What you need to know about mastitis

The journey of motherhood can be both incredibly rewarding and challenging. One challenge that some breastfeeding mothers may encounter is mastitis, a breast tissue infection characterised by painful, swollen breasts and flu-like symptoms.
 
Barbara Le Grange, a paediatric nurse and certified lactation consultant at Westville Hospital, in Durban, explains that mastitis can occur when one of the milk ducts is blocked and becomes inflamed. “This occurs frequently in mothers who have cracked, blistered nipples, or are undergoing a period of stress, such as returning to work or a change in daily routine,” she says. According to Le Grange, common symptoms of mastitis include fever, chills, body aches, breast tenderness and pain.

Common causes of mastitis

The primary cause of mastitis is often a blocked milk duct. When milk doesn't fully empty from the breast during breastfeeding, it can accumulate in the duct, creating an environment conducive to bacterial growth and inflammation. Bacteria do not generally thrive in fresh human milk. However, if the milk ducts are blocked, and the milk stagnates, infection is more likely.

In some cases, mastitis can occur due to a bacterial infection entering the breast tissue through a cracked or sore nipple.

Recognising mastitis symptoms

Mastitis symptoms can include:

· Breast pain and tenderness
· Warmth in the affected area
· A tender lump or hard area
· Fever and chills
· General fatigue
 
The symptoms of mastitis can be like those of inflammatory breast cancer (IBC). IBC is a rare but aggressive form of breast cancer characterised by redness, swelling, warmth, and pain in the breast. IBC is also associated with other symptoms, such as persistent itching, and nipple changes.
 
If you experience symptoms like those of mastitis, it's essential to consult a healthcare professional promptly. While mastitis is typically not cancerous and can be treated with antibiotics and proper care, IBC is a severe medical condition that requires immediate attention.

What you can do

Your healthcare provider can diagnose the condition and recommend appropriate treatment, which often includes antibiotics. Mastitis that isn't adequately treated or that is due to a blocked duct can cause a collection of pus (abscess) to develop in your breast. An abscess usually requires surgical drainage.

You can also:

Continue breastfeeding: Contrary to what you might think, it's generally safe to continue breastfeeding with mastitis. In fact, breastfeeding can help clear the blocked duct and promote healing. To manage mastitis, it is advisable to avoid skipping feeds, says Le Grange. “Apply moist heat before feeding, and ice packs after feeding. If necessary, hand pump before or after feeds for relief, and ensure your baby is positioned correctly when feeding to achieve a deep latch.”
Take pain relief: According to Infant and Child Feeding, over-the-counter pain relievers like ibuprofen or acetaminophen can help ease pain and reduce fever associated with mastitis – ask your doctor about this. If the symptoms persist or worsen after 24 hours of improved milk removal, see your healthcare provider as you may require antibiotics.
Rest: Try and rest, and have adequate fluids, and good nutrition.

How you can avoid mastitis

When breast milk fills the breasts, causing them to become engorged, proper care is required to avoid blocked tissue ducts which can lead to a bacterial infection such as mastitis. “The breasts should each be massaged for 30 seconds, once daily – up to four times during the first two weeks after birth – with a hot face cloth and coconut or tissue oil,” says sister Linda Britz, a registered midwife and lactation specialist at Tina Otte’s Family and Child Centre in Johannesburg.

She also recommends doing this prior to a feed to help with drainage. “Watch out for painful, sore and swollen lumpy breasts which are a sign that a bacterial infection is developing. However, even if this does happen, baby can continue to feed as the milk is unaffected. For engorgement, place a cold pack or a cabbage leaf from the fridge over the breast for 20 minutes, a few times a day.”

It's crucial to seek professional medical advice if you have concerns about your breast health. Early detection and proper treatment can make a significant difference in both mastitis and more serious breast health issues. Remember, you are not alone in facing these challenges, and healthcare professionals are there to provide guidance, support, and peace of mind.

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