What is Mastitis?
Mastitis is a breast tissue infection most commonly occurring during breastfeeding. This condition may arise when bacteria reach a milk duct through a crack in the nipple, often from the baby’s mouth (x).
The breast consists of a few veins and ducts, which lead to the shaded region called the areola and the nipple. The milk-carrying ducts spread like a wheel’s spokes from the nipple into the inner breast tissue. There are lactiferous ducts underneath the areola. These are filled with milk when a woman just gave birth and during the lactation period. When bacteria infect the milk ducts, this is called mastitis.
The most common occurrence of this breast infection is in the first three months after delivering a baby. However, those who have not delivered a baby recently may also be infected as well as women in the menopausal stage. Chronic mastitis and a very rare cancer form called inflammatory carcinoma usually cause these infections. Mastitis can also occur in women who are not breastfeeding as well as men.
Lactation mastitis can make the mother’s breast swell and be extremely painful. In severe cases of mastitis, it can force a breastfeeding mother to swap to formula due to the high levels of pain the activity causes. The mother can safely continue to breastfeed while taking antibiotics to treat the infection (x). However, if the pain is too extreme it is not a problem to use baby formula to supplement while the infection is severe, or to swap entirely if the mastitis is chronic.
The breasts can swell significantly and become tender. Veins may become more noticeable in your breasts as the swelling takes them nearer to your skin (x).
You may discover red spots on the breast when you have mastitis. It may stretch to the whole area of the breasts, including the area between them (x).
The whole breast area can be exceptionally tender, in addition to any pain from nipple cracking that may be in the area (x).
Flu-like symptoms such as fever (usually 101 degrees Fahrenheit or higher) or elevated body temperatures, aches, fatigue and frequent chills are also symptoms of mastitis.
A burning sensation can either be continuously felt over the whole breast continually, or only during the time of breastfeeding (x).
Abnormal Milk Appearance
Milk expressed may appear clumpy, lumpy or stringy. Although this milk is safe for babies, some mothers prefer straining out the “lumps.”
Due to the elevated salt and chloride content, milk can take on a saltier flavor. Some children may resist/refuse the milk.
Causes of Mastitis
Blocked Milk Duct
It is possible that the ducts can become clogged (x). Milk trapped inside the breast due to the clogging is a very common cause of mastitis. Due to this, the most important stage of preventing mastitis is frequent and effective expressing. The mother can often feel when this needs to happen. It is indicated by a full or tight feeling in the breasts and can often be tender or painful.
The infection itself is caused by bacteria being present in the lactating mother’s breast. Bacteria from the surface of your skin and your baby’s mouth or fingers can reach the milk ducts through that tiny hole in your nipple’s skin or by the milk duct’s opening. In an unemptied breast, stagnant milk offers a breeding place for bacteria.
Cracked or Bleeding Nipples
This can be a point of access to the milk ducts for the bacteria. These can be points of entry for the bacteria, which can trigger the infection. There are a variety of things that you can do to try and minimize nipples cracking. You can discuss these with your midwife, OBGYN or with other mothers.
Pacifiers and shields for nipples can make the flow of milk slow and may promote infection. Using artificial nipples and pacifiers can influence how the baby latches and may lead to the soreness of the nipples.
Irregular Feeding Due to Refusal of the
It is normal for babies to go through periods when they simply refuse to latch, though this can cause of significant distress for mothers (x). If this is occurring, you should be sure to express frequently to make sure that the milk doesn’t become backed up as this can lead to mastitis.
It is important to ensure that the bra you choose is not too tight or restrictive. Finding a bra and bathing shirt which are gently supportive, preferably without underwires or stiff structuring is a good step to preventing mastitis — and general discomfort during the breastfeeding period. Even a sturdy shoulder strap bag or a baby carrier’s frequent use can trigger the development of mastitis.
Any breast operation in the past, lumps found in the breast or a breast injury can increase the chance of developing mastitis.
Mastitis Remedies and Supplements
Echinacea is full of antioxidants and is a natural anti-inflammatory agent that can assist in alleviating minor pain caused by mastitis. It is also a popular fix for the common cold or flu as an over-the-counter herbal remedy. The recommended dosage is set at 450 milligrams taken once or twice a day, as directed by your doctor.
While it is generally considered safe, those with autoimmune disorders should not take echinacea as it can make the condition worse. In addition, those with ragweed, daisy and marigold allergies should avoid this supplement. Discontinue use if rash, itching or trouble breathing occurs.
An increase in lecithin has been suggested as a therapy for plugged milk ducts (x). The recommended dosage for this treatment is at 3,600-4,800 mg lecithin per day, or one capsule (1,200 milligram) 3-4 times per day unless otherwise directed by your physician (x).
Garlic serves as a broad-spectrum antibiotic. It is often used to help combat infection. The suggested dosage is two daily servings of 650 mg.
Intake of too much garlic can cause gastrointestinal problems, body odor and bad breath. Further, those taking anticoagulants should take caution, as too much garlic can interfere — especially warfarin.
Those with blood sugar or insulin problems should discuss with their doctor before adding garlic extract to their health regime, as should pregnant women to ensure that it is safe to do so in their current state.
Vitamin C is a popular vitamin that works well with the other enzymes and alternatives. It can also help in strengthening the immune system. Any type of supplement with vitamin C can be useful for any mother suffering from chronic mastitis or plugged ducts. Pregnant women should not take more than 6,000 mg of vitamin C daily or there is a chance that the child may develop scurvy in the womb (x). All pregnant or breastfeeding women should inform their doctor of planned supplement changes.
There can be severe side effects if levels of vitamin C are too high.
It is sometimes suggested to use cooled or room temperature cabbage leaves to relieve symptoms of engorgement. Researchers have found them to be effective in relieving pain, just like cold packs do (x). However, despite its pain-relieving effect, there is no evidence that it shortens the duration of the condition.
The Bottom Line
Mastitis and breast abscess are prevalent, but are mainly preventable, occurring in all communities, and creates an impact on breastfeeding. They are primarily triggered by unemptied breast milk. However, mastitis can also be caused by a bacterial infection, which is most likely the secondary cause of this infection (x).
Minimizing pressure on the breasts, nipple cracking and insufficient expression of milk are the main ways to prevent mastitis. As mastitis is an infection, antibiotics are commonly prescribed. If an abscess has formed and significant pus has accumulated, drainage may be required. Breastfeeding can be performed even when the mother has mastitis and it is safe for the child.
There are several supplements which may help the body fight this infection, though nursing mothers should always discuss any supplements with their doctors before starting to take them.