Every year around mid-November lactation consultants see a spike in mastitis that peaks at the end December but often lingers until mid January. During the holidays, everyone becomes really busy . New mothers are more vulnerable to stress and physical fatigue because they are trying to do a myriad of actives. If a mother has multiple children, the problem is compounded by the number of older children she has because family and friends assume as an experienced mother doesn’t need help. Let’s go over mastitis basics, what to look for, when to call for help and how to prevent it.

What is Mastitis?

Mastitis is defined as a preventable but common lactation complication that lead to an inflammation of breast tissue that may or may not lead to an infection.

Simply put, when you skip feedings and your breasts stay engorged, it causes extreme pressure in your breast tissue. Milk starts to leak out of the milk compartments into the surrounding tissues that where not meant to hold milk and they become inflamed. Mastitis can happen the first 3 to 4 weeks postpartum, when you wean abruptly or during sudden decreases in breastfeeding. It can take anywhere from a few days to ten days to resolve in most situations. Some mastitis can linger longer and some mother's will develop complications, reoccurring mastitis or plugged ducts.

What causes mastitis ?

• Over engorged breasts, going way to long between feedings.

• Over use of a pacifier to stretch out feedings so you do not have to stop an active at home/ in public to feed the baby.

• Using bottles to feed your baby in public or at family gathering instead of breastfeeding then waiting until you get home to nurse your baby instead of pumping at regular intervals.

• Trying to do it all by yourself: shopping, preparing meals, taking older children to practice, helping with school events, etc..

• Allowing yourself to be trapped at activities for four or more hours without pumping or using hand expression to relieve the pressure in your breasts.

• Prolonged separation of mother and baby that can be defined as daily or several times a week

How to prevent mastitis at any time of the year

• Nurse frequently, especially if you have a young baby.

• Plan to pump or express milk from your breasts for long separations from your baby.

• Watch your breasts for engorgement, feed your baby promptly if they feel too full.

• Don’t try to prolong feeding especially with young infants. This can cause poor weight gain with “polite” babies who will not let always cry when they are hungry.

• Remember the golden breast feeding rule: crying is a late indicator of hunger.

• Delegate jobs and do-list, don’t let others push everything onto you at home or work.

• Avoid sleeping on your stomach; do not wear tight, constricting clothing or bras.

• Get plenty of sleep and try to stick to healthy diet.

What are the physical signs of mastitis, what should I be watch out for ?

• Chills, headache, flu-like symptoms or a fever over 100.4°F.

• A painful swelling or hard area in your breast that is not going down after a feeding or pumping.

• A red, tender or painful area(s) on your breast that is hot to the touch.

• Red streaks that radiate over your entire breast or large parts of it.

• Your baby is reluctant or refusing to nurse on the affected side.

What should I do and when should I call the doctor?

Most mastitis is not infective. It can be treated with common sense measures such as rest, and frequently emptying your breasts. You should call your doctor if you feel worse after 24 hours, or have a fever over 101.8° F.

You can help your mastitis quickly resolve by:

Getting plenty of rest.

Eating healthy foods to boost your immune system and staying hydrated.

Sleep without a bra. During the day wear lose fitting bras or skip wearing one entirely.

Massage your breasts before a feeding and during feeding feedings to promote better drainage

Alternate between cool compresses to help with swelling, and warm to promote better milk flow.

Tip: Massaging your breasts in the shower or in a warm bath works best for most mothers to help with slowly draining breasts.

Use OTC analgesics such as acetaminophen and/or ibuprofen for fever and pain. They are safe to take while breastfeeding. Plus unrelieved pain not only decreases your ability to produce milk, but suppresses your body’s ability to fight infection.

Most babies do mind the saltier tastier of breast milk when their mother’s have mastitis while other will refuse to nurse. If your baby refuses to nurse on the affected side, pump or hand express to keep your breast drained. Tip: Start on the other unaffected breast first and switch to the mastitis side second.

Do not abruptly wean, this will make your mastitis much, much worse!!!

When to contact a lactation consultant:

If you cannot get your breasts to drain even using a pump or hand expression.

If you have pus leaking out your nipple or a hole has formed in the side of your breast.

If you are not getting better even after you started antibiotics and feel much worse.

If this is your second or third bout of mastitis in four to six weeks.

If you have large, painful lumps you can feel in your breast that are not draining and are getting larger.

If you find it too painful to nurse your baby or pump the affected side.

Anytime you want safe alternatives to treat non-infective mastitis that is lingering.