Rhiannon Giles’s son, Rowan, was born premature and spent weeks in the NICU, which made breastfeeding difficult. Without her baby being able to sufficiently empty her breasts of milk, Giles often became engorged, which led to her getting mastitis, an inflammation of the breast. She suffered through it three times before Rowan was six months old. “At its worst, my breast was very red and tender. I had a fever, chills, body aches, and was just plain exhausted. It was really miserable,” recalls Giles.
Mastitis commonly occurs in the first few weeks of breastfeeding, although you could get it at any point while you’re nursing (Giles also got it with her older daughter, Lorelei, when she was eight months old). It can come on because of a restriction of milk flow—whether that’s from a blocked duct, infrequent nursing, a poor latch or a tight bra—or from an infection entering your breast from a cracked nipple and getting into a milk duct.
The good news is, once you’re aware of the signs to look for, you can try to get the milk flowing again to prevent mastitis from getting more serious.
If you feel a hard spot in your breast, begin massaging it immediately, preferably while nursing. This little spot is likely a plugged duct, which is more easily cleared before the breast becomes too engorged and tender, explains Tracy Hydeman, a midwife in Regina, Sask. That said, even if you are engorged and in a lot of pain, massage is key to clearing the clogged milk. “I have seen women so engorged and so tender that the only way to clear the blockage is by literally getting deep into the tissue with your knuckles.” That’s what worked for Jeannine Thibodeau, a mom of two who lives in Boston. “It hurt like hell, but I found where the duct was clogged and massaged the heck out of it and eventually squeezed it out, in addition to pumping like crazy.”
Placing heat on the engorged breast will help soften the blockage and encourage the milk to flow. “Stand over the sink and wet a facecloth with very hot tap water to wrap around your breast,” suggests Veronica Lussier, a mom of two. Repeat this when it cools to keep it hot. Hydeman says warm compresses work really well to get the milk flowing, but it’s also OK to soothe your breast after nursing or pumping with a cool compress as well. “Whatever feels good,” she says.
Getting into the shower or tub can be an ideal way to soften your breasts, says Hydeman. “If I could feel a little blockage forming, standing in a hot shower facing the spray and letting the water work it out often helped,” says Sandy Gage*, a Winnipeg mom who got mastitis twice when her son was a baby. “It needs to be an old-school firehose-level spray though,” she says, because the pressure helps work out the blockage. Giles would take a warm bath, and hand-express milk. “It was so satisfying,” says Giles. “Normally, milk will float out in little smoke rings, but when you've gotten to the clog, it will come out in little snake-like ropes. It's fascinating to watch. Plus you have an excuse to take lots of baths!"
Ultimately, you need to get the milk out of your breast to start feeling better. So nurse your baby as much as you can, ensuring she has a proper latch. Lussier says nursing in different positions also helped. Some women use a hand pump or electric pump to clear the milk ducts. Hydeman tells women not to be surprised if the milk looks a little funny. There can be a range of discharge that comes out of your nipple once you’ve started clearing the blockage, but everything that comes out is safe for your baby to drink, unless it is green or foul smelling, in which case you should see a doctor immediately, as you may have an infection that needs to be treated.
If your nipples are sore and cracking from a bad latch, treating the nipples with a lanolin cream or even just breastmilk will help them to heal and reduce the chance of infection. However, you’ll need to fix the latch to prevent the damage from returning, says Hydeman. You may need to see a lactation consultant for help.
Boosting your immune system won’t necessarily cure mastitis, but it doesn’t hurt to take supplements like vitamin C and probiotics so that your body is better prepared to fight an infection. “Making sure your body has the best defences is always worth trying,” says Hydeman, adding that it’s also important to get lots of rest. However, she points out that addressing a poor latch or damaged nipples is what will ultimately prevent mastitis or keep it from returning.
If your breasts are engorged, Hydeman suggests placing cabbage leaves over them. “They cup the breasts naturally, and it relieves inflammation,” she says. Some women also swear by raw, wet potato slices to reduce the inflammation—something Hydeman has never recommended, but she says it could be helpful if used in addition to other techniques to clear the blockage and get milk flowing. While it’s a good idea to try to clear your breast on your own, if you have a fever (a temperature of more than 38 degrees Celsius/100 degrees Fahrenheit) for more than 24 hours, accompanied by flu-like symptoms, you need to see a doctor immediately for antibiotics, says Hydeman. An untreated mastitis infection could lead to an abscess, a painful collection of pus that’s difficult to treat, and may need to be surgically drained. So when in doubt, see a doctor.
*Name has been changed.