How to avoid Mastitis this Christmas…Make sure you know the updated treatment Guidelines!
- Rosemary Scott
- Dec 14
- 3 min read
I have suffered from Mastitis when breastfeeding both my daughters. The first when I was triple feeding so pumping a lot and the second I'm not quite sure how it started. Each time I was knocked out with a fever and felt awful. The treatment at the time appeared to make things worse so I wasn't surprised when the guidelines changed recently!
So let's talk about Mastitis...
When more milk is produced than your baby drinks this can produce pressure which your body responds to as a threat.
Inflammatory cells and fluids rush into the area to help repair the damage and fight off bacteria. The swelling that occurs from this inflammation presses on some of the ducts, which slows or blocks the milk from flowing well.This could occur any time your breasts become overly full.
Possible factors include:
You and your baby are separated for longer stretches than usual between feedings
Your baby starts sleeping longer at night
Your baby is teething, has a stuffy nose, or is otherwise feeling out of sorts and nursing less or not as effectively.
You start to pump as well as breastfeed rather than pump in place of a breastfeed when your baby has a bottle. This tells your body to increase milk supply.
Research in the last two years has led to a dramatic change in treatment for women suffering from Mastitis. However, this change seems slow to trickle down to health care providers such as GPs who are often first port of call when feeling unwell.
Here's what you need to know:
Mastitis is an inflammation of breast tissue that commonly affects breastfeeding women.
Symptoms often come on quickly, and may include a hard, hot, painful and often red patch of breast.
You may feel flu-like symptoms: aches, high temperature, chills, or tiredness.
It usually affects one breast but can happen on either side.
We used to say it starts as a “blocked duct” (milk is not draining well) or an engorged breast when not feeding or pumping as usual then if not dealt with early, it may progress to infection. But this has now been disputed.
The new research shows that the true cause of mastitis isn’t clogged ducts and the lack of frequent and complete milk removal, as once believed.
The real culprits? A narrowing of the milk ducts and congestion and inflammation within the breast that are caused by an imbalance of the breast microbiome (dysbiosis) and/or hyperlactation (also known as “oversupply”). Milk is made and stored in groups of milk sacs called "lobules". Milk is not stored in ducts. Painful lumps are caused by full milk sacs. Ducts become narrow from swelling around them. Milk may flow slowly as a result but there is no 'plug' to clear. Squeezing and vibration will not help.
Due to the supply and demand basis of milk production, frequent emptying and overstimulation of the breasts as per previous treatment guidelines (AKA: “pump, pump, pump!”) will in fact only exacerbate hyperlactation, increasing congestion within the breasts, and triggering the underlying inflammatory process that leads to mastitis.
Instead the recommended treatment is:
Focus on reducing the inflammation: apply cold compresses to the affected breast
Take anti-inflammatory and pain-relieving medication: see detailed 'Drugs and Breastfeeding Factsheets'
Do not feed or express more than usual and certainly do not squeeze or massage the breast
More details in this handy factsheet
Here's some more information from La Leche League on mastitis and other conditions such as blocked ducts and blebs: here
If you do not start to feel better within 24 hours and especially if your fever can't be controlled, do consult a doctor but make sure their advice is up-to-date. In some strong cases antibiotics may be recommended.
So now you are all clued up! I really hope you never experience it but if you think you have it at least you are up-to-date with how to treat it.
Here's to a healthy Christmas time!
Rose
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