Managing Mastitis: Breastfeeding Doesn’t Have to Be a (Literal) Pain

Breastfeeding can be challenging as it is, but bring a painful condition like mastitis into the mix, and it can quickly become a nursing nightmare. Typically caused by a clogged milk duct, inflammatory mastitis may develop if the blockage persists.

Breast pain, swelling, heat, redness, and even a fever are all symptoms of the common condition, which can be tricky to remedy and can even happen again if not properly treated.

The good news? (Yes, there is some!) The Academy of Breastfeeding Medicine (ABM) recently released a new treatment protocol for mastitis that can provide a little much-needed relief to nursing mamas.

“The prior treatments have been found to increase the inflammatory process,” said Amy Greene, RN, IBCLC, a lactation consultant at Baptist Medical Center Clay. “The new guidelines focus on the acronym BAIT: Breast rest, Advil®, Ice, Tylenol®.”

It doesn’t necessarily mean a mastitis infection if symptoms include chills and a fever. But if your temperature is feverish for more than 24 hours and the BAIT remedy mentioned above hasn’t helped, it may have progressed to bacterial mastitis — in which case, you will want to seek medical attention.

“The biggest change from the ABM is that you should refrain from trying to completely empty the breast at each feeding and stop applying warm compresses before feeding because it could increase inflammation,” Greene says. “Instead, ice and anti-inflammatories after breastfeeding or pumping should be your first line of defense.”

Treatment for Mastitis

The new mastitis treatment guidelines may provide some relief. Heed the below tips if having symptoms:

• After nursing or pumping, apply a cold compress or ice to the breast, rather than applying heat as previously recommended.
• When the baby is hungry, breastfeed on demand. Newborns need to eat every two to three hours.
• If breasts feel engorged, don’t overstimulate your breasts or pump excessively — this can cause oversupply.
• If you do have mastitis, wear a well-fitting, supportive bra (without underwire).
• A deep breast massage can actually increase inflammation and trauma to the tissues, which is why lymphatic drainage is suggested in order to relieve painful swelling. To do this, recline back and make light, gentle sweeping movements of the breast tissue with your fingers from the areola back to the armpit area and chest wall.
• Avoid saline soaks to the nipple, such as filling silicone pumps with Epsom salt.
• Probiotics and sunflower lecithin may also be helpful, in addition to over-the-counter anti-inflammatories.