Mastitis Remedies You Probably Haven’t Heard Of
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If you’ve had mastitis before or are dealing with it right now then you want remedies that will treat it fast!
This post will cover what mastitis is, ways to treat it at home (that you probably have never heard of before), and how to prevent it from happening again.
What is mastitis?
Mastitis is defined as inflammation of the breast. It’s commonly assumed that mastitis automatically means you have an infection, but this is not always the case. Estimates from research suggest that anywhere from 3-20% of lactating people will have mastitis and that the majority of these cases happen in the first 6 weeks postpartum. The fact is that mastitis can happen at any point during lactation, even during weaning! Deciphering between breast issues such as engorgement, plugged ducts, and mastitis can be tricky. In fact, it is probably easier to think about these breast issues along a spectrum rather than as completely distinct issues.
Engorgement can sometimes be mistaken for mastitis in the early postpartum days. If left untreated, engorgement can certainly turn into mastitis due to continued milk stasis. Plugged milk ducts are another breast concern that can lead to mastitis if left unresolved. Plugged ducts or engorgement aren’t the only things that can lead to mastitis, though those are certainly common triggers.
These are the clinical symptoms usually associated with mastitis:
Tender, hot, swollen, wedge-shaped red area of breast
Body temperature of 38.5C (101.3F) or greater
Chills, flu-like aching, and systemic illness
Pain or burning with nursing or pumping
Why does mastitis happen?
The two main causes of mastitis are milk stasis and infection. Milk stasis is basically milk getting built up in the breast because of inadequate or infrequent removal. This can be due to a baby with a less than optimal latch or issues with effective pumping. Infection can occur when there is broken, damaged skin on the nipples and bacteria enter the breast. A common time I hear from lactating clients experiencing mastitis is during times of stress or fatigue. This could be around the holidays, juggling going back to work, traveling, or having out-of-town guests. Other situations that can put you at risk of mastitis are having an oversupply of milk or weaning too rapidly.
How do I treat mastitis?
The key to treating mastitis is not to wait- treat it quickly as soon as symptoms first appear.
So how do you treat it? Here are my top recommendations:
Heat and cold therapy
So let’s talk about using heat vs cold therapy for mastitis. Since mastitis is inflammation of the breast, we want to reduce the swelling and pain. Inflammation is defined as “a local response to cellular injury that is marked by capillary dilatation, leukocytic infiltration, redness, heat, and pain and that serves as a mechanism initiating the elimination of noxious agents and of damaged tissue.” Cold will restrict blood flow and numb the area to reduce pain. Using cold therapy between nursing or pumping sessions can aid the inflammation. Inflammation in the breast can further restrict milk flow by restricting milk ducts. Heat therapy has the opposite effect, by increasing blood flow to an area. Heat used during lactation is helpful for milk flow and getting a milk let-down. If you are having trouble getting a let-down or getting milk out of the inflamed breast it is ok to try using some heat before breastfeeding or pumping. If your breast is hot, red, and swollen then I would focus on moving the breast (as I will explain below) and avoid heat. It is good to have a hot/cold pack on hand, or you can also easily make your own.
DIY rice sock for heat/cold therapy:
1 knee or tube sick
2-3 cups rice or beans
Fill sock up halfway with uncooked rice or beans. Tie a knot at the top of the sock. Heat in the microwave with a cup of water for 1-2 minutes. To use for cold therapy, place in the freezer for at least 45 minutes before use.
