The following is general information only. If you have any questions about any aspect of your health, please consult your physician.

Mastitis and/or Blocked Ducts are obstacles many, but not all, nursing women face once, or maybe several times, while nursing. Both are caused by babies or pumping not completely draining the breast(s). Here are some ideas on how to handle them.

Mastitis

Is a bacterial infection of the breast that can occur in breastfeeding mothers. It is different from a blocked duct, which has similar symptoms. A blocked duct feels painful, is swollen, red and a mass can usually be felt within the breast. Mastitis has these same symptoms with the addition of fever and greater pain. It is easy to get the two mixed up. The added sign of a fever is the key that it is mastitis. It is important to see a physician if you have fever, breast pain (in one or both breasts) and redness for more than 24 hours, as antibiotics will need to be prescribed. Once antibiotics are prescribed improvement will be noticed within 2-5 days. Continue your course of antibiotics until they are finished or there is a chance the mastitis will return.

NOTE: If you need antibiotics, it must be effective against Staphylococcus aureus. Amoxicillin, plain penicillin and some other antibiotics are often prescribed for mastitis but are usually not effective. Effective against this bacterium are: cephalexin, cloxacillin, amoxnicillin-clavulanic acid, clindamycin and ciprofloxacin. The last two are effective for mothers allergic to penicillin. You can and should continue to breastfeed while taking these medications. There is no need to pump and dump.

Mastitis does not harm the babies and continuing to breastfeed will speed up the healing process. If you cannot put babies to breast because it is too painful, try pumping as best you can and bottle feed the milk to the babies. This will also help keep your supply up.

Blocked Ducts

These (there may be one or more) can also be very painful, skin becomes “hot” and as lump(s) can be felt when massaging the breast. For treatment of these, hard, deep massage at the point of the clog while baby is breastfeeding can be used. It is painful but the only way to pass the clog is through massage to move it along, and then baby nursing will clear the duct. The released clog will not hurt the baby. There is no need to pump and dump with blocked ducts either.

It isn’t unusual to have one of multiple-birth babies be a stronger, deeper sucker than his/her sibling(s). Another idea for getting rid of a clog in a duct is to place the stronger sucking multiple on the “offending” breast, with his/her chin on the lump. Sometimes the baby can unblock the duct during the nursing session.
Other ways to relieve the swelling for both Mastitis and Blocked Ducts:

  • Heat applied to the affected areas helps healing;
  • Massage in a hot shower;
  • Rest helps with infection;
  • Fever* helps fight off infection;
  • Medication (aspirin, ibuprofen, others) for pain can be helpful; and
  • Two external ways to help with swelling and hotness:
    1) thinly sliced raw potatoes in the bra, and
    2) cold cabbage leaves directly from the fridge in the bra helps sooth. Believe it, they work!!

*Because of so many medications now available, parents get worried around a fever, and so they should. However, a fever has a purpose. The body heats up in order to kill off the infection. But that being said, IF YOU ARE IN ANY DOUBT AT ANY TIME, CONSULT YOUR DOCTOR as he or she is in the best position to properly diagnosis what is going on for you or your child/children.

Adapted from a Guide on Mastitis from The Ottawa General Hospital, and Handout #22 Blocked Ducts and Mastitis written by Jack Newman, MD, FRCPC.

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