. If this happens, you may need to discharge a small amount of milk before nursing.

• Keep your nipples moisturized

You may need to moisturize your nipples in addition to keeping them clean and dry. Nipples are delicate and might crack and bleed if they become too dry during nursing.

To use a nipple cream, first, rinse the region with water, then apply the cream immediately after feeding your baby so that it has time to absorb before the next feeding.

Make sure that these nipple creams are doctor-recommended and safe for your baby!

• Do cold compress

By lowering swelling, cool compresses can help ease sore nipples after breastfeeding. A chilly compress can be applied to your breast and nipple, as well as under your arm.

Between your skin and something cold, such as an ice pack, place a piece of fabric. Applying an ice pack to your skin is never a good idea. Apply the compress to the affected area for a few minutes at a time. You can do this for a few hours on and off until the swelling goes down.

• Make sure you have the right-sized breast pump

If you use a breast pump, employing the incorrect size breast shield might irritate and sore your nipples. It can also have an impact on how much milk you express when pumping.

You probably need a smaller shield if you see a lot of your areola inside the shield while pumping. And if your nipples brush against the shield’s inside, you’ll probably need a larger shield.

As your breasts vary over time, you may need to alter sizes as well. Also, while pumping, make sure to utilize a vacuum strength and speed that feels comfortable to you. Over-pumping the pump will not result in more milk, but it may harm you.

• Treat and prevent nipple thrush

Each time you nurse, your nipples become wet with milk. Thrush, a yeast infection of the nipples, can result from this. 

During breastfeeding, thrush can spread from mother to infant, thus it must be treated by a medical professional immediately. 

To prevent this, make sure to dry between feedings. You can dry your nipple by blowing on it or patting it with a baby towel. When bathing, use mild soap on your nipples and thoroughly rinse them.

Abscess as a result of mastitis

Abscesses are noncancerous masses commonly tender and often mobile under the skin. The edge of this mass is usually regular and well-defined in form.

A breast abscess is a painful result of pus in your breast, this may be a cause of an infection. It usually affects women who are breastfeeding.

In addition, mastitis is a common cause of breast abscesses. You should call a doctor if you have the following signs and symptoms:

• a painful, reddening warm breast
• a lump or any swelling in your breast

Furthermore, there can be serious cases of breast infection or abscess. You may observe that is a more serious abscess with the following signs:

• A tender lump in your breast that does not shrink after breastfeeding a newborn.
• Pus leaking from the nipple.
• Persistent fever
• No progress within 48-72 hours of treatment

Causes of breast abscess

The breast abscess may develop if you have an infectious ailment such as mastitis. Abscesses due to mastitis can not be treated easily.

Mastitis usually affects breastfeeding mothers. It could also develop in women who are not yet breastfeeding. However, this case could be less common.

Whatever the condition is, mastitis treatment should be immediate to reduce the risk of having an abscess.

Treatment of abscess in the hospital

First, when the doctors treat your abscess, you will have an ultrasound scan of your breast to check for any signs of abscess.

Then, if the doctor detected an abscess, they will drain the pus with either:

• a needle; the doctor may repeat this treatment a few times, therefore, you might need to get into the hospital a few more times.
• a small cut on your skin

Your doctor might ask for your consent to inject anesthetics before draining the pus. Usually, you may go home the same day, and the doctor will give antibiotics as a prescription.

After the treatment, the abscess should fully heal after a few days or weeks.

Meanwhile, if you only have a breast infection your healthcare provider may prescribe antibiotic tablets for treatment.

How do I know it’s cleared?

When mastitis is cleared you will feel your breast go back to normal. There will be no hardened lumpy area and your breast will be softer. It will still have some residual soreness but that will ease off.

Need Help? Don’t fret!

When in doubt, please refer to a lactation consultant, who can offer you more personalized advice according to you and your baby’s situation.

Republished with permission from theAsianParent Singapore

Additional information by Nathanielle Torre

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