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how to prevent mastitis |prevent mastitis while breastfeeding

How to prevent mastitis while breastfeeding

Anyone who has had mastitis will be well on a search to prevent it ever happening again and it’s something we’ve considered extensively at the Melbourne Mastitis Clinic. It is horrendous. I know…I had it too. In terms of preventing any condition we must understand the possible causes of the process in the first place. So regardless of whether you are searching for answers of how to prevent mastitis with breastfeeding or how to prevent mastitis when pumping, the underlying issues are the same. This is also the case when looking at how to prevent mastitis while weaning or how to prevent mastitis if you stop breastfeeding cold turkey. We go into these in more detail below.

Given many mamas are told that mastitis is all to do with milk, and draining milk by keeping it flowing, if you’ve been regularly draining your breast and still get mastitis it can feel like a pure place of defeat. You’ve kept your milk moving but you still get mastitis. 

So firstly, it’s so important to keep milk draining from your breast. That is the number one reason women get mastitis. Think of your breast a bit like a balloon. As it makes milk, it fills up and becomes more distended. Eventually if the breast has not been drained soon enough, the milk that is being made will seep outside of the cells, there’s no where else for it to go. And this is what causes an inflammatory reaction in the breast tissues. 

Did you not I said inflammatory and not infection? That’s because a lot of mastitis cases are not an infection, they are inflammation. Many people, even medical professionals will define mastitis as a breast infection and it’s simply not true. It’s another case of a lack of education in women’s health. 

Nipple or breast pain is not normal

too many women put up with nipple or breast pain thinking it’s just part of the journey. Unfortunately this can result in a want to end breastfeeding due to the ongoing nipple or breast discomfort. Nipple or breast pain should always be investigated to determine why there is an issue. Nipple pain can result from a number of factors including poor latching, biting from the baby, and potentially nipple vasospasm. Nipple thrush is also a very painful condition. Another consideration is where the nerve that supplies the nipple (known as T4) may be affected in its pathway to the nipple from it’s journey from the spine.

With regard to breast pain, you don’t need to be breastfeeding to experience that. Breast can be from breastfeeding conditions such as mastitis, blockages, blebs or engorgement. but may also occur from referred pains from the ribcage or spine and less commonly breast cancer Although breast cancer may present with breast pain it is not a common symptom for detecting breast cancer.

Blood in breast milk

It is important to note that blood in breast milk is considered safe but the underlying cause she would be ascertained so it can be rectified. Although it can feel scary when you notice it, there’s likely no need to worry. Blood in your breast milk isn’t usually a serious medical problem. There are a number of reasons you may get blood in breast milk. Most often it is caused by bleeding of the nipples from damage when the latch being a problem or pump flange size incorrect.  An IBCLC can help with this so if you notice that this is the potential reason you have blood in breast milk then seek support.

You may have also heard of rusty pipe syndrome which usually occurs early in your breastfeeding journey. This is due to blood seeping into breast milk when the breast starts to make milk. There is a lot of activity going on in the breast to launch into breastfeeding, and this requires a good blood flow to the breast tissue which can tint the breast milk. Rusty pipe syndrome is seen more often in first-time mums. The good news is that it’s not dangerous or painful, and it usually goes away on its own in a few days.

Blood may also show up in breast milk with a case of mastitis, a broken capillary that leaks into the milk, or another non-cancerous growth called an intraductal papilloma.

Tips on caring for your breast while breastfeeding

There are a number of things you can do to keep your breasts in good condition. This is really important because healthy breast tissue usually means less problems and a good milk supply.

Firstly, nipple care is paramount. Not only are nipples a re common site for a mastitis infection to develop from, it also hurts like hell when you have nipple damage. So a good latch is essential if you are a direct feeder, and pump flange size needs to be a good fit for your shape and size.

There are many nipple creams and balms on the market to support nipple care but you can also leave your nipples wet with breast milk and let them air-dry. There a reason breast milk is so good, and it’s good for you too!!

