Health Tips

Problem during breastfeeding: mastitis

Breastfeeding is a lovely moment between the mother and the newborn—it is filled with intimacy and allows the newborn to receive adequate nutrition, while bringing some health benefits to the mother too! 

Photo by William Fortunato from Pexels

We wrote an article on the benefits of breastfeeding previously, click here to read. However, some breastfeeding mothers may face various issues during this endeavor, and one of them is called mastitis.

What’s mastitis?

Image credit: JayneLut, CC BY-SA 4.0 , via Wikimedia Commons

Mastitis is the inflammation of the breast tissue. It is primarily caused by milk stasis, i.e. build-up of breast milk due to incomplete drainage. Besides milk stasis, mastitis can also be caused by a bacterial infection. Staphylococcus aureus is the most common bacteria associated with mastitis. 

Milk stasis can be caused by many reasons, such as: 

• Incomplete breast drainage due to missed feedings, positioning and attachment issues, infant mouth abnormalities (cleft lip or palate)
• Breast swelling and inflammation due to oversupply of milk 
• Blocked milk ducts 
• Injuries in the breast tissues
• Yeast infection
• Illness in mother or baby 
• Tight-fitting clothes or external pressure on the breast 
• Poor maternal health such as fatigue, stress, malnutrition 
• Prior history of mastitis 

Women who have mastitis may experience painful, red, and swollen areas in the affected breast; they may also experience fever of more than 38°C and flu-like symptoms. Some may have nipple discharge that is white or contains streaks of blood.  While mastitis can happen to any woman, it mainly affects the lactating women, especially during the first 6-8 weeks after delivery; although it can still happen anytime during the breastfeeding period. 

Treatment of mastitis

Here are something you can do if you experience mastitis during breastfeeding:

1. Bed rest- Extra bed rest helps your body to fight against the infection
2. Get comfortable- You may experience chills when having mastitis. You can keep your socks on and dove under your blankets. 
3. Keep hydrated by drinking lots of fluids and eliminate sugar
4. Take the baby to bed
5. Deal with the pain- Soak a cloth in warm water and place it on your breast to help relieve the pain – a warm shower or bath may also help. You can also take paracetamol or ibuprofen (NSAID safe for breastfeeding) to reduce any pain or fever. Do not take aspirin because it can be excreted into the breast milk and get ingested by the baby.
6. Massage your breast to clear any blockages – stroke from the lumpy or sore area towards your nipple to help the milk flow. Do not wear tight-fitting clothing or bras until you feel better

If you are breastfeeding, continue to breastfeed. This helps to drain out the breast milk. Ensure that the baby is well positioned and attached at the breast. You may hold the baby with the chin towards the breast. Always start feeding with sore breasts first ,this promotes milk drainage while the baby still has the appetite to get fed. Breastfeeding while having mastitis does not generally pose a health risk to the baby. You should see a doctor if the condition does not improve after 24 hours despite continuing to breastfeed, or you get what may seem like mastitis and you are not breastfeeding. 

If your doctor thinks you may have an infection in the breast, the doctor may prescribe oral antibiotics to you. The choice of antibiotic depends on many factors. 

As mastitis is commonly caused by staphylococcal aureus bacteria, the doctor will usually prescribe cloxacillin 1-2 grams intravenously every 6 hours or cefazolin 1-2 grams intravenously every 8 hours. Alternative treatment is oral Augmentin 625mg three times daily or oral Unasyn 750 mg two times daily. Do let your doctor know if you are allergic to any antibiotic medication! If your condition does not improve despite finishing the antibiotic therapy, visit the doctor again. In more severe cases, drainage may be required if abscess is present in the breast.

If you are breastfeeding and keep getting mastitis, it might be due to problems with positioning and attaching. You can learn the correct technique of breastfeeding here, or consult your healthcare professional.

Read more about breastfeeding:

1. How To Care For Your Breasts When Breastfeeding
2. Is it safe to take medications while breastfeeding?

A word from DOC2US

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Cover image credit: Photo by William Fortunato from Pexels

Written by

Ms Joyce Toh