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Mastitis is a subject that has come up several times in the past few months, so I thought I would pass on some of the information gleaned from my doula course about it.

Mastitis – inflammation of the breast tissue – is a painful condition that sometimes affects breastfeeding women. It can occur with or without the presence of infection, and is almost always attributable to poor milk flow. Its onset can be sudden; generally you will feel “achey” and feverish as if developing ‘flu’ and part of your breast will appear swollen, red (sometimes shiny) and feel hot and painful to the touch.

Mastitis occurs when milk is not being removed from the ducts deep inside the breasts effectively, and milk begins to “back up” in the duct. Some of this milk may leak into surrounding tissue, triggering an immune system response characterized by the feelings of fever and illness. If untreated, infection can develop in milk stagnating behind the blockage.Blockages can be caused by an over-tight bra, persistent pressure from a handbag strap or car seat belt, or even lying in bed with an arm pressing into the breast. Supporting your breast incorrectly with your fingers digging into the breast tissue as you feed can result in a blockage over a period of time, as can your baby pressing his/her fist or fingers into your breast as they feed. He most common cause of mastitis remains incorrect positioning of your baby at the breast during feeds.

As soon as you suspect a problem, the most effective step you can take is to feed your baby from the affected breast first as often as possible. The milk will not harm your baby. Warm flannels, or a warm shower or bath, prior to feeds will encourage the milk to flow and ease pain. As your baby feeds, gently massage the affected part of the breast towards the nipple in small circular motions to assist the milk flow. It may help to express a little milk before your baby feeds to stimulate the flow and make it easier for your baby to “latch on” if your breast is engorged. Varying feeding positions ensures the milk ducts are fully drained – try the “football” or “rugby ball” hold, or try feeding lying down. ake sure your baby is correctly latched to the breast, as poor attachment results in “nipple-feeding” and worsens the problem.

Cold compresses between feeds ease pain and reduce inflammation – try a bag of frozen peas well wrapped in a tea towel. Proprietary gel-filled packs are available which can be warmed or chilled as required. Arm rotating (as if doing back stroke) helps drain excess fluid from breast tissue and improves circulation, thus relieving discomfort. Rest as much as you can; if possible take your baby to bed with you and feed frequently. The more you feed, the quicker you will begin to feel better. You can take Paracetamol or Ibuprofen to bring down your temperature and ease pain, but DO NOT TAKE ASPIRIN – it is unsuitable for breastfeeding mothers. Natural remedies for mastitis are available, but as they are always prescribed specifically for the mum in question, consult a qualified herbalist or homoeopath rather than self-prescribing. Homoeopathic remedies and some herbal remedies are completely safe to use when breastfeeding, but do seek professional advice.

If, despite self-help measures, you feel no better after 24 hours, consult your GP as you may have a bacterial infection that requires antibiotics. Many antibiotics are compatible with breastfeeding, so there is absolutely no need to stop breastfeeding your baby. When the mastitis clears up, ensure that your baby is always well-positioned at the breast and latched correctly – prevention is better than cure!