Another lesser known part of breast care is considering the deeper foundation connective tissue in your breast. It is not just milk making lobes and ducts under the skin, there is a lot of ligaments to support the shape, and sheets of connective tissue (think cling-wrap) that surrounds and encloses the space. These tissues can become restricted and create resistance for the flow of fluids in and out of the breast. Treatment of these breast tissues is a lot of the work we do at the Melbourne Mastitis Clinic, and our sister online education company Your Two Jugs.

Treating mastitis with ultrasound therapy is another approach we use in our mastitis treatments. Ultrasound is a useful tool in addition to genuine breast tissue massage therapy. Many clinics offer mastitis ultrasound but very few combine it with a therapeutic massage approach.

Although we find ultrasound for mastitis useful massage therapy is underestimated in it’s value to treat mastitis. It’s for this reason that we offer Virtual Mastitis consultations for women that can not make it to our location in Melbourne, but want assistance to overcome their mastitis. We simply teach you how to work on your mastitis affected breast over the internet. And yes, it can be that simple! Find out about our Virtual Mastitis Consultations.

What is the main cause of mastitis?

If you want to understand how to prevent mastitis, one of the first things you’ll need to understand is what is happening in your breast and why. Mastitis in an inflammation of the breast tissue, this is true for both infective mastitis and inflammatory mastitis – our two types of mastitis. 

Bacterial Infection

The first one, INFECTIVE mastitis is probably what you think of immediately when it comes to mastitis. Infective mastitis is when there is an active infection with bacteria that has been introduced to breast in some manner. Usually, you may be able to see a pathway the bacteria could have taken like a cracked nipple. When it comes to an infection, we need antibiotics as a part of our treatment plan. This is the way we kill the bacteria stopping the infection. However, the antibiotics will not move along the inflammatory fluid in the deeper breast drainage system. To prevent a mastitis infection, it is really important to get a good latch, so you don’t suffer nipple damage as this is the most common entry point for bacteria to enter the breast.  

Blocked Milk Duct 

The second type of mastitis occurs following milk stasis (when the milk doesn’t move along through the duct). Milk stasis is the catalyst for blocked ducts, which can very quickly progress to mastitis when not addressed as the system ends up with high pressure and milk seeps into surrounding breast tissue. When milk ends up where it shouldn’t, your body is very proficient at inflaming the area to clear it out. However, that inflammation creates all the typical mastitis symptoms. 

Regardless of what type of mastitis you have the symptoms are much the same: 

  • Fever 
  • Aches and pain 
  • Red, hot breast 
  • feeling unwell 

but then with an infection, most of the symptoms are worse and you may also experience fainting, dizziness, vomiting. Seek medical advice if you suspect an infection. 

Does a fever with mastitis mean you have a mastitis infection?

No it doesn’t!  When breast milk is obstructed, irrespective of the cause, there is leakage of milk outside the ducts and lobes that make the milk. In that milk is a protein called a ‘cytokine’. It’s the leakage of
inflammatory cytokines can provoke fever, chills, and muscle aches, clinically mimicking an infection.
Therefore, the presence of whole-body symptoms adds to the confusion about whether or not the mother is experiencing mastitis inflammation or a mastitis infection.

How to Prevent Mastitis

There are many suggestions to prevent mastitis. We have broken these down into 2 categories with this first list being the common suggestions put forward to prevent mastitis. Then just below you can read about lesser know mastitis prevention strategies.

Draining your Breast Milk

This is one of the common ways to prevent mastitis but it’s important to not drain every last drip out and traumatise the tissue.  Draining the breast will definitely reduce the pressure inside the milk producing lobe and duct system which will reduce the likelihood of mastitis as milk is less likely to seep into the breast tissues (which is actually what mastitis is!).  Draining the breast can be via a suckling baby, expressing with a pump or hand expressing milk. Either way you want your breasts to feel supple following a draining session.

Emptying your breast

This can be misunderstood to mean you have to keep your breast void of milk as much as possible. What is good practice is to maintain a consistent schedule so your breasts do not become overfull and then cause mastitis. So yes, please continue to remove milk from the breast but emptying the breast may create the wrong picture that you might think “keep the breast empty”. If your baby has been unwell, is going through a wonder week, is unsettled or tired, if they do not feed very well for a feed, it’s a good idea to empty the breast if that would have been your usual routine at that time.

