Some Advise to Mastitis

- Jan 12, 2020-

Mastitis is an inflammation of the breast that may be accompanied by infection. Mastitis mostly occurs during the first six weeks post-partum, however, it can also occur at any other point during lactation. Causes of mastitis are linked to insufficient milk drainage, milk stasis and inflammation. Blocked ducts and engorged breasts can also lead to mastitis if they are not treated appropriately. 

In conjunction with advice from a healthcare professional, evidence-based strategies that may be implemented include:

· Feeding with the affected side first and breastfeeding frequently to help clear blockages. If pain interferes with milk ejection (let down), mums can start with the unaffected breast instead

· Help with positioning and attachment, trying different feeding positions to try and clear a blockage if present

· Resting as much as possible

· Warming the breast with heat packs before feeding to help stimulate milk flow and cooling with cool packs after a feed to help relieve pain and inflammation

· Using analgesics: following consultation with a medical professional, analgesics may be recommended to help with pain and milk ejection. In particular, an anti-inflammatory agent such as Ibuprofen is considered safe during breastfeeding

· Consultation with a medical professional regarding the need for pharmacological treatment vs. non-pharmacological treatment

· Using antibiotics: if the mum is ill or symptoms have not improved within 12 hours, antibiotics are usually recommended for the treatment of mastitis

· Completing the whole course of antibiotics is recommended. An antibiotic that is effective and compatible with breastfeeding should be chosen. During this time the mum should continue breastfeeding, as there is no evidence of risk to a healthy term baby feeding from a mum with mastitis, and continued milk removal is important

· Different antibiotics are required if mastitis is caused by methicillin-resistant S. aureus (MRSA). If MRSA is present in the community, breast milk culturing and assay of antibiotic sensitivities may be required if the mastitis does not improve

· If symptoms of mastitis do not clear within a few days, a wider differential diagnosis should be considered to confirm resistant bacteria, abscess formation or another breast issue