While many mothers can completely avoid mastitis without extra thought, a few mothers have to be more careful. First, make sure your baby is latched on well so that you avoid cracked nipples and there is no way for germs to get in. Mastitis is much less prevalent when mothers feed their babies as frequently and for a long as the baby wants, i.e. on cue. If your baby suddenly changes his sleeping and eating pattern, your breasts will need to adjust to longer stretches without being emptied. Listen to your body: express a little milk, or wake the baby, if needed.
A common cause of a breast infection is normal bacteria from your skin entering the milk ducts through a crack on, or other damage to, your nipple. Most likely this crack is from a shallow latch. Sometimes a breast infection follows a plugged duct and can be caused by the same things: irregular feeding patterns or missed feedings, tight clothing (bras, bathing suits, etc.), pressure on the breast from a baby carrier, heavy purse or diaper bag, sleeping on one’s stomach and unusual stress or fatigue.
Yes. Because the breast is hot and inflamed, some mothers find that cold or cool compresses applied between feedings (not during as it constricts the vessels) makes them feel more comfortable.
Use heat or cold, whichever works best for you.
There are many kinds of heat sources you can use. Many mothers find that moist heat (wet washcloth) is more effective than dry heat (heating pad). It is most important that the heat source to be not too hot or it might cause minor burns to the skin. Heat is required for 10-15 minutes at a time to be effective. Some commonly used safe heat sources are:
Nurse frequently on the affected side, get extra rest and drink plenty of fluids. Many mothers also find heat on the sore breast helpful. Drop any activities except for breastfeeding to lie down and rest. If you are doing all of this and are the same or worse after 24 hours, contact a health care provider. If your fever or pain is worsening rapidly then see your doctor the same day. You may also wish to discuss pain relief options with your health care provider. Many mothers find that pain relievers which have anti-inflammatory effects are the most useful.
No. In fact, you will want to nurse more often on the affected side. A breast infection may require treatment with antibiotics (see next FAQ). Most antibiotics are compatible with continued breastfeeding. Your baby will not get sick from drinking milk from your affected breast.
With a plugged duct, there is a hard, tender area (about the size of a pea, sometimes larger) in one breast that may hurt when you press on it; you do not feel sick, just uncomfortable in that specific area. With mastitis on the other hand, a larger part of the breast is painful and tender to touch, will feel warm or even hot, and may look red and swollen. Most mothers will have a fever and feel achy and sick, like when they have the flu. Many mothers will feel sick enough that they will want to be in bed.
Nurse frequently on the affected side. Nurse in different positions. One position that mothers find especially helpful is the all-fours position. (To use this position lay your baby on his back. Get on your hands and knees or elbows and knees. Gravity will help get the milk out as baby sucks on the breast hanging down.) Whatever position you use, it is especially helpful to have your baby’s nose and chin in line with the hard area. A few minutes of heat applied to the tender area before nursing can also be helpful.
Plugged ducts either result from milk not being taken out (baby sleeps through the night, misses a feeding or changes how he nurses) or pressure on a milk duct (tight bra/clothing, straps from a baby carrier or bag, how you sleep). Very often two causes happening at the same time creates the problem.
A plugged duct is when one of the ducts (tubes) that carries milk from the “milk factory” in your breast to the nipple is blocked in some way—usually by a thick clump of milk. It might be tender or feel bruised, and you may be able to feel a lump.