Recognizing Mastitis

Is It the Flu or Mastitis?

By Terreece MyKole Clarke

Fever, headache and achy all over? If you’re a breastfeeding mom, take a second look at your symptoms before you reach for the flu medicine—you may be exhibiting signs of mastitis. Mastitis is an inflammation of the breast that occurs in some breastfeeding women. While not life threatening, mastitis can be a painful and inconvenient surprise.

When my daughter was a month old, I woke up feeling like I had the flu. I turned to my husband and said over the hungry cries of my daughter, “Great! Just what I need.” I disregarded the soreness in my breast as a normal part of early breastfeeding. It wasn’t until after I developed a fever and found hard, tender spots on my breast that I became concerned. I contacted my doctor and was diagnosed with infectious mastitis.

Two Types

There are two types of mastitis: noninfectious and infectious. Noninfectious mastitis is the inflammation of parts of the breast or breasts as a result of blocked milk ducts. There is no fever associated with this condition; however, you may have some discomfort. Symptoms of noninfectious mastitis include tenderness in the breast, hardened areas of the breast and some redness in the area over the mass.

Infectious mastitis is cause by a bacterial infection and requires medical attention. A fever over 100.4 degrees and hardened areas of the breast or breasts accompanied by red wedges on the skin are symptoms of infectious mastitis. Many times these symptoms are accompanied by flu-like conditions including body aches, shivers and nausea. With infectious mastitis, the breast can also take on a shiny, tight appearance.

Mastitis is an inflammation of the breast that occurs in some breastfeeding women.

While mastitis can affect anyone, experts agree that it more often appears in women during the first couple of postpartum weeks. During that time, women are still learning how to breastfeed or are reacquainting themselves with the process, which can result in poor latch-on, nipple damage, and not completely emptying the breast. These issues can lead to mastitis.

“If the mother has a condition associated with poor resistance to bacterial infections: diabetes post-delivery, is a smoker, has anemia, etc., she is at a greater risk for developing mastitis,” says Karen Kerkhoff Gromada, MSN, RN, IBCLC, of Cincinnati, Ohio.

Fortunately neither form of mastitis poses any harm to the nursing infant. Nursing through mastitis can be anything from uncomfortable to painful; however, frequent nursing is the first step in relieving mastitis. Be sure to use different positions while nursing to ensure you are draining the breast. Some research suggests that you position the baby so that his chin is facing the mass to help open and drain the duct(s). Your breast milk may taste saltier, but there is no risk in passing the infection on to your baby. Many babies don’t even notice the change in taste.

Relief Is Near

Nursing or pumping frequently helps relieve both forms of mastitis. Other treatments of noninfectious mastitis include:

  • Cold packs if engorgement is present.
  • Apply heat packs and massage, starting above and over the blocked duct while nursing and between feedings or pumping sessions. Be aware that using heat while engorged may further compound the problem by adding to the edema or swelling.
  • Get enough rest. It may seem impossible when you have a newborn, but the old adage of sleeping when the baby sleeps still works. The laundry—and even the shower—can wait.
  • Eating a well-balanced diet and drinking plenty of fluids, especially water, will help bolster your immune system.
  • Use gravity. “In instances of a plugged duct, making use of gravity while feeding or pumping may help,” Gromada says. “A breastfeeding or pumping position that allows a woman to ‘bend over’ at the waist uses gravity to help move the plug.”

All of these methods work to relieve infectious mastitis, but with infection you also need to see your doctor. Infectious mastitis requires antibiotics. Some doctors may prescribe antibiotics immediately, while others may want you to try the methods described above and then take antibiotics if the condition doesn’t improve. As with any antibiotic regimen, you must complete the prescribed dosage. Missing doses or stopping treatment can result in the infection returning.

Advice for Avoidance

All research shows that the most important way to treat both forms of mastitis is to keep breastfeeding or pumping. In rare cases, abrupt weaning may lead mastitis to develop into an abscess. When this happens, you will need to seek medical intervention to drain the abscess.

As always, prevention is the best way to avoid the discomfort and pain associated with mastitis. My case stemmed from trying to do too much, too soon. I entertained the guests that came to visit; I took care of the relatives that stayed to take care of me, forgot to eat and tried to work and attend class two weeks after I had given birth. I also experienced cracked nipples from improper attachment. It took a painful infection for me to listen to my body and slow down.

“Although some infectious mastitis seems to develop quite suddenly, often a woman is dealing with a condition, such as a cracked nipple or plugged duct, that can precede mastitis,” Gromada says. “In those instances, a woman may be able to avoid mastitis—nip it in the bud—by working with a knowledgeable international board certified lactation consultant (IBCLC), certified lactation educator (CLE), or other breastfeeding support leader. Don’t wait to get help for an issue or problem! Most issues are easier to deal with and cause less worry and pain when tended to early.”

Breastfeeding can be a rewarding experience for both you and your baby, and while some problems may occur, most can be overcome without much disruption to your routine. Seeking the help of knowledgeable health and lactation professionals can help remedy problems without premature weaning.

Visit the International Lactation Consultant Association or La Leche League International to find qualified lactation professionals in your area.

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