How to Prevent Mastitis

Mastitis is a common complication while initiating breastfeeding, weaning, or at any point in between. Because of the pain and swelling that typically goes with it, many women are discouraged from breastfeeding and may consider weaning their babies prematurely. However, some strategies can help prevent this complication, and that’s exactly what we’re going to talk about in this article.

How to prevent mastitis? Lactation mastitis, or breast inflammation that occurs while a mother is breastfeeding, is caused by breast milk that has not drained effectively from the breast. Therefore, preventive measures for mastitis generally involve techniques on how to completely remove milk from the breast. This includes breastfeeding more effectively and avoiding milk ducts from becoming clogged.

 So how do you know if you have mastitis? What should you do to prevent this painful condition? Here are some tips on how to prevent mastitis.

What is mastitis and why it occurs

 Mastitis is the inflammation of the tissues in the mammary glands of the breast. It usually happens among lactating women. According to the American Academy of Pediatrics, when an area in the breast is not adequately drained, bacteria will thrive in that area, potentially leading to an infection. 

 So how can you spot the signs of mastitis? Most women find it hard to differentiate mastitis from the normal engorgement that usually occurs during the adjustment period of breastfeeding. When your milk comes in and your breasts get engorged, they will generally feel warm, tender, and heavier. This is NOT mastitis. Instead, it indicates normal breast engorgement that can be relieved by frequent nursing or pumping. It will usually fade away as your body adapts and calibrates your milk supply, depending on your baby’s needs.

 Engorgement may be normal, but if your breast milk isn’t sufficiently removed from the breast, bacteria can accumulate and trigger an inflammatory response. This will result in the inflammation of the breast tissue, which is termed as mastitis. 

Mastitis can also occur when you stop breastfeeding. After weaning, your breasts will continue to produce milk, until such time that your body recognizes that it is not needed anymore. If you abruptly stopped breastfeeding, your breasts will become engorged with milk. This is when mastitis is more likely to occur.  

With mastitis, the following signs and symptoms can be observed:

  • Your breasts are swollen, hot and painful to touch
  • Painful lumps (where breast milk may be clogged)
  • The skin of the breast appears red, shiny and stretched
  • The nipple becomes taut and hard to latch on
  • Fever (Temperature 38.5°C or more)
  • Flu-like symptoms like fatigue and body pain
  • May also be accompanied by tenderness of the nearby lymph nodes (located near the underarm)

Mastitis needs to be treated by antibiotics and other relief measures to prevent more serious complications such as a breast abscess or septicemia (when the infection spreads to the bloodstream). Contact your doctor without delay once you spot any of the signs of mastitis.

How to prevent Mastitis

 As you can see, mastitis is a serious and painful condition that should be treated promptly. There are some ways to prevent mastitis, and you can easily carry out these from home. Here are some expert tips to avoid mastitis in different situations:

How to prevent mastitis when pumping

If you have been pumping milk to build your up your supply, or to store some extra breast milk in the fridge for use when you are away from your baby, here are some ways to prevent mastitis:

Pump immediately after breastfeeding

If your baby does not fully empty your breasts, pumping right after your nursing session can help drain the breast. You can use a high-quality hand pump or an electric breast pump to remove the remaining breast milk. This will prevent engorgement that can lead to mastitis.

Pump before breasts become overfull

When pumping to maintain your milk supply while you’re away from your baby, make sure you pump during your baby’s usual feeding schedule. This will prevent your breasts from producing too much. Aside from being uncomfortable, breasts that become over engorged are at an increased risk of mastitis.  

Apply warm compress before pumping

This technique is helpful in stimulating your milk let down. If you have clogged milk ducts, the warmth will help open the ducts and encourage the flow of milk. By avoiding clogged ducts, you will also decrease your chances of getting an infection.

Gentle breast massage while pumping

Concentrate on the painful areas of your breast. This will help clear the milk ducts and prevent clogging. Gentle massage and compression while pumping can also facilitate better milk flow.

Exclusive pumping for cracked nipple

Cracked nipples are a point of entry to bacteria, and this could leave you at an increased risk of getting mastitis. If you have a cracked nipple, consider exclusively pumping on that breast for some time. This will allow some time for your nipple to heal while you continue breastfeeding on the other side. 

How to prevent mastitis when I have stopped breastfeeding

At some point, mothers will eventually stop breastfeeding. It may be temporary for reasons such as hospitalization, or out of town work. It may also be permanent.

Whatever the reason, ceasing breastfeeding will eventually lead to milk stasis, which puts you at a higher risk of getting mastitis. Preventative measures can help relieve or prevent breast engorgement without compromising your goal of getting back to nursing or permanently weaning your baby. 

