Mastitis—prevention, detection, and care

For many women, breastfeeding is synonymous with well-being and emotional bonding with the baby. When breastfeeding is at the root of tenderness or pain, certain questions must be asked, such as if mastitis is the cause.

What is mastitis?

Today, breastfeeding is a natural for a great number of parents. Its benefits have been proven many times over. When all goes well, breastfeeding brings joy and tranquility to both mother and child. However, complications can occur, casting a shadow on these joyous moments. This is the case for mothers who must deal with mastitis.

Mastitis is an inflammation of the breast tissue that is likely to affect women who breastfeed. It can infectious or non-infectious. Infectious mastitis is caused by the spread of bacteria in the breast, often originating from small cracks in the nipple.

Non-infectious mastitis is mainly attributed to milk stasis (obstruction or slowed milk flow), and may be caused by plugged milk ducts. In some circumstances, it may develop into an infectious form.

Ideally, the occurrence of mastitis must not put into question your decision to breastfeed. Before discontinuing to breastfeed, speak to a healthcare professional, who will tell you how to remedy the situation.

Who is at risk of developing mastitis?

Mastitis affects one breast and sometimes both. Although it can occur at any time during breastfeeding, it often occurs in the six weeks following childbirth. It is more frequent in women who have had cracked nipples or when the breast stays engorged for too long.

Incorrect latching is one of the main risk factors of mastitis; that is why one of the basic prevention and treatment methods is to review breastfeeding techniques. Abrupt weaning can also be a contributing factor.

It is not known exactly why some women develop mastitis, while others do not.

What are the signs and symptoms of mastitis?

The most common signs and symptoms of mastitis include the following among others:

  • firm, red or swollen area of the breast
  • tenderness or pain in the breast
  • sensation of warmth in the breast
  • nipple discharge
  • fever
  • muscle pain
  • chills
  • general malaise
  • flu-like symptoms

If the following signs and symptoms occur, it may be advisable to see a doctor promptly:

  • high fever that lasts more than 24 hours
  • bleeding nipple
  • intense pain that lasts throughout a feeding

In the most serious cases or without treatment, mastitis can lead to complications such as a breast abscess or sepsis (infection of the blood).

How is mastitis diagnosed?

Clinically, it can be difficult to distinguish between infectious and non-infectious mastitis.

Doctors are the best-suited healthcare professionals to diagnose mastitis. Most of the time, they base their evaluation on the description of symptoms and on a physical examination. Strictly speaking, there is no medical test that allows the diagnosis to be confirmed.

Although mastitis generally affects women who are breastfeeding, it can also occur in women who are not. If this is the case, the doctor may want to do some additional tests, such as a mammogram or a breast biopsy.

How is mastitis treated?

If you are suffering from infectious mastitis, a prescription may be recommended. Your doctor will choose the antibiotic according to the type of infection, your health, and whether or not you are breastfeeding. It is important to tell your doctor about any drug allergies you may have, as the medications used in this situation are often in the penicillin or cephalosporin family.

If you take an antibiotic, you should note an improvement of your symptoms within two or three days. It is crucial to take your medication as prescribed, and to take it consistently to the end of the determined treatment period. If you do not see any improvement after a few days, contact your doctor.

Regardless of the type of mastitis, if you feel pain, you can take an over-the-counter analgesic (a product containing acetaminophen or ibuprofen, for instance). Always ask your pharmacist for advice before taking any over-the-counter medication, especially if you are breastfeeding.

What else can I do?

If you are suffering from mastitis, here is some practical advice:

  • First, do not stop breastfeeding. This would not benefit you or your baby and could even make the situation worse.
  • Breastfeed more often (ideally 8 to 12 times a day) and try to vary breastfeeding positions.
  • Consult a breastfeeding specialist to review your technique. It is important that breastfeeding be effective and that the milk be emptied from both breasts after each feeding.
  • Gently massage the affected breast in a circular motion while you breastfeed
  • Consider using a breast pump to remove excess milk after a feeding, if necessary. Milk stasis should be avoided.
  • Apply warm compresses to the breast before a feeding, and cold compresses between feedings.
  • Wear a well-adjusted bra, but not one that is too tight.
  • Rest. Breastfeeding can be tiring, especially when you are having difficulties.
  • Be sure to hydrate adequately; drink plenty of water.
  • Take your temperature regularly to check if you have a fever.

How can a pharmacist help me?

For a new parent, it is completely normal to have some moments of insecurity and doubt concerning the health of both mother and child. Fortunately, you can surround yourself with healthcare professionals who can give you sound advice and guide you during each step of your baby’s development. For instance, it is important to be able to count on the expertise of a pediatrician, a CLSC nurse, or on your pharmacist. These experts can offer support in a variety of situations.

If you have questions about breastfeeding, your health or that of your baby, speak to your pharmacist (unless, of course, it is a medical emergency). Pharmacists can advise you about what to do, or direct you to certain resources, depending on your situation. In some cases, they can recommend over-the-counter medications to prevent or treat a health issue or to relieve symptoms.

If you must take or would like to take medication, your pharmacist will indicate if it is appropriate for you depending on your health, medical history, and other medication you may be taking. He/she will also tell you if it is suitable to take while breastfeeding. You can find a wide range of products at the pharmacy that are likely to make your everyday life easier and offer adequate care for you and your baby—breast pump, breastfeeding pads, anti-chafing nipple cream, thermometer, etc. Ask your pharmacist to talk to you about the different options that are open to you. Consult him/her as often as needed!

Finally, mastitis can be one of the obstacles that arise on a new mother’s path. Being well-informed will help shorten the extent and duration of these inconveniences. Ideally, nourishing your baby in the most natural way possible should be a source of joy and not pain!

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Mastitis—prevention, detection, and care

For many women, breastfeeding is synonymous with well-being and emotional bonding with the baby. When breastfeeding is at the root of tenderness or pain, certain questions must be asked, such as if mastitis is the cause.
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