The cause, the symptoms and what to do about mastitis and blocked ducts when breastfeeding your baby.

Symptoms of mastitis
Almost every breastfeeding mum has been there: You wake up with a sore area on your breast. It looks red and may feel hard or tender to touch. You may feel as if you have the flu’ with some or all of the following symptoms: you have a headache, feel hot & cold chills (fever), sore body, and just want go to bed and sleep.

Determine the cause
When this happens, it’s best to try to determine what the cause of the blockage or mastitis is in the first place, so that you can avoid the same thing happening in future: i.e. baby going for too long without feeding like suddenly sleeping through the night, or a bra or tight clothing digging into you. Mastitis is not something that will just go away on its own. Mastitis may also be the first sign that you are trying to do too much.

What is mastitis?
Mastitis is best understood to be an infection of the lactating breast tissue. It does not always start out being infected. At first you may have no other symptoms other that simply a sore or hard spot on the breast. If this happens it’s best to gently but firmly start taking the steps to get the milk flowing in that area or it could lead to mastitis…

Other causes
Mastitis can also be caused by a crack in the nipple, which is why it’s so important to learn to latch baby correctly to minimize nipple trauma. (It’s always a good idea to get expert hands-on help for this.) That being said, I have found that infective mastitis usually starts off as a blocked duct which, when left to itself, causes pressure to build in the enclosed area as the milk-producing cells continue to produce almost the same amount of milk they are used to producing. This then can cause microscopic tears, which then leads to an infection when the milk gets into extra-cellular spaces it’s not meant to be in.

What to do
So even though you may just want to sleep until it’s all over, you first have to do a few things to help unblock a blockage. If you follow these instructions, it should clear up without needing antibiotics. If after doing all this and there’s no alleviation within 24-48 hours, or if you have an infected nipple, it may be time for stronger meds. (You may also want to try natural antibiotics anyway, such as raw garlic, Vitamin C, etc.)
Please note: There’s almost NO reason to wean due to mastitis! It’s alarming the amount of health care practitioners that suggest this! Weaning can actually worsen the problem in the short term, even when medication is given to ‘dry up’ the milk and mother told to wean baby immediately! Such medication does not work the way mothers think it will: it does not ‘dry’ the milk up. It may slowly start to slow production like a fast moving steam train putting on the breaks – it takes a while! (When weaning, it’s best to let nature take its course and do it slowly over a period of time. No ‘medication’ is needed for this at all. I will write another article on that at a later stage.) Furthermore, sudden weaning puts a mother at risk of developing a breast abscess, a much more serious condition.

FIRST-AID for a blocked duct or mastitis
Take a small frozen pack of peas and a hot-water bottle. Start and end with heat and do the following: Place the hot-water bottle on the area for about a minute or until you can’t stand the heat, then change to the frozen peas until you can’t stand the cold. Alternate the hot and cold, which helps to expand & contract the area. This helps the plug to dislodge or the blockage to ‘move’. End on the heat, then gently massage your breast towards the nipple. Do not hurt or bruise yourself – listen to your body – but be firm enough to help. Then feed baby with chin pointed in direction of sore spot, or express. Your aim is to keep the breast as empty as possible while it heals (so feed/express often).
Afterwards while you rest, place a cabbage leaf just on that spot. Discontinue the cabbage patch once you are feeling better as it can slow down production when used for too long. It also contains anti-inflammatory properties.

Anti-inflammatory medication may me helpful (tell the doctor or pharmacist that you are breastfeeding so that they prescribe the right medication) Vitamin C, essential fatty acids and Vitamin E (found in raw seeds, avo’s & olives) are also essential for your body to heal and can help prevent further mastitis.

You may find that having a plugged duct or breast infection causes a temporary decrease in your milk supply in the affected breast. Be assured that, once the milk is flowing again, you will be able to increase the supply again by feeding frequently. This may take several days or even longer, so don’t lose heart!

Drink plenty of pure water, go to bed with your baby, and REST 🙂

(C) Yulanda Ridge
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About the author:
Yulanda Ridge, IBCLC, RLC
(International Board Certified Lactation Consultant)

Yulanda has been helping moms and babies since 1995 with regards to breastfeeding. A married mother of 3 with some nursing background, Yulanda currently works as a Lactation Consultant in Private Practice.