Mastitis and the advice we now give
WHAT IS MASTITIS?
Mastitis is an inflammation of breast tissue that sometimes involves an infection.
The inflammation results in breast pain, swelling, warmth and redness.
You may experience chills, and a fever.
CAUSE
The main cause thought to lead to mastitis is oversupply (hyperlactation) which leads to narrowing of the milk ducts which could then progress to inflammatory mastitis.
Mastitis when breastfeeding can make you feel rundown, making it difficult to care for your baby. Sometimes mastitis can lead to a mother weaning before she intends to.
Continuing to breastfeed is better for you and your baby even if needing to take antibiotics.
OLD TERMINOLOGY
We use to use terms such as
‘blocked ducts or ’plugged ducts’
NEW TERMINOLOGY
We now use the new terms
‘localised breast inflammation’ or ‘inflamed breast tissue’
We are now aware that lumps in the breast are most likely caused as a result of inflammation, that has caused ductal narrowing not an actual blockage.
OLD TREATMENT RECOMMENDED
Empty breast by expressing or feeding more frequently
Release the blockage by deep tissue massage and by use of a vibration device
Soften and release the blockage by using heat
Remove blocked ducts by soaking nipples in Epsom Salts
NEW TREATMENT RECOMMENDED
Physiological breastfeeding by maintaining your normal supply with no increase to feeding or expressing, just feed on demand
Handle the inflamed breast tissue gently, only use lymphatic massage (a light sweeping of the skin)
Use gentle techniques to stimulate oxytocin for milk flow
Gentle stroking can be used
Cold compress can be used which will reduce the blood flow and swelling
Take NSAID’s such as Ibuprofen for inflammation
WHAT HAS NOT CHANGED
Enlist in the support of a lactation consultant to assess your positioning and attachment is correct
Try and rest and maintain your hydration
If your symptoms are still present at 12-24 hours then seek a medical review as antibiotics may be needed
If you are uncomfortable you can hand express to relieve any discomfort from your breasts.
Remember to be gentle and not to over stimulate.
OTHER NEW ADVICE
Antibiotics use to be advised immediately for mastitis, and sometimes as a precautionary measure. But the new protocol says that actually antibiotics may not always be required (only reserved for what’s called ‘bacterial mastitis’) and not for inflammatory mastitis nor for mastitis prevention.
Some new research supports the use of probiotics for mastitis prevention and nipple pain. Also there is some new research on using probiotics along side antibiotics to support the improvement of mastitis symptoms and the duration of time of mastitis.
*If using a probiotic with antibiotics they must be taken 2 hours apart
THERAPEUTIC ULTRASOUND
Some new studies suggest that using therapeutic ultrasound for reducing inflammation and oedema may be an effective treatment if performed by an experienced physiotherapist