Mastitis

One of the joys that many mothers are able to experience is the incredible bonding that occurs through breast-feeding their babies. Not only is it a wonderful time of nurturing, but it is the best thing you can do for your baby health wise as well. That is why it can be so discouraging when an obstacle comes up like mastitis, an infection of the breast. But instead of weaning your baby early, continuing to nurse is the best course of action, and poses no danger to your baby. How does mastitis occur, and can it be avoided?

What is Mastitis?

Mastitis is an infection of the breast, usually, but not always, found in women who are lactating and breastfeeding their baby. Most cases of mastitis first surface within six weeks after birth. The infection can be very draining to the new mother, especially at a time when she needs lots of energy. Some women do not come down with mastitis until several weeks or months later.

Many women are reluctant to continue nursing, both for their own good and for concern over the baby’s health. However, it is perfectly fine to continue breastfeeding even while in the midst of a mastitis infection. There may be discomfort on the mother’s part, but absolutely no danger to the baby.

Mastitis is a relatively rare condition, affecting only about 2% of nursing mothers. It normally affects only one of the breasts, and can come on quite suddenly anytime during the nursing period.

What Are the Signs and Symptoms of Mastitis?

The first noticeable sign is often warmness and tenderness of the affected breast. Other symptoms may include:

• Fatigue and general feeling of malaise.
• Redness on the breast, often in the shape of a wedge
• Swelling of the affected breast, and uncharacteristic hardness of the tissue
• Fever of 101F or greater
• Pain and/or burning sensation in the breast continuously or while nursing
• Chills
• Increased heart rate

What Causes Mastitis?

When a baby suckles at the breast, many women will experience sore or cracked nipples due to the friction caused by the sucking action. These abrasions can compromise the skin of the nipples and allow bacteria on the mother’s skin or in the baby’s mouth to enter tiny openings in the breast. Breast milk is very high in sugar, which is the perfect medium for these bacteria to grow and flourish. Once they begin to multiply, an infection may occur. The most common bacteria that is responsible for most mastitis infections is called Staphylococcus aureus. It is found in the mucous membranes lining the nose of approximately 25-30% of the general population. Many mastitis infections may start from exposure to these bacteria from the baby’s nasal passages.

Certain risk factors may affect your chances of getting a mastitis infection. These include:

• Previous mastitis infections. If you have had mastitis while nursing before, it is more likely that you will develop another one.
• Wearing a tight-fitting bra, that does not allow adequate circulation in your breast.
• Not fully draining your breast when nursing. This is often due to poor positioning.
• Nipples that are cracked or have areas of broken skin.

Are There Complications That Can Occur From Mastitis?

Yes, there are several possible complications that you should be aware of:

• The most serious one to watch out for is called a breast abscess. If you have mastitis, don’t treat it inadequately or delay treatment, because this can lead to a more serious infection known as abscess. This involves a pocket of pus that forms in the interior of the breast, which is a substance composed of white blood cells sent by the immune system and bacteria from the infection. Abscesses can lead to more serious infections, and must be drained, often surgically. Abscesses are thought to occur in about 10% of all women with mastitis.
• Another complication that can happen if you don’t promptly deal with mastitis is called recurrence, which is just a fancy name for another mastitis infection. Most recurrence happens because original infections were not treated effectively. This can create a vicious cycle that makes it easier and easier for women to get mastitis infections in the future with the same baby or the next one.
• Milk stasis is a phenomenon that occurs when the breast is consistently left partially full of milk after nursing. Milk stasis can make existing mastitis infections worse by leakage of undrained milk into the surrounding breast tissue, causing increased swelling and tenderness.
• A rare form of breast cancer called inflammatory breast cancer will sometimes mimic the symptoms of mastitis. If your mastitis infection has not cleared up after the traditional 10-14 day dose of antibiotics, I would get examined by your health care practitioner just to make sure that you do not have this form of breast cancer.

What Treatments Are Available for Mastitis?