Therapeutic breast massage & breast gymnastics
Therapeutic breast massage in lactation (TBML) is not at all like getting a deep tissue massage for those tight and sore back muscles. Instead, TBML is GENTLE and the goal is to move lymphatic fluids from the inflamed site and out of the breast. During the inflammatory process, blood vessels will release fluids into the spaces between the cells. This is what leads to swelling. TBML addresses this fluid congestion. This is quite a different way to look at breast massage as opposed to the common advice to do a deeper massage in order to get the “plug” out of the duct (this can actually make things worse). Remember, mastitis isn’t always the result of a plugged duct. I want you to think of massage as a way to get the pressure off the ducts from the excess fluid instead. Think about a garden hose that is turned on and you come and step on it. The fluid behind your foot will back up and cause pressure in the hose. When you relieve the external pressure on the hose (your foot) the water will start flowing again. This video from Breastfeeding Medicine of Northeast Ohio demonstrates this gentle approach to massage:
Now, what in the world is breastfeeding gymnastics? Basically, it is another way to move the breasts in order to encourage fluid drainage. In this video, Maya Bolman video demonstrates this gentle and simple tool that can be used for engorgement, plugged ducts, and mastitis.
Castor oil packs
Castor oil contains ricinoleic acid which can reduce inflammation and swelling and help stimulate lymphatic drainage. Castor oil packs can also help with plugged ducts. You can easily make your own with a few items from the drug store:
DIY castor oil pack: *This is for external use only. Please note that castor oil stains, so wear old clothes and use towels you don’t mind staining. After each use, wash the breast well so that your baby does not ingest the oil from nursing or pumping.
High-quality castor oil (organic if possible)
Dry cloth (any material that will soak up the oil well)
Saran wrap or plastic bag
Old towel (to cover oil-soaked cloth or to lay on)
Heating pad or warm rice sock
Soak the cloth in the oil, it should be saturated but not dripping. Apply cloth to the affected area of your breast then cover with saran wrap or a plastic bag (or old towel) if desired before placing the heating pad on top. Leave the cloth on for 20-30 minutes, repeating every few hours until symptoms are relieved. After use, cloth can be re-used, just place it in the refrigerator after each use.
Breastfeeding or pumping, rest, and nutrition
I know it hurts, but keep removing milk from that breast. It is safe for your baby to have that milk and it will not give them an infection. You DO NOT need to nurse or pump excessively! This again can make matters worse if you have an area of the breast that is unable to drain. You may notice a dip in supply from that breast for a bit and that is normal. It will pick up again after you begin to feel better and milk flow in that breast is no longer obstructed. If your baby refuses the breast while you have mastitis this can be normal as your milk will have a higher salt content and some babies may not like the taste. In this circumstance, make sure to pump on that side if your baby is not removing the milk. Rest as much as possible- chores and laundry can wait or ask for help. Make sure you are drinking enough water and eating nutritious foods, including getting enough protein and avoiding excess sugar. Eat a supportive diet of immune-boosting nutrients like vitamin C (oranges, kiwi, broccoli), zinc (seeds, nuts, eggs), and prebiotic foods (garlic, bananas, apples).
Preventing mastitis
There are definitely some tips that will help you keep mastitis away.
1. Empty your breasts frequently and avoid letting them get super full. If your baby is having trouble with feeding, your pump isn’t effective, or you continue to have plugged milk ducts then it’s time to see a lactation consultant.
2. Heal any nipple damage. If you have cracks, sores, or open wounds on your breasts you want to heal this in order to prevent bacteria from entering the breast. This post gives some tips on nipple healing.
3. Make sure you have comfortable and supportive bras that are not too tight and avoid underwires.
4. If you have reoccurring plugged ducts consider why this is happening (see #1 above). The herbal remedy called Happy Ducts helps support lymphatic function and is good to have on hand as well so it can be taken at the first signs of a plug, along with other supportive measures (TBML and breast gymnastics).
5. Consider taking a high-quality probiotic, look for one containing the strains Lactobacillus fermentum or Lactobacillus salivarius. Studies have shown that these strains can lower the reoccurrence of mastitis. Here are some quality brands containing these strains:
Mastitis can be a serious issue, and if left untreated can develop into such issues as a breast abscess. If you continue to experience reoccurring bouts of plugged ducts or mastitis then it is time to reach out to an IBCLC or your medical provider.
This is not personal medical advice, nor is it a substitute for professional medical advice or treatment. If you continue to have symptoms or worsening symptoms after 12-24 hours of home treatment contact your IBCLC, OBGYN, or midwife.
