Mastitis

Mastitis is a common complication of breastfeeding, affecting up to 20% of breastfeeding mothers, particularly during the first six weeks postpartum. It can occur at any time during the breastfeeding period. Understanding the causes, symptoms and treatment methods of mastitis is essential for breastfeeding mothers and healthcare professionals.

What is mastitis?

Mastitis is a painful inflammation of the mammary gland, often due to milk stasis, where breast milk is not properly evacuated. This condition may be non-infectious or progress to a bacterial infection if not treated promptly. The germ most often involved in infectious mastitis is Staphylococcus aureus.

Symptoms of mastitis

Signs and symptoms of mastitis include:

• Pain and tenderness: A painful and hard area in the breast, often warm and red.
• Flu symptoms: Fever (> 38.5°C), chills, fatigue, and sometimes nausea.
• Engorgement: A feeling of engorged breast even after breastfeeding.
• Reduction in milk production: The affected breast may produce less milk. In fact, the reduction in milk production comes from the fact that inflammation prevents and reduces the transfer of milk. The milk is trapped by the inflammatory fluid and cannot come out despite the baby sucking at the breast or with the breast pump. Baby will also have more difficulty latching onto the breast correctly. So less drainage means a reduction in milk production.

Causes of mastitis

Common causes include:

• Insufficient drainage of the breast: Infrequent feedings, difficulties in sucking the baby, restrictive lingual frenulum leading to a lack of milk transfer, poor latching or replacement of a feeding with a bottle.
• Obstruction of milk ducts: Due to tight clothing, high milk production, or inappropriate breastfeeding positions due to infant torticollis, plagiocephaly. In fact, it is rarely the mother who latches her baby poorly.

Mastitis prevention

To prevent mastitis, it is important to:

• Maintain a good breast latch: Make sure your baby has good milk transfer to promote effective milk drainage.
• Breastfeed frequently: Learn to observe the baby’s waking and resting rhythms to offer the breast regularly.
• Avoid pressure on the breasts: Do not wear clothes or bras that are too tight.
• Manage stress and fatigue: Take rest and eat a balanced diet to support your general health.

Treatment of mastitis

Effective breast drainage:

• Frequent breastfeeding: Continue to breastfeed frequently to empty the affected breast. Alternate breastfeeding positions to ensure all areas of the breast are well drained. We advise you to favor the natural breastfeeding position.
• Before breastfeeding, do not hesitate to apply cold compresses and drain the inflammatory liquid by massaging the breast areola in the armpit to direct this liquid towards the lymphatic drainage system. This will soften the entire breast. The cold compress will reduce inflammation. Most of the time, you no longer need to apply hot compresses afterwards because by doing this, the milk will be free of the inflammatory fluid and will come out on its own.
• Manual expression: If breastfeeding is too painful, express milk manually to maintain breast drainage. We really need to encourage manual expression and then the baby’s sucking. Avoid using a breast pump.

Relief from pain and inflammation:

• When you have a sprain, you immediately apply cold to reduce the inflammation. It’s the same on the breast.
• For medications, refer to your doctor.

Antibiotics:

• Medical prescription: If symptoms do not improve within 12 to 24 hours or if they are severe, antibiotics may be necessary. Again, in this case, we advise you to contact your doctor.
• Continue breastfeeding: It is crucial to continue breastfeeding or expressing milk during antibiotic treatment to avoid complications such as breast abscess. Continuing breastfeeding and draining the mammary gland manually if necessary is part of the treatment.

Conclusion

Mastitis, although painful and uncomfortable, can be effectively treated with proper care and proactive management. If in doubt or at the first symptoms, it is essential to continue breastfeeding and quickly consult a health professional such as your ibclc or midwife. With the right support and information, mastitis can be overcome without compromising breastfeeding.