Mastitis


 

Mastitis is an inflammation of the breast that is often associated with fever (which might be masked by pain medications), muscle and breast pain, and redness. Mastitis can happen at any time during lactation, but it is most common during the first six weeks after delivery. Muscle aches, chills, malaise, or flu-like symptoms are very common.

If you do have an infection, your healthcare provider will probably put you on antibiotics. Here are some things you can do to manage mastitis:

  • Take your antibiotics exactly as directed. If you don’t start to feel better within two to three days of starting antibiotics, please call. You may need a different antibiotic or may have a different problem.
  • Continue breastfeeding, even while you are being treated, and work on your feeding technique, so that your breasts empty well and you avoid nipple cracks. You may need to pump after a feeding to be sure that the breast is empty.
  • Take a mild pain reliever, such as acetaminophen (sample brand name Tylenol) or ibuprofen (sample brand names: Advil, Motrin), if you think it could help.
  • Apply cold compresses or ice packs. Apply warm compresses before breast feeding or pumping to help prevent blocked ducts and to help ensure that the breast is getting completely empty.

To help prevent mastitis: make sure the baby is latching well (see below) to avoid nipple damage/cracks, make sure you avoid engorgement (when the breasts are too full of milk), and avoid blocked/plugged ducts.

The prevent engorgement and blocked ducts you can use warm compresses and massage prior to feeding or pumping to be sure that the breasts are emptying. You should manually massage your breast from the outer part of your breast toward the nipple.

LATCH ON — Latching on refers to the baby’s formation of a tight seal around the nipple and most of the areola with his or her mouth. A correct latch-on allows the infant to obtain an adequate amount of milk and helps to prevent nipple soreness and trauma.

Signs of a good latch-on include:

  • The top and bottom lips should be open to at least 120°
  • The lower lip (and, to a lesser extent, the upper lip) should be turned outward against the breast
  • The chin should be touching the breast, while the nose should be close to the breast
  • The cheeks should be full
  • The tongue should extend over the lower lip during latch-on and remain below the areola during nursing (visible if the lower lip is pulled away)


When a baby is latched correctly, you may feel discomfort for the first 30 to 60 seconds, which should then decrease. Continued discomfort may be a sign of a poor latch-on. To prevent further pain or nipple trauma, you should insert her clean finger into the infant’s mouth to break the seal and then reposition the infant and assist with latch-on again.)

Signs of poor latch-on include:

  • The upper and lower lip are touching at the corners of the mouth
  • The cheeks are sunken
  • Clicking sounds are heard, corresponding to breaking suction
  • The tongue is not visible below the nipple (if the lower lip is pulled down)
  • The nipple is creased after nursing