Mastitis / Breast Inflammation / Clogged Milk Ducts

A MUST READ for breastfeeding moms with tips to avoid and get better.

Some tips from Mary, an international board certified lactation consultant (IBCLC) & Gravidamiga.

One of my favorite times to meet with new parents is during pregnancy; prenatal education is so key to feeling prepared for breastfeeding. We often start our discussion with what is already known about breastfeeding and any concerns.
A common concern among many new parents is mastitis. Soon-to-be parents have heard the horror stories of painful, hard breasts and they are downright scared.
I’m here to tell you today that information is power and the mastitis monster doesn’t have to be scary.
Today’s blog is meant to empower and prepare you for healthy, pain-free breastfeeding and NO mastitis.

WHAT IS MASTITIS

Simply put mastitis is breast inflammation. Mast means breast and itis means inflammation.
Symptoms usually include painful, hot, hard breasts, painful spots (clogged milk ducts) decreased milk flow, up to general unwellness, fever, chills and breast pain.
Mastitis often occurs when milk stops flowing freely from the breast and inflammation and often infection develops. 
This can also happen if you are stressed!
During lactation the blood flow to your breasts is increased, milk ducts proliferate (grow), and you have an increase in, well, milk. That’s a lot of fluid and tissue in your breasts. It’s with this setting that by virtue of lactating you are at an increased risk of mastitis, but fear not because mastitis is not a given during breastfeeding and you *can* avoid it altogether.

HOW TO AVOID MASTITIS

The key to avoiding the mastitis monster is frequent milk removal, good breast hygiene, and breast movement. Let’s talk a little about each one.

MILK REMOVAL

In the early weeks of breastfeeding, babies need to feed quite frequently. They may “cluster feed” wanting to come to the breast every hour for several hours before finally taking a short nap. In fact, for the first several months babies will nurse about 8-12 times in 24 hours. This frequent feeding keeps them growing and thriving, and is great for your milk supply and breast health. It is also common for babies to continue to feed 6-8 times in 24 hours up until one year of age and beyond. This transition to fewer feeds and longer sleep periods at night can mean longer periods between breast milk removal.
A good tip
If your breasts are engorged and uncomfortable during these times, a session of light hand expression just to comfort, can help keep the milk flowing and therefore keep the mastitis monster at bay.

BREAST HYGIENE

Breast hygiene during breastfeeding is actually quite simple. During your pregnancy you may notice prominent bumps on your areolas as your breasts grow and darken. These bumps are actually called Montgomery glands. They are sebaceous or oil-producing and keep your breast area clean and moist; pretty amazing, right?! While you don’t need special soaps to further clean the breast or nipple area, it is recommended that any open cuts on the nipple be washed with warm soapy water and treated to encourage healing so as to not become a vector for bacteria introduction to the breast. If you experience bleeding or abrasions on the nipple or breast during lactation, a special nipple ointment with lanolin (e.g. Lansinoh or Medela Purelan) or compresses from e.g. Multimam can help or speak to a lactation professional or your midwife.

BREAST MOVEMENT

You’ve likely heard of yoga or gymnastics for limber muscles and increased range of motion, right? This type of movement is also good for your breasts during breastfeeding. Remember what we said in the beginning about increased fluid and tissue in the breasts? It’s very important to move the breasts to avoid milk stasis or pooling of the milk in your milk ducts. A gentle full breast massage and lifting the breast up, down, left and right before breastfeeding can work wonders in preventing mastitis and keeping the milk flowing.

WHAT TO DO IF YOU THINK YOU HAVE  A BeGINNING INFECTION, a clogged milk duct OR MASTITIS

What if you do everything above and you still think you may have the beginning of a breast inflammation?
There are a few things you can do at home before you may need to reach out to your doctor for further antibiotic treatment.

Mastitis can feel like the flu; you feel generally unwell and require rest. Jump back in bed with your baby, push fluids like warm tea, broths or plain water, and keep your milk flowing. A gentle full breast massage and alternating warm moist heat before feeding and cold therapy after feeding can help the milk flow and reduce inflammation.
In Germany the recommendation is to use curd (Quark)and/or Retterspitz for cooling and for reducing inflammation. Make a whole in two kitchen tissues as big as your nipple. Than smear the Quark on one tissue and then put the other one on top and then on your breast. If you use the Quark directly on your skin it can get very messy :-)
Also white cabbage right from the fridge can help to reduce the pain as well as a cream called Mercurialis Perennis from Weleda (a natural company) which you can get in the pharmacy.
In general it might help to let your baby drink frequently or pump and let the baby latch in different positions. Especially if milk duct is clogged make sure the chin of your baby when nursing is close to the clogged duct.
You may also use an electrical toothbrush or vibrator (whatever you have on hand) to massage and release the clogged duct.

Another tip is to use your Haakaa cup if you have one:

*Fill your Haakaa with enough warm water to make contact with your nipple.
*Add one or two tablespoons of Epsom Salts.
*Attach your Haakaa to the blocked breast and allow the combination of heat, the salts and suction to help remove the clog
*Keep the pump attached for between 10-15 minutes.

links to YouTube Videos on how to apply

Retterspitz & Quark

If your symptoms resolve in 8-12 hours, then no need to see the doctor.
If your fever persists beyond this, if you cannot get the milk to flow, or if you feel worse, it is recommended that you reach out to your doctor (usually your midwife or OB) for antibiotic intervention or go back to the hospital you gave birth in.

TO SUM IT UP

Mastitis is just plain awful, but it does NOT have to be part of your breastfeeding journey. Keep the milk flowing with frequent feeding, keep your breasts healthy by treating open wounds, and encourage movement of your breasts to increase blood flow and reduce milk stasis.

Have more questions about breastfeeding?
We have a regular breastfeeding & formula Workshop  - dates and booking via our Calendar. and also a Video-on-Demand course which you can read more about here.
Gravidamiga is here to help!

October 2020 Mary Unangst, IBCLC & Gravidamiga
This blog post has been prepared with the greatest possible care and does not claim to be correct, complete or up-to-date.“

Tell someone of us today - thank you!

https://www.instagram.com/gravidamiga/
https://www.facebook.com/gravidamiga

or more general information about life in Stuttgart  on our partner page
Kiramiga and sign up for our NEWSLETTER on our website.