Every now and then I hear what strikes me as a very sad story of a woman who has chosen to stop breastfeeding on the grounds of mastitis. I feel a great surge of frustration because I feel: WOW. Did this woman get the support that she needed, when she needed it? Or maybe it is even a more personal thing that I am projecting, about whether I myself could personally have helped them. I’m open to this being about my stuff, but anyway. I think I have something to share that may help one woman and so for me it is worth sharing.
Mastitis is in most cases a treatable, preventable affliction if you catch your symptoms early. Yet you still hear of women feeling that this factor was big enough to mention in the reasons that they decided breastfeeding was not for them. I can’t help but think that we need to share the nuts and bolts of what mastitis actually is to empower women to care for their own bodies in this situation. Sure, if you are experiencing frequent bouts of mastitis like monthly recurrence you may consider an underlying buy flagyl cream online cause like for example a latch issue or poorly fitted bra restricting flow. If you are experiencing mastitis frequently, try to focus on addressing the cause rather than the symptom and please seek help either from a lactation consultant or from your local ABA counsellor or their helpline. For most women I would say that the cause is most usually a blocked duct which is something that happens every now and then.
We don’t talk about it a lot and so to a new Mama who has so very much to grow into and learn about in parenting, it can seem like an overwhelm. For me, mastitis goes along with breastfeeding. It’s one of those things, like kids get colds in winter and sometimes ear troubles when they take swimming lessons. Or maybe like, kids graze their knees when learning to ride a bike. But you don’t stop them riding the bike; you support them and know how to care for that graze and not to feel lost, alone, defeated. It is this sense of wanting to offer support and guidance to those who choose it that has me writing today. When you are learning to ride a bike you need someone to spot you, to hold the bike up a bit, to be there. Breastfeeding mothers need this support too.
So, what’s the go with Mastitis. Sure it can be the result of generalised inflammation but my focus is going to be on the blocked duct. It starts off as maybe a bit of fatty milk or maybe just milk that is left in the breast and not sufficiently sucked out, might be thicker than usual for whatever reason and the result is a blocked milk duct. Maybe your toddler accidentally bopped you one right in the breast, another common cause in my household 😛 The milk duct is simply the tube carrying milk from deep in the breast up to your nipple and out to baby. In many cases of blocked duct, the duct just gets properly sucked and cleared out by a more hungry/interested/[whatever-the-case-may-be-they-suck-stronger] baby at the next feed. If the babe doesn’t manage to unblock the duct though, the milk that is stuck there continues to solidify and settle in. If it stays there long enough, it can be pushed out into breast tissue which gets inflamed and if not cleared, also can become infected. If the duct clears, it can block again if the breast tissues are so swollen that they in themselves stop the next lot of milk getting through. These are the end signs: so I feel that by sharing information among us as women, we might be able to prevent that significant level of discomfort and give back a feeling of control and preparedness to new breastfeeding mamas.
I want good treatment for mastitis to be something that every woman who chooses to breastfeed has in her little pocket book of parenting so that she can jump right on those first cheeky symptoms and wipe them and any chance of full blown mastitis infection clean out of town! As I’m not saying that full blown mastitis is a fun undertaking or comfortable by any stretch of the imagination. Especially for new mamas trying to balance those 8(00?) tasks with 2 hands. I’m saying that many many times, we can nip that sucker in the bud and have happy days!
How do I know that I have a blocked milk duct?
You’re going to be feeling sore in your breast somewhere, almost like a bruise but there isn’t a bruise. Later on their might come a red mark – but the first thing is just that tender feeling.
How do I know that my blocked milk duct has become inflamed?
You are definitely feeling quite sore now, and there could be a red mark either a circle or sometimes a line (professionals might call that a ‘flare’).
How do I know when my blocked milk duct has become infected?
