Mastitis: tried-and-tested treatments

Mastitis. Milk fever. “Melkkoors.” Any woman who has gone through these things will agree with me: it’s hell. I once read a post where Jessica Martin-Weber of The Leaky Boob blog described mastitis as “the red-eyed breastfeeding monster”, and I thought that was a pretty appropriate name. I’ve personally had mastitis four times, and while the milder bout was not too bad, when it’s at its worst it’s something I wouldn’t wish on anyone. Let’s be honest, mastitis is really excruciating. But the good news is, at least we know how to treat it so that things can get back to normal as quickly as possible. Let’s look at how mastitis develops, how you treat it and what you can do to make sure it doesn’t come back.

Causes of mastitis

Mastitis is a condition where there is inflammation of the breast. It can happen with or without infection being present. Mastitis usually develops in one of two ways: The most common type, non-infective mastitis, develops when a blocked duct or engorgement is not managed properly. Infective mastitis, on the other hand, often develops because an infection from outside spreads to the breast – a cracked nipple often provides the entry-point for the infection. Stress, fatigue and feeling generally run-down also seem to predispose one to developing mastitis.

If you have mastitis, you will have the following symptoms:

• Initially, there is pain and tenderness in the breast. It may be the whole breast or, more often, a part of the breast. Mastitis usually occurs in only one breast at a time, but it’s not impossible to get it in both breasts at once.
• Next, you usually develop flu-like symptoms. Headache is probably the most common, along with other aches and pains. You will also feel more tired than usual.
• Once you have full-blown mastitis, you develop fever, which may be accompanied by chills. The presence of fever is what confirms the diagnosis of mastitis. I should point out, though, that fever is not necessarily a sign of infection; you will have fever whether there is an infection or not.

Treatment of mastitis

Home treatments for mastitis

If you have mastitis, it’s important to act quickly and treat it; untreated mastitis can progress to a breast abscess. Fortunately, you don’t have to wait to see a doctor and get medication – you can do almost everything yourself with what you have at home. Here’s what you need to do:

Drain the breast

This is absolutely the most important thing of all! If you do not move the milk out of the breast, it will just get worse and worse. Some uninformed healthcare providers still tell moms to stop breastfeeding because of mastitis – that is absolutely the worst thing you can do. Breastfeeding as often as possible will help to drain the breast, which will speed up your recovery.

Your goal is to soften the entire breast and to keep it soft. If baby doesn’t want to drink enough, you will need to express. Try both pumping and hand expressing to see which is more comfortable. I find that hand expressing and massaging the breast in a very hot bath, with the breast under water, is usually the most effective and least painful. A hot cloth or beanbag on the breast before you feed or express can also help to get things moving.

Also check out the posts on engorgement and blocked ducts, if that was the initial problem; the advice I give there will be helpful for treating the mastitis too.

Manage the pain

The pain is the worst part of mastitis, by a loooong way. So don’t try to be a hero, take your pain meds. Paracetamol and Ibuprofen are both very effective and aren’t excreted in your milk in large amounts, so they won’t affect baby either. As a bonus they both help to relieve fever, which is the second worst thing about mastitis.

Alternating hot compresses and ice packs on the breast can also help a lot. You can make an easy hot compress by filling an old sock with rice or lentils and popping it in the microwave for a minute or so. For an ice pack, you can use a baggie full of ice cubes, a bag of frozen peas, a commercial gel pack or a home-made breast-shaped ice pack (see the picture below). Remember to wrap your ice pack in a towel – you don’t want frostbite on your breast!

You can also massage the affected area of the breast with arnica oil to help decrease inflammation. Just keep the arnica oil away from the nipple area.

Rest!

I can’t emphasize this enough: you need to rest. Mastitis is like flu: if you try to carry on with life as usual, you will struggle to get rid of it for two weeks instead of two days! Trust me, I’ve been there and it’s not worth it. If you can, call in sick and stay in bed for two days. If that’s not an option (stay at home moms don’t get sick days, right?) at least do as little as possible. Don’t stand if you can sit, don’t sit if you can lie down. Leave the housework, eat out of paper plates, let hubby do the laundry and serve take-aways or bread for dinner. The more you rest, the quicker you’ll be back on your feet.

Bonus remedies

Physiotherapists offer various forms of ultrasound and light therapy. If you’re struggling with a stubborn case of mastitis, it may be worth looking into them. I’ve found it especially helpful if the mastitis developed from a blocked duct or engorgement.

There’s also a homeopathic remedy that can be used. Take the following every hour: 10 drops of Natura Organo 1 drops and one tablet each of tissue salts numbers 4, 9 & 12. I must add a disclaimer: I learned about this from a colleague, not from a textbook, and I have no training whatsoever in homeopathy. But it seems to be very effective, and the substances used have very few if any side effects.

To take antibiotics or not?

Once the diagnosis of mastitis is made, doctors usually want to start antibiotics. But remember, antibiotics will only be helpful if you actually have an infection; for non-infective mastitis, they’re a preventative measure at best. So how do you know the difference? Well, there’s a few things you can look for:

• If you can see pus coming from the breast, there’s an infection.
• If you have a cracked nipple, especially one that looks a bit septic, there’s a good chance you may have an infection.
• Give it 24 hours of self-treatment and good breast care, as explained above. If there is no improvement, or if things are getting worse, you probably need antibiotics. If you are improving, carry on without them.
• If you are HIV-positive, it’s probably a good idea to take antibiotics regardless, as you are at high risk of getting an infection.

Keep in mind that taking antibiotics can increase your risk of thrush, so it’s always a good idea to take a probiotic when you’re using antibiotics. Fortunately, the antibiotics that are used to treat mastitis are safe to use during breastfeeding, so there’s no need to pump and dump.

Keeping the mastitis monster away

If you’ve made it this far, you’ll definitely agree that need to prevent mastitis from coming back! To make sure you don’t get another visit from the red-eyed monster, keep an eye on the following:

• Breastfeed often enough to ensure that your breasts don’t get engorged and you don’t develop blocked ducts.
• Look after you breasts: if you develop cracked nipples, blocked ducts or engorgement, act immediately and treat it as quickly as possible. Don’t let it progress to mastitis.
• Take care of yourself. Eat well, get some exercise and rest enough (ha ha ha…). If you get too tired and run down, you’re more vulnerable to mastitis.

Recap

Because that was such a mouthful, let’s just go through it again:

• Mastitis develops because of a blocked duct or engorgement that wasn’t managed properly, or because there is an infection in the breast. You need to treat the underlying condition to make sure that you will recover as quickly as possible.
• The hallmark signs of mastitis are breast pain and fever. You will likely also have general body pains, headache, fatigue and flu-like symptoms.
• To treat mastitis, you need to:
  • Drain the breast – by frequent breastfeeding and/or expressing
  • Manage pain – with heat and cold, and medication if needed
  • Rest!
• If home remedies do not start to make a difference in 24 hours, or if you are feeling worse, it may be necessary to see your doctor and get antibiotics.

Have you ever had mastitis? What helped you get better? Leave a comment below and tell me about it, especially if you have some more tips to share!