Mastitis means inflammation of the breast. It can be caused by blocked milk ducts (non-infective mastitis) or a bacterial infection (infective mastitis).
The causes of mastitis are varied and are not inclusive to poor drainage of the breast. This can be caused by poor attachment of the baby at the breast or limiting the baby’s time at the breast. Engorgement of the breast due to a missed feed or delaying a feed, ill-fitting or a tight bra and nipple trauma caused by incorrect attachment of the baby during feeds.
If a blocked milk duct is not cleared, flu-like symptoms such as fever, aches and pains may develop. Milk duct blockages cause milk to pool in the breast and inflammation (pain and swelling). A cracked nipple can allow bacteria to enter the breast and cause an infection.
Symptoms of mastitis include tender or painful, hot, reddened, hard and/or swollen breasts (outside initial engorgement), mum having flu like symptoms and/or a high temperature (over 38°C).
To help prevent mastitis is to ensure your baby is well positioned and attached on the breast, feed frequently and wear loose fitting clothing and/or correctly fitted maternity bra.
Treating / unblocking the early signs of a blocked milk duct is the best treatment to avoid mastitis developing. If mastitis does develop, it is important to continue breast-feeding from the affected breast. Making sure the baby is feeding well on the affected breast (if not breastfeeding ensuring frequent drainage of the breast through feeding expressing) and varying the feeding position to increase breast drainage – pointing the chin towards the block duct can help with this. Applying heat for a few minutes before a feed, gentle massage of the affected area during feeding, and cold packs after a feed and between feeds for comfort can also help. Rest and adequate fluid intake is also recommended.
If the blockage does not clear within 8 to 12 hours or you start to feel unwell, you must see your doctor. Your doctor may not immediately be able to distinguish between simple inflammation and a bacterial infection but will usually treat you as if it is infected with oral antibiotics. If managed early mastitis can be treated very easily but if left it can be very difficult as abscess can develop.
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