You may start getting hot and cold chills and feel nauseous. May feel a bit like you have the flu. Your breast will likely be red and swollen around the affected area. You might have all of these symptoms, and still no infection. Or you may have an infection: however like any infection bacterial or viral there is no mandate on anti-biotics. If you can clear the blockage and remove the source of inflammation you may well find that you resolve your mastitis without pharmacological treatment. I have chosen to take this route for the more than 10 times I have had mastitis in my over 5 year feeding history mainly because I concern over the affect of antibiotic use on the vulnerable infant gut. That said, of course you need to trust your instincts about when something is wrong and when you need professional support and guidance from your chosen health care professional. You can work with your care provider to find an appropriate solution for your complete medical history.
IF you decide to take antibiotics, considering taking a probiotics with it for the next 9 months to support your gut health and in the short term to prevent the occurrence of thrush which is commonly associated with antibiotic use also when breastfeeding.
I think I’m getting Mastitis – what now?!
What is the one VERY first thing that I will say about treating ‘pre-mastitis’ or mastitis symptoms. COLD first then HOT. When I have symptoms of a blocked duct, I grab a small ice pack and cover it with a very light sock [or not at all] and pop it into my bra right on the affected area. I LEAVE IT THERE UNTIL I NEED TO FEED OR IT GETS HOT. This is about minimising inflammation which can compound the blockage, making a less favourable environment for growth of bacteria and helps with any associated pain. Treating your pre-masitis with cold is vital to your chances of overcoming it or circumventing a full on infection and is the one element of mastitis treatment that I believe is not near widely known enough. This should be common knowledge to any breastfeeding woman in my opinion.
When I need to feed, I take a heat pack and warm it to ‘skin comfortable’ warmth before feeding. I very gently massage my breast only using my fingertips as pressure, this prevents damage to the tissue simply from being pressed too hard! It’s hard to press too hard with fingers alone, still you should be gentle. The ducts are small. Applying heat is about allowing the milk to flow out of the duct. Think, melting the blockage so it can be liquid and get out of there! This might not be completely accurate but it is a good visual. However when you are finished feeding, you need to turn back the clock, because heat encourages bacteria growth and inflammation which are not your friend in this situation. Once you are finished your feed, wait for your skin to cool back to room temperature and then apply the ice pack as soon as you can.
Feed your baby more often that usual, always starting on the sore breast so that the most vigorous, hungry, powerful sucking is happening on the sore breast with the most chance of drawing the ‘stuck milk’ out of the milk duct. Remember that your breast milk is safe for baby even when you have an infection.
More on probiotics! This is vital information; gut health and immunity have a close relationship. Some probiotic studies have shown them to be as or more effective than antibiotics in treatment and prevention of mastitis. In the way that I understand it, they work by preventing the bacteria that causes mastitis from growing. If you seem to be prone to mastitis or are trying to fight it, please consider a probiotic. Probiotics are a bit like antibiotics in that you have to have the right strain for the right complaint. Though it might sound unhelpful :/, I am not allowed to recommend specific brands here; but you are after L. fermentum or or L. salivarius containing products for Mastitis specific benefit.
Some other ideas
Keep very well hydrated; that means 2-3L of WATER per day for a breastfeeding woman
Take off your bra if you can or wear loose support (always wireless breastfeeding bras) to give your breasts minimal restriction, you never know if your bra is putting pressure on just the wrong place to make it difficult to dislodge the ‘stuck milk’
Try a different feeding position to see if your bra or current position has been restricting flow from the affected duct or if that duct gets better suction in the different positiion. You are basically doing what you can to try dislodge the milk
It is tempting to express with a pump, but even the most fancy pumps don’t have the suction that even a small baby offers to clear a blocked duct, and will likely simply increase your supply which can increase your discomfort. Better idea is probably to let baby to do the sucking if that is your normal deal.
Rest: leaving your body with fighting against any possible infection as the only job it needs to spend energy on
A friendly word from a friendly bird xx I hope that my down to earth description of Mastitis and treatment ideas is useful to you or a woman that you know today or in the future.
Need breastfeeding support? Call 24/7 on the Breastfeeding Association Hotline 1800 686 268.