I don’t normally recommend the use of antibiotics too often, but in the case of mastitis, I would make an exception for most women. The reason is that if mastitis is not treated promptly, it can easily lead to recurring infections in the future, and other complications such as those discussed above. If you take antibiotics, use one from the classes cloxacillins or cephalosporins. These are the safest and most effective for this type of infection.

In addition to or in lieu of the antibiotics, there are other steps that can be taken to help clear up mastitis infections and prevent future ones. Some of these include:

• By all means, continue to breast feed, even while your infection is healing. This helps to keep the milk ducts open and free flowing, which can discourage infection and encourage more rapid healing. Don’t worry, the infection cannot be passed on to your baby from nursing.
• Apply warm compresses to the affected breast. This will help reduce pain and swelling, and may speed up the healing process as well.
• Drink plenty of fluids, mostly purified water. This will help strengthen your immune system, and water has even been shown to decrease pain in many individuals.
• Make sure that you empty your breasts each time you nurse. Don’t switch to the other one until your baby has fully drained the one she’s on. Alternate breasts whenever possible, but only after one has been emptied. Leaving them empty decreases your risk for mastitis.
• If you are having difficulty emptying your breasts, try warm compresses or a hot shower before breast-feeding. This will help the milk flow easier.
• To avoid pain when you have mastitis, do not let your breasts become engorged with milk between feedings. Use a breast pump if necessary.
• It is important to keep the milk flowing in the infected breast. If it is too painful for you to nurse on that breast, use a breast pump or hand-express the milk. If the milk ducts are inactive, it only encourages the infection. Sometimes babies will not want to nurse from the affected breast. This may be because the infection may increase the amount of saline in your milk from that breast, and some babies do not like the change.

Are There Any Effective Alternative Treatments?
Many naturopaths believe that there is much more at stake with wellness than just the medical facts regarding the situation. Overall wellness includes our mental and emotional attitudes, the quality of foods we put into our bodies, and the state of our immune system to deal with potential infectious agents. Some suggested therapies that can fight mastitis and other infections include:

• Sweating:  Allowing your body to perspire can be a wonderful cleansing activity. Try a sauna, or languishing in a hot bath or steam room. Even drinking hot tea in a warm room can help you sweat. Try wearing layers of clothing when exercising. All of these behaviors can help rid your system of infections such as mastitis and many other toxic substances in the body that can stifle your immune system.
• Rebounding on a mini-trampoline can also help to rid your body of all kinds of antigens and infectious agents. It is also great for your lymph system, which is closely linked to the immune system and your overall ability to fight mastitis and all other infections as well. Exercise is great for your mind and emotional well being too, and these positive attitudes will help you fight off infection better as well.
• Plenty of sleep: Getting enough quality sleep is always important, but especially when you are fighting an infection. Sleep will help boost your immune system, and make you feel more relaxed and stronger emotionally too.
• Herbal remedies:  Many folks swear by garlic to help fight mastitis infections. Eating it raw several times a day, or blending it into smoothies with Echinacea has also shown positive effects in many women with mastitis and other infections.

Mastitis is one of those conditions that can be avoided by a healthy, wellness-centered lifestyle long before having a baby or having to deal with the issues of nursing. Lifestyle choices that contribute to building a strong immune system are the best way to “treat” any illness, including mastitis. Watching what we put in our bodies and making sure that we have a clean bowel and digestive tract will go a long way towards ridding our systems of many toxins, and boosting our natural infection fighting functions that are designed to keep us well, not just fight off invaders.

The most important thing to remember when it comes specifically to mastitis infections is that the worst thing you can do is to stop nursing because of fear or painful breast-feeding. Nursing your baby is the best thing you can ever do for both you and her, and even if you do have mastitis, it will only help, not hurt. It is hard enough to encourage women to nurse in this age of bottles and formulas. Spread the word that an occasional breast infection such as mastitis is not another reason to stop nursing. On the contrary, nursing helps the infected breast to heal faster and avoid future infections as well.