So we all have one, that friend that breastfeeds her baby with no dramas, pops the baby on with relative ease and talks about how simple it is!  But in truth many women have issues in the early days and often beyond.  For many of those women (approx. 50% by six months), the issue is Mastitis.

So what is it (and if we are so prone), what can we do to help?

Mastitis is Inflammation of the breast tissue and surprisingly isn’t always due to infection. As a breastfeeding mum you may have experienced lumps and bumps in your breasts that come and go as your baby feeds or you express your milk out. These hard grape like areas are milk ducts, full to the brim with milk that isn’t being drained …but why?

It may be that your supply is still settling down in that first 6 weeks after birth and your baby, despite being a ravenous feeder, just can’t keep up….
Or it may be that your slightly older baby has started to space their feeds out and your breasts are having to be on hold between feeds….
Or it could be due to your baby having an attachment difficulty when feeding, so the milk isn’t being removed as it should be…..
Or it could be as simple as a nursing bra that’s too tight across your breast and blocking the milk flow from those ducts.
These situations can all lead to a lump or bump that can generally be fixed relatively easily…. We’ll come to that in a minute.

Mastitis related to infection is a whole different ball game …
This is generally caused by a bacteria travelling up the nipple ‘holes’ and multiplying in the ducts way up in the breast or anywhere along the milk pathways.
Mostly this is caused by damage to the nipple from a latch that needs correcting or sometimes with an older baby …a bit of tooth action!
The delicate skin on the nipple if broken, can allow bacteria to enter the breast and set up home.
This situation can be a bit trickier to fix, but we’ll come to that….

So how do you know you have Mastitis?
In its early stages it may present itself as a hard lump in the breast, just about anywhere, from the areola (the dark area around the nipple), right up to the armpit.
Yep that breast truly is the shape of a chicken fillet!
You may find it changes in size with feeds or can be reduced by massage while feeding or expressing. The skin may look the same as always and it may only feel uncomfortable when you touch it. If that lump persists and the milk isn’t shifted or if there is infection present (as previously discussed), then the area becomes more inflamed and angry looking.

If you strip down to your birthday suit and check in the mirror you may see a red area on your breast, it may be a big patch of red or streaks.  The skin may be shiny and swollen.
You may also be feeling unwell.

Mums that have experienced mastitis report it’s like being hit by a truck. Shaking, sweating, shivering, headache and achy limbs (very similar to flu).You may find your whole breast is painful to touch and feeding is uncomfortable, you may even find that your baby is reluctant to feed on the affected side.  (It’s thought that the milk tastes different).

So what are we going to do? How do we fix this?
The most important thing is to continue to feed your baby, if it’s too painful then at least use a breast pump, but your baby is best at removing milk efficiently. The milk will not harm your baby at all.

Start each feed on the affected side to encourage your baby to drain the breast. Massage the sore area as you feed/pump to shift the milk. Try to feed you baby with his/ her chin to the affected area, this will further increase that part of the breast being drained (this may mean some weird positions!!)

Drink plenty of water, rest and feed, feed, feed. You can also use cold packs for comfort. If you are feeling lousy, it could be that antibiotics are needed. Make a trip to the GP asap, once it reaches the stage where your are feeling unwell.  The conservative methods above are less likely to work.
Of course there are other more natural methods of treatment and prevention, but always seek qualified advice…

There are probiotics that contain Lactobacillus fermentum, an isolated strain of probiotic found in breastmilk, that helps to maintain healthy microflora and may reduce the incidence of mastitis and relieve breast pain and discomfort.

Lecithin is another ‘new’ breastfeeding friend, (not really new as it’s always been in our bodies) but taking a supplement may help to prevent blocked ducts. This works by the Lecithin decreasing the stickiness of the milk, therefore reducing the risk of it getting stuck in those ducts.

So in a nutshell……  Prevention is better than cure.

  • Whether you are breastfeeding or expressing, demand feeding, mixed feeding or feeding your best friends baby too… Breast health is everything.
  • Those breasts know what to do but they need some TLC.
  • Check your attachment is as good as it can be, your baby can only do so much to drain that breast.
  • If you have doubt that your baby is attaching well, seek advice from an LC,
    poor attachment = poor milk removal + sore nipples = lumps + potential infection.
  • Feed regularly, drain those breasts and keep that supply and demand going.
    Have a ‘babymoon’ if possible, long lazy feeds, rest and eat well.
  • Watch out for lumps and act quickly if you find one. If you start to feel unwell, make a plan ie;  a GP appointment, in case it gets worse.

Sometimes despite doing all the right things, we hit a problem.  The most important thing is to seek expert advice (preferably a Lactation Consultant, not Dr Google) to help you quickly get back on track.

Melanie Boulter RN RM IBCLC

Newman J. (2009) Blocked ducts and mastitis.
ABA ( 2016)  Breastfeeding: Breast and nipple care.
Ayoro R, Martin V et al (2010) Treatment of infectious mastitis during lactation.
Antibiotics V Oral Lactobacillus isolated from breastmilk.
NCBI (2007) A descriptive study of Mastitis in Australian Breastfeeding women.


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