A guide to understanding this common ailment, including mastitis causes, symptoms, and treatment—plus how to prevent it.
Tender breasts may seem the norm when you're breastfeeding, but if they turn red and become painful, there may be more at issue than just the normal discomfort of new motherhood.
The real cause may be mastitis, a painful condition caused by a bacterial infection in the breast. A whopping 10 percent of breastfeeding women develop mastitis, although such infections are not restricted just to nursing mothers.
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Knowing the symptoms, treatment options, and how to prevent mastitis in the first place can help keep a clogged milk duct from turning into something even more distressing.
Mastitis Causes and Symptoms
"There's skin bacteria on all parts of our body, and with breastfeeding, sometimes the nipples are cracked, which allows the bacteria to get into the tissue and to get into the milk glands," says Tamika C. Auguste, M.D., FACOG, OBGYN at MedStar Washington Hospital and associate professor of OBGYN at Georgetown University. "An infection of the skin bacteria into the milk glands causes the mastitis."
Mastitis can make your breasts feel tender, swollen, and hot to the touch, or even result in a hard, wedge-shaped mass in the breast tissue that is pointed toward the nipple—these are some of the more common mastitis symptoms. Many women even experience fever, body aches, chills, and general flu-like symptoms.
How to Prevent Mastitis
Although the infection can be hard to head off, the following tips can help prevent clogged milk ducts and mastitis:
- Keep a predictable nursing schedule. Avoid going long hours between feedings, except perhaps at night once your baby is older than about 2 months. (Milk can become thick and clog the ducts if it gets backed up.)
- Don't sleep on your stomach.
- Free yourself from overly restrictive bras and tight-fitting clothing that squish your breasts.
- Avoid carrying anything that chafes your breasts, such as wide-strapped crossbody bags.
If you have cracked nipples, Dr. Auguste encourages using a lanolin cream or vitamin E ointment, either of which can serve as a barrier to infection. It's also important to eat healthy foods, rest, and avoid stress as much as possible.
For women with recurrent blocked ducts, the international La Leche League recommends reducing saturated fat and sodium in the diet, and the Canadian Breastfeeding Foundation recommends taking a 1,200-mg capsule of lecithin, a dietary supplement derived from sunflower seeds, four times a day. (Or try one tablespoon of oral granular lecithin daily instead.) Sunflower lecithin is believed to reduce the thickness of breastmilk by increasing the amount of polyunsaturated fatty acids in it—thereby making the milk less likely to clog ducts.
Home Mastitis Treatment
While mastitis may be hard on the mother, the good news is that it does not affect the child (you can't pass the infection to your baby).
Some home remedies can help reduce breast engorgement. The La Leche League of Canada, for example, encourages the use of ice packs to reduce swelling.
Several studies have also evaluated the use of cabbage leaves—which are placed in the bra and serve as a sort of cold compress to reduce swelling—although with mixed results. Still, if you're eager to use cruciferous homeopathy, choose white versus red leaf cabbage as the darker leaf can stain clothing. Cut the heavy vein from the middle of a rinsed, refrigerated or room temperature cabbage leaf, and place it directly on the skin. Wear a bra or snug top over the leaves to keep them in place, removing them when they wilt or when it's time to feed your baby.
It's also critical to ensure your baby latches on to the breast and drains the affected breast entirely. If the baby cannot drain the breast, use a pump or hand press the breast to express it fully.
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Medical Mastitis Treatment
When swollen breasts progress beyond the engorgement phase and become hot, red, and infected, or the nipple cracks, women should turn to their doctors for mastitis treatment.
If left untreated, the infection could spread, and mastitis could turn into a breast abscess that could require surgical draining. While in this case, warm compresses can help alleviate pain, when those—and breastfeeding—don't relieve clogged milk ducts or resolve mastitis symptoms, an antibiotic may be required.
"Mastitis is a known bacterial infection, and what treats bacterial infections are antibiotics," says Dr. Auguste. "The risk of letting mastitis go untreated or treated inadequately are too high of forming a breast abscess. I would err on the side of real caution and take the antibiotics."
Meanwhile, it's also critical to keep nursing, get a lot of rest, and take it easy while you recover. While you may begin feeling better after a couple of days on medication, always take the entire prescription of antibiotics.
Jessica Hartshorn contributed to an earlier version of this article.