Mastitis: what are the symptoms of mastitis and how to treat it

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  • Mastitis is a condition that affects a lot of mums who breastfeed their babies. Baby expert and parenting mentor Rachel Fitz-Desorgher discusses mastitis symptoms, and explains how to treat and prevent this painful condition.

    Mastitis is a condition that affects many mums who breastfeed their babies, and can even affect those who decide not to breastfeed. It’s one of a few conditions that can cause breastfeeding pain.

    The thought of getting mastitis can cause mums unnecessary worry and yet it can be avoided and quite quickly dealt with if it does occur. So here is your quick guide to avoiding, spotting and treating mastitis …

    What is mastitis?

    Mastitis is an inflammation of the breast and is almost always caused by engorgement. Occasionally it is caused by bacteria getting in through a damaged nipple.

    When breasts get full of milk and, for whatever reason, your baby leaves a lot behind after feeding, you may get a bit of a gridlock of swollen blood vessels and milk. This can cause tissue fluid to leak, creating even more gridlock. This engorgement leads to inflammation.

    Although most people assume you have to be a breastfeeding mum to get mastitis, this isn’t true. Almost all new mums get engorged around day three when the milk “comes in”. So even a mum who has never breastfed can get the inflamed breasts that signal mastitis. Also, nipple piercings and cracked skin can open the way to bacteria getting in and causing infective mastitis.

    What are the symptoms of mastitis?

    The most common symptoms of mastitis are one or both breasts being red, swollen and hot. A painful lump on the breast and flu-like symptoms, such as aches, a sore throat and high temperature.

    The symptoms often come on suddenly but, if you are checking your breasts regularly and gently before feeds, you will spot the firmness and tenderness before the redness appears and the full-blown symptoms of mastitis take hold.

    mastitis symptoms and treatments

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    What is the treatment for mastitis?

    Because most mastitis is caused by engorgement and not bacteria, antibiotics should not usually be needed if you treat the problem fast.

    Engorgement mastitis is actually self-limiting. If baby leaves a lot of milk behind after feeding then that milk starts to be re-absorbed back into your body. This has the effect of turning down the supply, thereby reversing the mastitis. This is why expressing to relieve mastitis can make matters worse. The body can’t work out the true needs of your baby and so continues to over-supply.

    As soon as symptoms start to appear take regular paracetamol and ibuprofen to reduce pain and inflammation, and reduce your temperature if it has risen. If you feel poorly, go to bed and drink plenty of fluids.

    Don’t express but do start doing reverse pressure softening before every feed. Using a flat hand on your breast, firmly massage from the nipple back towards the ribcage.

    Go all around the breast massaging backwards firmly. This will reduce the engorgement and ease the swelling and tenderness without stimulating more milk to be made. Once you have softened the breast a little, feed your baby.

    Let your baby feed for as long (or as as little) as they want on one side and then, after a short break and a nappy change, offer the second side for as long as they want. It is important to let baby lead and not try to interfere in any way by tickling them to make them feed more or taking them off before they are ready. Your baby knows what they are doing and interfering can simply confuse your body, which is trying to work out your baby’s unique needs.

    If, despite your efforts, the symptoms persist, you should see your GP. Just occasionally there is a bacterial infection rather than simple inflammation from engorgement and antibiotics are needed.

    Can you still breastfeed if you’re suffering with mastitis?

    Although mastitis is painful and can make you feel poorly, it is helpful to carry on breastfeeding. Your body needs to know your baby’s needs and the quicker it can work this out, the sooner the mastitis will pass. Lie down to feed as this can be more comfortable and will also allow you to rest.

    If you simply cannot get baby onto your breast to feed, express for 20 minutes from each breast which has not been fed off and feed this milk to your baby. Sometimes the milk will have blood in it and, although this looks grim, it will not harm your baby at all.

    Mastitis symptoms and treatments

    How can mastitis be avoided?

    The best way to avoid mastitis is not to interfere with your baby’s natural feeding pattern.

    Offer your baby only one breast each time, tickling them to keep them continually sucking and repeatedly putting the baby back to the same breast to help them “get more hind milk” are all common mistakes women make which can increase the likelihood of engorgement and, therefore, mastitis.

    Always offer both breasts at every feed – baby won’t always take both but do offer. Give your little one a nice break of 10-15 minutes between sides and use this time to make yourself a drink and change their nappy.

    Unless there is a clinical need like a poorly baby or a poorly mum, avoid expressing before you baby is 6 weeks old. Expressing sooner than this can confuse your body whilst it is still trying to work out the unique needs of your little one and this can lead to over-supply, engorgement and mastitis.

    Every day, practice good breast care. As part of your daily routine, examine your breasts carefully for tender spots and lumps. Work backwards from the nipple and areola and check the entire breast. Any lumps need firm but gentle massage and reverse pressure softening (see above). This daily care can help to prevent blocked ducts, mastitis and “bleps”.

    Although common, mastitis is not an inevitable part of the breastfeeding journey. By looking after yourself, checking and massaging your breasts daily and feeding your baby responsively and on demand, there is no reason why you should ever suffer from this complaint.

    Rachel is one of the main speakers at The Baby Show which is held three times around the UK. She’s also the author of Your Baby Skin to Skin.

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