How to prevent mastitis when you have temporarily stopped breastfeeding

Bring along a manual or battery-operated pump for travel

If you stopped breastfeeding due to travel, make sure you bring a high-quality manual breast pump or a battery-operated pump in your hand-carry bag. This will ensure that you can express your milk anytime when you’re starting to feel full and prevent engorgement. 

Pump at regular intervals

Pump your breasts at regular intervals to keep your milk supply. Pumping works the same way as nursing your baby, and it will tell your body to produce the same amount of milk that your baby needs, even while you’re not with your baby. Milk removal is the most effective way to prevent engorgement and mastitis.

Seek advice from your doctor

If you’re temporarily stopping breastfeeding due to medical reasons, ask your doctor about the possibilities of continuing to breastfeed. Your doctor will prescribe medications that are compatible with breastfeeding and advise you on what to do to maintain your milk supply while having medical treatment.

How to prevent mastitis when weaning

Gradually slow down your milk production

Ideally, you need to give your body and your baby some time to get used to a new routine before you finally wean. Experts recommend to do it gradually. For example, you can remove one feeding every 1 to 3 days, and replace it with solids (if your baby is 6 months and above). You may also shorten your feeding sessions by one minute every day. Abrupt weaning is not advised as it is stressful for your baby and puts you at an increased risk of mastitis.

DON’T over remove your milk

Weaning will make your breasts feel uncomfortably full. If you don’t remove some milk, it will lead to engorgement and possibly mastitis. However, if you remove too much, it will trigger your milk production and produce more milk. So what should you do? Remove just enough breast milk to provide comfort. The frequency and quantity to be removed may vary for every individual.

DON’T bind your breasts to stop milk production

This is an age old practice on weaning that has not proven helpful. Binding your breasts won’t stop your milk production. Instead, it could lead to clogged ducts, sore breasts, and worse, mastitis.

Consider herbal treatments to decrease your milk supply slowly

Some herbs, like sage, jasmine, cabbage leaves, and peppermint, are found to help decrease milk production. However, be extra careful in using only the right amount. For example, sage is found to effectively reduce milk production when taken at recommended amounts and has been helpful for many mothers who are weaning. However, if not taken properly, it could instead stimulate oversupply. Seek appropriate and accurate from a lactation consultant on how to use these herbs safely.

Medications for weaning

If you decide to wean your baby, speak with your doctor. Your doctor may prescribe medications that could help relieve your discomfort while weaning, such as Ibuprofen. Some also consider prescribing birth control pills that are high in estrogen, or medicines which can decrease milk supply depending on your and your baby’s health condition. Do not ever take these medications without your doctor’s consent as close supervision is necessary. 

General tips to prevent mastitis in all situations

Avoid tight-fitting outfits and underwire bra

Constrictive clothing and an underwire bra can create unnecessary pressure to your breasts. Compressed areas of the breast may result in incomplete draining of milk and this could increase your risk of mastitis. If you need to wear them for a particular occasion, just make sure to change to well-fitting clothes and a comfortable bra once you get home.

 Check your positioning and attachment

A poor latch and using the same position every time you breastfeed will make you more prone to clogged ducts and mastitis. If you often feel a sore spot on an area of your breast, try to re-latch and explore other nursing positions. This can help drain the milk from that area more effectively. 

Avoid long stretches in between feedings

If you’re not weaning, it is not good practice to wait for an extended period of time before you nurse your baby. Frequent feedings are often advised to prevent engorgement and mastitis. If it’s not possible to nurse at your usual feeding schedule, you can hand express or use a pump to remove your milk.

Avoid unnecessary use of nipple shields

Nipple shields can be used to promote the healing of cracked nipples or help breastfeeding babies with latch problems. However, its misuse can lead to complications such as blocked ducts. This could eventually develop into mastitis. Follow your doctor or lactation consultant’s advice about the proper use of nipple shields.

Avoid breast injuries

The straps from your sling bag, seat belt, or baby carrier can cause unnecessary pressure to your breasts, especially if you wear them frequently. If you have older kids, be vigilant about accidental hits or bumps on your breasts. An unintentional kick by your toddler may unknowingly cause breast injury. These mild breast injuries may lead to blocked milk ducts and increase your risk of breast infection.

Rest and stay hydrated

Rest and hydration are essential requirements for better health, and moms who are breastfeeding are at a higher risk of not meeting these requirements. Sleep and adequate fluids will minimize your risk of getting an infection. Make sure you get enough sleep by compensating while your baby is asleep. Have a glass of water near your breastfeeding corner so that you can quickly replenish the fluids you lose while breastfeeding. Even while weaning, adequate rest and fluids will help your body recover to its healthier state more quickly. 

With an awareness of the symptoms of mastitis, you can successfully continue breastfeeding or wean your baby without going through this painful condition. You can also ask your doctor or lactation consultant for an individualized care plan to prevent mastitis.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5118955/
https://academic.oup.com/aje/article/155/2/103/107880
https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Mastitis.aspx

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