Breast Feeding Positions

There are a number of breastfeeding positions you can try with baby, and also consider your own posture here. the more comfortable your baby the more relaxed their neck and skull, and the better they will usually feed. Mother’s should also consider their own hand hold of the breast, especially with a new baby. Sometimes crowding over baby, leaning forwards is combined with a firm grip of the breast as you try to feed more of the breast into baby’s mouth. The more open you can leave your shoulders, the least slouchy and the more relaxed, the better. In saying that it may be useful to prop baby with pillows, as well as under your arms to reduce neck stress while breastfeeding.

Is Baby Properly Latching?

Baby latch is paramount for good breast drainage, a less stressed mum and less nipple trauma. Although it’s common to need to put in a little work with a new baby, a good latch should feel comfortable and not graze your nipples. If latching issues persist, mastitis is a common issue, including the infectious type as nipple trauma creates an opening for bacteria to enter the breast. So ask yourself, is baby latching properly, and if not then get some assistance from an IBCLC.

Mastitis Prevention Tips

  • position baby well at the breast 
  • ensure a good latch and if struggling, seek help from an IBCLC 
  • if you have an abundance of milk, ensure you are draining adequately
  • massage engorged breasts 
  • wean slowly if you’ve decided this is the right path for you 
  • drain breasts evenly 
  • be more diligent of draining if there is illness in mother or baby 
  • avoid ill fitting bra, breast shells worn for too long in a bra with too small cups 
  • avoid straps that press into the breast for too long 
  • avoid stomach sleeping 

Lesser known Mastitis Prevention Strategies 

You had a breast well before you breastfed. The tissue that forms the foundation of your breast impacts the lactation (milk-making) tissue of your breast. This underlying foundation tissue can become restricted kind of like a tight muscle or stiffness. When this occurs, it can impact the drainage patterns of fluid in the breast almost like mild kinks in the hoses that create a small amount of turbulence or resistance to drain breast tissue. 

The thing about breast tissue is it extremely ACTIVE. think about the process of making a whole nutritional source for another person. Your breast are working really hard right now. Any upset in the background will affect how easily milk flows and drains which in turn may be the reason you keep suffering bouts of mastitis. 

Factors that impact background breast structural support tissues: 

  • pump fit (athletic chest musculature) 
  • posture 
  • tight muscles 
  • tight breast tissue mobility 
  • tight breast tissue mobility 
  • history of shoulder & arm injuries eg fractures/tendonitis/surgery 

These factors are unfortunately ill-considered in a mother’s breastfeeding health and can be the number 1 reason mastitis keeps happening. It’s something we have see many times in clinic and worked with clients to rectify. 

How to prevent mastitis when weaning? 

The first rule is never to wean when you have mastitis, you’ll only make it worse. After that you need to do this slowly by dropping 1 feed every 5-14 days depending on your body response. Although you may have mentally prepared yourself to wean, that message takes time in your physiology to accommodate the new routine so be patient with your body but trust that it will respond in time. If you require a plan to wean, speak to your IBCLC for assistance. 

How to prevent mastitis when stopping breastfeeding cold turkey? 

If this is your situation you will still need to drain the milk out of your breast. As stated above, your hormones need time to accommodate your new routine. Mums often become anxious that if they remove milk from the breast how on earth will the milk stop being produced? It’s a really good question but that milk still needs to come out. One strategy is to get your let-down and then milk the breast by hand in the shower. The way your body knows to produce more milk is by the stimulation of nerve cells in your nipple. If you reduce that stimulation, you will consequently reduce milk production. So you could use a pump to get the let-down and then hand express. Hand expression down not stimulate the nipple and so in time will reduce milk production. 

Set up a consultation

Would you like to see someone about preventing your mastitis? The Melbourne Mastitis Clinic has in-clinic consultations or virtual consults if you cannot make it into clinic. We can teach the techniques we’ve been using for years to work on the underlying breast tissue that may be the cause of your mastitis. Call 03 9859 5059 or book online via the button below.

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