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How to Prevent and Treat Mastitis

For breastfeeding moms, mastitis isn't much fun. Here are some expert tips on how to deal with it...and how to avoid it all together.

By Teresa Pitman
How to Prevent and Treat Mastitis

Photo: iStockphoto

Plugged ducts (or mastitis) are the main cause of breast pain for nursing mothers. Thankfully, many breastfeeding women never experience them, and others only go through these challenges once or twice. But for some women, they are ongoing and recurring.

What’s a plugged duct? When one of the milk ducts becomes inflamed or constricted, milk can back up behind that point, causing swelling and discomfort, even pain if it isn’t resolved. After the milk has been backed up for awhile, it can become thicker (like toothpaste) and it becomes harder to get it flowing again. To the mother, this often feels like a tender lump in one part of the breast (or under the arm where the milk ducts extend).

In some cases, bacteria will grow in the backed-up milk (or bacteria may have caused the initial inflammation of the duct and then proliferated in the milk). Then the plugged duct can progress to mastitis.

With mastitis, the infected area of the breast becomes more swollen, looks red and often feels hot to the touch. The mother may feel feverish, nauseated and tired—like having the flu.

Not all cases of mastitis are related to plugged ducts, though. In some cases, bacteria gets into the breast through cracks or other damage to the nipple. If not treated, mastitis can sometimes turn into a breast abscess, which may need to be drained by your doctor.

That’s the technical side. Here’s what you can do to prevent and treat plugged ducts and mastitis:

Under pressure

Plugged ducts are often caused by pressure on some part of the breast that stops the milk from flowing through the duct. A poorly fitting bra (especially an underwire one), sleeping on your stomach, or a baby carrier with tight straps across your chest are things to watch out for.

woman putting on bra bymuratdeniz / Getty Images

Express your breasts

Ducts can also get inflamed or plugged up when your breasts become too full because the milk isn’t being effectively removed. If you need to be separated from your baby, or if he suddenly sleeps all night without nursing, make sure you hand express or pump some milk to keep it flowing.

This can also happen when you're in the process of weaning your baby and is one reason that gradual weaning is usually recommended. We suggest keeping a manual breast pump on hand or nearby at all times.

Close up on midsection of unknown caucasian woman holding baby bottle and breast pump pumping milk for her baby - parenthood and motherhood concept top view Miljan Živković / Getty Images

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Feedings can help

When you detect a plugged duct, encourage your baby to feed frequently on that side. Try different positions in case one is more effective in getting the milk to flow through that particular duct.

Mother breastfeeding baby at home Westend61 / Getty Images

Massaging for the win

Use gentle massage or pressure on the part of the breast where the milk is backed up as the baby is nursing. Applying heat between feedings can also help. Taking over-the-counter anti-inflammatory medication may make you more comfortable and reduce the swelling.

woman massages her breast Mykola Sosiukin / Getty Images

Act fast

Responding to a plugged duct quickly will help to prevent it from turning into mastitis.

woman with baby crying in arms and covering her breast Peter Dazeley / Getty Images

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Use supplements

If you have repeatedly plugged ducts, sometimes taking lecithin (a food supplement) can prevent them from returning. Also, see if there are ways you can get some extra help: being stressed and busy can be a risk factor for plugged ducts.

This sunflower-based lecithin supplement is one of the best for lactation relief.

woman taking vitamins blackCAT / Getty Images

Get a massage (seriously)

Some massage therapists are skilled at treating plugged ducts and reducing the risk of them returning.

Relaxed woman receiving massage in a salon AntonioGuillem / Getty Images

Keep your breasts clean (with breast milk)

If you have cracked or bleeding nipples, keep them clean to prevent infection. The best protection: your own milk, which has antiseptic properties. Express a little milk after each feeding, drip it onto your nipples, and let it dry there before putting on clean nursing pads. When you shower, use plain water on your breasts and nipples, then use milk on the nipples again.

woman putting breast pad on bra FotoDuets / Getty Images

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Use heat, massage, and rest

If mastitis does develop, use the same strategies as with a plugged duct: keep the milk flowing, use gentle massage and pressure, try different positions and apply heat. Rest in bed as much as possible.

Try these affordable Lansinoh Breast Therapy Packs for both hot and cold relief.

woman with heating pad fizkes / Getty Images

Keep breastfeeding

Even with mastitis, your milk is not harmful to the baby, and it will help you recover more quickly if you continue breastfeeding. Occasionally a baby won’t like the slight change in taste of the milk on the affected side. If that’s your baby, keep breastfeeding on the unaffected breast and pump the breast with mastitis, using heat and massage and hand expression to keep the milk flowing.

(If you're pumping, you may see some of the thickened milk come through, or you may see small amounts of pus or blood in the milk. These are not harmful to the baby.) You may need to supplement temporarily.

Need a boost? Check out our list of the best lactation cookies on the market.

Mother breastfeeding baby on arm chair in living room Oscar Wong / Getty Images

If nothing helps, see a doctor

If the mastitis doesn’t improve or seems to be getting worse after 24 hours, see your doctor. You may need antibiotics. If the infection progresses to an abscess, your doctor may need to make an incision to drain it. You can continue breastfeeding while on antibiotics and after the abscess is drained.

While mastitis is not much fun while you have it (to put it mildly), recovery is usually quick – you’ll notice a big improvement within 24 hours of taking antibiotics. And, in most cases, you simply continue breastfeeding and the problem never returns. If it does become a recurring problem for you, talk to a breastfeeding expert such as a Lactation Consultant or LLL Leader who can help you sort out possible causes and solutions.

This article was originally published on Oct 11, 2017

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