How to Avoid Mastitis and Breastfeed in Comfort

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It’s an image as old as the Madonna herself: a serene mother contentedly breastfeeding her baby. For many mothers, however, mastitis makes breastfeeding painful.

“Mastitis is inflammation of the breast tissue that can lead to an infection,” says Sharon Burbelo, Ph.D., CDE, RN. As a maternal family health liaison working within the University of Miami Health System, Dr. Burbelo sees new mothers at The Women’s Hospital at Jackson Memorial Hospital.

In helping women overcome mastitis, she dispels common misunderstandings.

“A lot of moms feel they’re supposed to stop feeding, but the infection can’t be passed onto the baby, and if she’s taking antibiotics, they will not hurt the baby. We encourage women to continue breastfeeding because it improves mastitis,” Dr. Burbelo says.

Mastitis is more common in large-breasted women and women with breast augmentation.

“If the ducts aren’t reattached correctly during surgery, it can cause problems,” Dr. Burbelo says. Women who breastfeed or pump their breast milk less than three to five times a day can also develop mastitis. And the condition tends to recur in women who have had previous bouts.

Milk flows through a duct system in the breasts.

If your breasts produce a lot of milk or don’t empty after a feeding, a duct can become engorged or blocked. Milk may back up into the duct, causing an infection. Another way infections start is when bacteria – from your skin or your baby’s mouth – enter through a cracked nipple.

What are the symptoms of mastitis?

One or both breasts may look red and feel tender or sore when a milk duct is blocked. You might notice a thick, hard, or painful lump.

“Most women say, ‘I thought I was getting the flu,’ because they have fever, chills, and feel poorly.” Some women don’t experience symptoms. And while mastitis usually occurs in lactating mothers, it can happen in women who aren’t breastfeeding as well as in men.

How do I prevent mastitis?

The easiest way to avoid this painful situation is so simple it seems obvious to anyone but a sleep-deprived mother who finds nursing painful. “Nurse on demand and learn your baby’s feeding cues. Your body responds to those,” says Dr. Burbelo.

Other options:

  • Take time to rest and destress.
  • Eat healthy meals.
  • Stay hydrated with non-caffeinated fluids.
  • If you smoke, quit.
  • Use a proper nursing technique and vary your position. Talk to a lactation specialist if you don’t know the best position or technique.
  • Express some milk before nursing if your baby has trouble latching onto your nipple.
  • Ensure the baby latches on properly and empties one breast before switching to the next.
  • Make sure your breasts are comfortably drained after feeding. If not, you may need to express more milk.
  • Wash nipples with plain warm water to remove any traces of dried milk.
  • Wear a supportive nursing bra that is not too tight.
  • Apply dry or wet heat to the breast to open milk ducts and increase flow.
  • Manually express some milk while taking a shower.
  • Gently express colostrum, apply it to sore or cracked nipples, and pat dry. Apply lanolin if you develop problems past the colostrum stage. (Dr. Burbelo says that when a baby latches on properly, nipples should not become sore or cracked.)

Pain, pain go away

mastitisNew moms rejoice – there are simple ways to relieve mastitis symptoms:

  • See your doctor as soon as possible if you develop symptoms. You may need antibiotics to treat the infection. If your doctor prescribes antibiotics, finish the prescription.
  • Ask your doctor if you can take over-the-counter medication to relieve the pain.
  • Avoid tightfitting bras or clothes and excess pressure from seat belts, heavy totes, or purses.
  • Breastfeeding improves mastitis; sudden weaning makes it worse.
  • Breastfeed on the affected side first when the baby is most hungry and more likely to nurse thoroughly.
  • Apply a cold cloth or ice to reduce breast pain.
  • Soak your breasts in a clean basin or sink filled with warm water. Massage the affected area gently while warm, then try nursing your baby.
  • While baby nurses, gently massage any hard lumpy areas of your breast.
  • Gently massage the area above the blocked duct, then express milk, by hand, from behind your nipple.
  • Whenever possible, breastfeed your baby on the affected breast. Change positions so that baby’s nose and chin point in different directions from the plugged duct. Switch positions if necessary.

Dr. Burbelo and her co-workers are available to help, “Women are welcome to call our lactation office throughout their breastfeeding experience. As long as a mother is educated and supported, she can successfully breastfeed.”

Multilingual nurses answer the lactation office phone line. To reach a nurse, call 305-585-4744.


Nancy Moreland is a regular contributor to UMiami Health News. She has written for several major health care systems and the CDC. Her writing also appears in the Chicago Tribune and U.S. News & World Report.


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