Mastitis

The mastitis puerperal, associated with breastfeeding is one of the main triggers of early weaning, depriving the baby of physical and emotional benefits of breastfeeding : the bacteria present in breast milk are probiotics to the gut of the child, as well as an important reinforcement for its defenses.

The poor grip of the child, the return of the woman to her job or breast discomfort can lead to spacing the feedings too much or the breasts not emptying at all, facilitating this breast inflammation.

What is and how is mastitis produced?

One or both breasts become swollen due to blocked milk ducts or infection of the breast tissue. It mainly affects lactating women, although it can occur outside of lactation or in men.

In fact, non-puerperal mastitis is related to breast infection after a blow, an allergy or the entry of bacteria, viruses or fungi through wounds or cracks in the nipple.

The mastitis due to stagnation of milk is more common than non – puerperal and usually occurs a few days after birth or during breastfeeding . In the first case, the baby is usually less than 2 weeks old and the infection contracted in the hospital affects both breasts.

Causes of mastitis

A poor grip of the baby that prevents the complete emptying of the breast, breast engorgement in the first weeks postpartum, breastfeeding twins, reducing the feedings or spacing them often cause the over accumulation of milk.

In some cases, the entry of bacteria from the skin such as Staphylococcus aureus or Escherichia colli also cause this painful infection.

The snuff is a risk factor highlighted, as more than 90% of mastitis occur in mothers who smoke.

Mastitis symptoms

The usual symptoms are those of any infectious process:

• Sudden fever
• Shaking chills.
• Pain in the nipple or areola accompanied by warmth, redness, tenderness, or palpable lumps.

Mastitis treatment

Before any indication, you should go to a specialist doctor to determine its cause and adapt the corresponding treatment. If left untreated, it can lead to an abscess and need surgery to reverse it.

As a general guideline, it is recommended not to self-medicate and if you are breastfeeding, prioritize draining the affected breast. Always start with that chest, even if it bothers and increase the frequency of feedings.

Massaging and applying heat with a cloth before feeding and drinking water facilitate this emptying, as well as applying cold after it to relieve pain.

During mastitis, milk has a higher sodium and chlorine content so its taste will be more salty and the baby may reject it. If this happens, it is recommended to express the milk manually and use the bottle until it subsides.

If after 24 hours it does not improve, antibiotics will be prescribed that occasionally could cause mild diarrhea, to the little one.

Given the worsening of symptoms 48 hours after treatment , a milk culture will be used and the antibiotic will be modified.

Antibiotics such as flucloxacillin and erythromycin are usually prescribed.

Aspirin is contraindicated due to its relationship with Reye’s Syndrome in the baby.

Some patients feel a marked improvement after a greasy brown or greenish substance is expelled.

Consequences of mastitis

In addition to breast abscess , mastitis often leads to premature weaning because of how painful it is to breastfeed. The mother feels guilty and the baby confused, if such weaning is not done gradually.

How to prevent it

There are a series of helping habits to keep mastitis under control :

• It is not advisable to compress the chest with clothing that is too tight.
• Place the baby with the chin close to the affected area to facilitate sucking.
• Try to rest.
• Take care of hydration, as well as diet, increasing the consumption of fruits and vegetables for their preventive capacity against diseases.
• Limit your intake of saturated fat.
• Take salt in moderation, but without being overly restrictive about it.

However, when the condition is already with us, the following practices should be taken into consideration:

• Always start with the damaged breast and ensure its emptying before offering the other breast.
• Administer exclusive breastfeeding during the first 6 months of the baby’s life.
• Keep pacifiers and bottles away to stimulate the sucking action of the little one, otherwise they will settle.
• Do not sleep on your stomach.
• Respect the duration of the treatment and comply with it until the end.
• Replace the cream for cracked nipples, because it could be contaminated.
• Plan to stop breastfeeding gradually: it is recommended to reduce 1 feed every 5 days to allow the body to adapt to the new situation.

WHO or the Spanish Association of Pediatrics claim the breastfeeding mother , at the least the first 6 months of the baby. The current pace of life or the inexperience of some mothers favor the appearance of mastitis . Luckily, their discomforts usually subside in just 24 hours with a few simple recommendations.