on March 12, 2014 in Breastfeeding, Mastitis

One of the worst complications that can happen during breastfeeding is developing a case of mastitis.  Bacteria in the breast can lead to a breast infection.

Some mothers are late in diagnosing a case of mastitis, as the symptoms are similar to the flu; feverish one minute, experiencing chills the next.  Headaches are common but having a fever distinguishes it from the symptoms of  a plugged milk duct.  In addition to fever, usually a pink or red area on the breast is visible.  Some mothers may not see a pink or red area unless they carefully inspect on the entire breast including the underside of the breast in a mirror.  Mastitis not only causes a mother to become quite ill, but it also places her milk supply at risk.

So what leads a mother to develop mastitis?  While mastitis most commonly occurs during cold weather months, it is very common after a mother has had injured nipples.  One study found that 75% of mothers with injured nipples at 5 days post partum or beyond, usually from a faulty latch, would develop mastitis in the coming weeks.  Skipping or delaying feedings, wearing underwire bras, or pumping with a poor quality breast pump are other reasons that mothers develop mastitis. Being bitten and having an open wound can also lead to a case of mastitis.  Using creams or ointments to sore nipples with unclean hands can lead to a case of mastitis, so thorough hand washing before applying anything to the nipples is imperative.

Mothers with an overabundant supply may be more prone to developing a breast infection.  Perhaps that is because that when a breast is not well drained, bacteria from the skin climbs up into the breast and begins to grow.  Nursing from just one breast at each feeding can help keep the breast well drained and help prevent bacteria from entering the breasts and multiplying.  Mothers with overabundant milk supplies can lower their supply to a more normal amount by nursing from one breast per feeding.

Some mothers opt not to treat mastitis with antibiotics or may be advised by their healthcare providers to simply use moist heat and nurse more often.  But by not aggressively treating mastitis, a mother risks losing her milk supply on that side, developing another case soon after she recovers, or worse, developing an abscess, a pocket of puss that may require surgical drainage.

Because so many mothers develop wounded nipples during the early days of nursing, I often recommend oral antibiotics to help the wound heal and prevent getting a breast infection days or weeks later.  If you have injured nipples at or after 5 days post partum, call your midwife or OB for a prescription of antibiotics.  Nipples heal very slowly when they have bacteria in the wound and taking an antibiotic and fixing the latch, will not only help with the pain and healing, but will also help prevent getting mastitis down the road.  You may also find help with sore and injured nipples by reading my blog on “Sore Nipples in the Early Days of Nursing”

If you develop a case of mastitis, call your midwife or OB for antibiotics, a 10-14 day course.  Nurse as often as possible using moist heat just prior to nursing and start each nursing on the affected breast.  Take ibuprofen, 600 mgms every 6 hours, to help with pain and inflammation. If your baby is not doing a great job of draining the breast well, you can also use moist heat prior to using a high quality pump to keep the breast as empty as possible.  Drink fluids so that you are urinating hourly.

Should you not be feeling much better in 48-72 hours, you may need a different antibiotic.  Call your midwife or OB if this is the case.  Some antibiotics, like penicillin are very ineffective against the bacteria that commonly cause mastitis.  Although uncommon, some mothers may have a Methicillin-resistant Staphylococcus aureus, MRSA, an infection that is caused by a strain of staph bacteria that has become resistant to the antibiotics commonly used to treat some cases of mastitis.  When mothers do not feel better after a change in antibiotics, MRSA could be the cause and is worth bringing up this possibility.  We are beginning to see more mothers with MRSA who have mastitis.

When mothers get a subsequent case or cases of mastitis, and they were treated with antibiotics, that usually means the incorrect antibiotic was used and a different one should be tried.

If you find that your milk supply is affected, using a strong galactagogue can be very helpful.  My favorite is More Milk Plus by Mother Love Herbals.  You can go to Mother Love’s website to find a local distributor or order it directly from Mother Love.  Teas are often suggested for improving milk supplies, but keep in mind that teas are a very weak form of any herb.

Many mothers today forego antibiotics out of concerns about using them.  Some mothers fear that they, or their baby will get a yeast infection if they take antibiotics.  If a mother did not use antibiotics and seemingly got better but then they get sick with a breast infection soon after, they should definitely take a course of antibiotics.  Yeast can be treated fairly easily with the right remedies.  Should you and your baby develop a yeast infection, read my blog on “The Yeast Beast” and how to treat is quickly and effectively.