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All Your Mastitis Questions Answered

All Your Mastitis Questions Answered

Any mama who’s had to deal with a bout of mastitis will tell you that it’s no joke. This painful milk duct infection can really knock you on your feet for a few days!

Mastitis is the worst; I feel you right now mama.

All you want is relief and to start feeling like yourself again. Well, you are in the right place! As a first time mom, I had a few encounters with this frustrating breastfeeding hurdle, but since then I’ve learned a lot about how to cope and prevent mastitis in the first place.

When you have mastitis, there is an infection present in your milk duct. Sometimes, antibiotics are necessary, but other times natural remedies at home can clear it up. If you’re like me, you try to avoid antibiotics unless they’re absolutely necessary, so learning natural remedies is important. 

What’s more, whether you’re dealing with mastitis for the first time, or you’re having recurring cases, you want to stop the cycle. Today we’ll also learn about best breastfeeding practices and a few other natural tips to help keep mastitis and clogged ducts away from your breastfeeding journey for good.

Read on to learn all about mastitis, treatment options, and prevention tips, all with a natural focus in mind.

What is mastitis and what are the symptoms?

Mastitis is the swelling and inflammation of breast tissue. It’s usually associated with an infection in your milk duct. Mastitis causes redness, swelling, tenderness and pain on the affected breast. Often, it will feel warm to the touch, and the redness may take on the shape of a wedge.

In addition to these localized symptoms, the hallmarks of mastitis that will tip you off that this is more than just a clogged milk duct are the often intense, flu-like symptoms. Many mamas spike a fever, experience chills and shivering, feel achy all over, and extreme exhaustion. 

According to Kelly Mom, Mastitis occurs in approximately 20% of all nursing mamas in the US and is most common in the first 2-3 weeks of breastfeeding (but it can happen any time in your nursing journey!).

How does mastitis happen?

Mastitis can occur when bacteria enters your milk duct through a crack or abrasion on or near your nipple. Often, this is bacteria that is naturally occurring on your skin or in baby’s mouth, but when it breaks through the skin, it can cause infection (source). This is why some mamas experience mastitis early in their breastfeeding journeys when their nipples may be healing from cracks and sores. 

Mastitis can also happen because of milk stasis. Milk stasis is essentially a build-up of milk in your milk duct that becomes stagnant, creates swelling and can lead to infection. Milk stasis or restricted milk flow usually first appears as a clogged duct. If the clog isn’t cleared quickly it can progress to mastitis.

Milk stasis and clogged milk ducts can occur for a number of reasons including (source):

  • Tight clothing or bras
  • Sleeping on your stomach (especially when engorged or when your milk is first coming in) 
  • A bag strap or baby carrier that’s positioned too tightly across your breast
  • Forgetting to switch sides or nursing on the same side twice in a row
  • Inadequate milk removal due to latch issues, tongue ties, etc.
  • Issues with oversupply
  • Skipped feedings or pumpings due to going back to work, baby sleeping longer than usual, or any other reason

Additionally, it’s important to note that stress, extreme fatigue, anemia, being immunocompromised and a past history of mastitis all increase your risk of developing a breast infection.

Treating mastitis

Whether you notice a clogged duct forming, or you’re dealing with full blown mastitis, your first line of defense will be the same: nurse, nurse, nurse! You want to keep the affected breast as empty as possible, and baby is your best bet for helping to clear the clog. 

Decreasing or skipping nursing can put you at an increased risk for serious complications. Nurse on, mama! The saying for breastfeeding treatment of clogged duct and mastitis is: “heat, rest, empty breast”. Let’s take a look at everything you can do.

Clear any clogged ducts

In addition to nursing on demand, with favor given to the affected side, you’ll also need to work diligently and aggressively to clear any clogged ducts. Until the clogs are clear, you are at risk for further complications and the infection may just keep coming back (even with antibiotics).

Clogged milk ducts can be difficult to remove, but with patience and persistence, they will give way. Here are some of the best ways to get that duct cleared:

  • Applying moist heat before you nurse can help get things moving. Taking a bath, shower, or applying a warm compress all work well. You can also gently massage your breast while applying heat to help clear the clog
  • Use vibration to help get things moving, an electric toothbrush can work well
  • Try doing a dangle feed (or pump) where you feed baby with them lying on their back. Gravity can help clear the clog
  • Use a comb to massage your breast and basically comb out the plug

Home treatment and natural remedies

If you do find yourself with a case of mastitis and you are working on clearing the clogs, there are some other home treatments and natural remedies you can try. In some cases, antibiotics are the best option. Infection that doesn’t improve can lead to dangerous complications including an abscess. Remember, mastitis is not always infectious, however, if your milk stasis is not cleared, infection can (and will often) occur, making it more difficult to treat your mastitis without antibiotics.

