Mastitis

• Part or all of the breast is intensely painful, hot, tender, red, and swollen. Some mothers can pinpoint a definite area of inflammation, while at other times, the entire breast is tender.
• You feel tired, run-down, achy, have chills, or think you have the flu. A breastfeeding mother who thinks she has the flu probably has mastitis. Mothers with mastitis will sometimes experience these flu-like symptoms, even before they get a fever or notice breast tenderness.
• You have chills or feel feverish, or your temperature is 101F or higher. These symptoms suggest that you have an infection.
• You are feeling progressively worse, your breasts are growing more tender, and your fever is becoming more pronounced. With simple engorgement, a plugged duct, or mastitis without infection, you gradually feel better instead of worse.
• Recent events have set you up for mastitis: cracked or bleeding nipples, stress or getting run down, missed feedings, or longer intervals between feedings.

• Relieve engorgement promptly. Milk that doesn’t flow gets thicker and clogs the ducts, which is a set-up for mastitis.
• Breastfeed frequently. Don’t restrict the length of feedings.
• If you feel your breasts getting full, encourage your baby to nurse. You don’t have to wait for baby to tell you he’s hungry.
• Avoid sleeping on your stomach or so far over on your side that your breasts are compressed against the mattress.
• Take care of yourself and get plenty of rest (both of mind and body).

Rest, rest, rest.

• Mastitis is an illness, so take a medical leave from all responsibilities other than breastfeeding. Take your baby to bed with you and nurse. Rest relieves stress and replenishes your immune system.

Alternate warm and cold compresses on your breasts.

• Cold compresses relieve pain; warmth increases circulation, which mobilizes infection-fighters in the inflamed area. Lean over a warm water basin, stand in a warm shower, or soak in a warm bath. Warm water or a warm, wet towel is more effective than the dry heat of a heating pad. For cold compresses, use crushed ice in plastic bags or bags of frozen vegetables, covered with a thin dish towel to protect your skin.

Gently massage the area of tenderness.

• This increases circulation, helps to loosen any plugged ducts in the area and mobilizes local immune factors. Try doing this while soaking the breast in a warm shower or bath.

Breastfeed frequently on the affected side.

• If it hurts to nurse the baby, start the feeding on the breast that is not sore, and switch to the sore side after your milk lets down. Breastfeeding is usually more comfortable when the milk is flowing. It’s important to empty the inflamed breast. As in other parts of the body, fluid that is trapped can get infected. Your baby can empty your breast more efficiently than a breast pump. However, if your baby is not nursing well, you may have to use a breast pump or hand expression to get the milk out.

Vary the baby’s position at the breast.

• Take advantage of all positions so that all the ducts are emptied.

Take analgesics for fever and pain.

• Acetaminophen and/or ibuprofen are safe to take while breastfeeding. Unrelieved pain not only decreases your ability to produce milk but suppresses your body’s ability to fight a mastitis infection.

Drink lots of fluids, as you would if you had the flu.

• Fever and inflammation increase your need for fluids.

Boost your immune system with good nutrition.

Sleep without a bra.

• At other times, wear a looser fitting bra that does not put pressure on the affected area. Or, if possible, go without a bra.

Don’t quit nursing at this point.

• Weaning increases the risk of a breast infection, turning into a breast abscess that requires surgical draining. Continuing to nurse your baby is the best treatment for engorgement, mastitis, and breast infections.

If baby refuses to nurse on the affected breast.

• Inflammation of the milk glands increases the sodium content of your milk, giving it a salty taste. Most babies either don’t notice or don’t mind and go right on nursing. Some may object to the change and fuss or refuse to nurse from that side. Try starting the feeding on the unaffected side and finishing on the salty side. As the inflammation subsides, your milk will soon return to its usual taste.

• Do not have a history of frequent episodes of mastitis.
• Don’t feel that sick.
• Have not gotten progressively sicker over the last few hours.
• Fever is not rising.
• Breast pain and tenderness are not increasing.
• You can easily correct whatever factors may have set you up for engorgement in the first place.

• History of frequent mastitis
• Fever that is rising.
• Feeling progressively sicker as the hours go by.
• Nipples are cracked, which allows bacteria to get into your breast tissue more easily.