Kelly Mom quotes the Academy of Breastfeeding Medicine’s Clinical Protocol for Mastitis which states: 

“If symptoms of mastitis are mild and have been present for less than 24 hours, conservative management (effective milk removal and supportive measures) may be sufficient. If symptoms are not improving within 12–24 hours or if the woman is acutely ill, antibiotics should be started.”

With that guidance in mind, and in the name of avoiding antibiotics because of their association with thrush and yeast infections, gut issues, and other negative impacts, here are some effective alternatives:

  • Take a probiotic supplement. A number of research studies have shown probiotics to be as effective and just efficient as antibiotics in treating mastitis, even infectious mastitis (see the research here)
  • Boost your immune system with Vitamin C and Echinacea. You can take 3000-5000 mg of Vitamin C per day, and 900 mg of Echinacea during a bout of mastitis (source)
  • Raw Garlic is known for its antibiotic properties. Aim for 3-5 cloves a day to use for treatment against mastitis
  • Try compresses made with healing herbs to treat inflammation. Rosemary infusion, fenugreek seed poultice (which is a traditional, natural treatment for mastitis) and dandelion root compresses are all recommended (source)
  • Ibuprofen taken around the clock can be very effective for reducing inflammation and pain to help get your clogged ducts cleared and avoid antibiotic use
  • Sunflower Lecithin Supplements may reduce the viscosity of your milk. This may help clear clogged milk ducts faster and prevent them from forming if recurring clogs are an issue for you (source)

In addition to these treatments, remember that you are ill! You need to rest and sleep as much as possible so that your body can heal. Try to enlist your partner or another loved one to help with the baby, but be sure you are nursing every two hours (or even more often).

Additionally, hydration is so important! Being well hydrated will help your milk supply and support your body in fighting off an infection.

When you might need an antibiotic

There are some cases of mastitis where antibiotics cannot be avoided. Often, you can call your provider and they will prescribe antibiotics over the phone based on an explanation of symptoms. Instances where you need to begin antibiotics immediately include:

  • Mastitis in both breasts
  • Visible red streaking on your breast
  • Visible infection (pus, blood) on the nipple
  • A sudden increase in temperature
  • Very sudden onset of symptoms
  • Symptoms persisting or worsening after the 24-hour mark

If you have any concerns about infection, it’s always best to check in with your doctor or midwife for clinical advice on how to proceed! What’s more, with repeated mastitis, you may need professional guidance and support from a lactation consultant to help address the root issue.

If you do need to go on an antibiotic for your mastitis, it is highly recommended to take a probiotic supplement at the same time. It will increase your body’s ability to fight off the infection, help restore your gut bacteria, and reduce the risk of other negative antibiotic side effects. 

How to reduce your risk of getting mastitis

Hopefully, mastitis and clogged milk ducts don’t become a regular thing in your life. But if you’re already facing recurring bouts, or you want to make sure they don’t happen, here are some steps you can take:

  • Prioritize nursing your baby or pumping at least 8 times in a 24-hour period. When baby is awake, every two hours is ideal, at night it’s safe to follow their lead
  • Keep track of what side you nurse on first at each feeding and start the next feeding on the alternate side. Baby usually sucks most vigorously and more adequately empties the first breast of every feeding
  • Avoid tight clothing. Ill-fitting, too-tight bras are especially notorious for causing clogged milk ducts
  • Remember that stress and exhaustion can lead to mastitis. Mastitis is actually recognized as our body’s way of telling us to slow down! With this in mind, prioritize self-care and don’t overdo it as a nursing mama
  • Get professional support from a Lactation Consultant to address latch issues or other signs that baby is not adequately removing milk
  • Address symptoms of an oversupply which can lead to recurring clogged ducts and mastitis, read more information from La Leche League International about oversupply here

Feel better, mama!

Mastitis is no fun, and when it comes on suddenly with chills and flu-like symptoms it can even feel a bit scary. With the proper care, rest, and hydration your condition should improve quickly. If you have any doubts about what’s going on, don’t hesitate to reach out to your OB/GYN, Midwife, or PCP.

Do you have an additional tip or remedy that helped you when you had mastitis or a clogged duct? We’d love to hear from you below!

Additional sources:

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