A Pain in the Boob: Preventing and Treating Mastitis

Mastitis, in short, is terrible – you are knocked down as if you have the flu (complete with a fever, chills, and pain), your boob feels like it’s going to explode, and oh, you still have to take care of a baby and pump every few hours. Here’s how to know if you have mastitis, mastitis treatment information, and how to prevent mastitis.

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What is mastitis?

Mastitis is an inflammation of the breast. Generally speaking, it has two causes: obstruction of milk coming out of the breast (essentially, a clogged duct), or infection. Mastitis that is caused by obstruction can lead to infection, so it can be one or both that is causing the issue.

How can I tell if I have mastitis?

There are two kinds of symptoms – those specific to your breast and those that affect all of you.

• Your breast (the affected one – normally mastitis only hits one breast at a time) will feel painful and very tender to the touch. Sometimes you can feel a lump, which is likely the clogged duct that caused the mastitis. You may see red streaks on your breast, and it might be warm and a bit swollen.
• The rest of you will feel as though you have the flu, minus the nasal congestion – generally, if you have mastitis, you’ll have a fever, chills, and aches. (I also had a dull headache and what I would describe as “general malaise,” i.e., I just did not feel well. That was the only way I can describe it.)

How do you know if you have a clogged milk duct vs mastitis? If the issue is localized to your breast, you probably just have a clogged duct. If the entire body is affected, you likely have mastitis (along with a clogged duct that is causing the mastitis).

How do I treat mastitis at home?

If your symptoms have been present for less than 24 hours, only one breast is affected, your baby is more than two weeks old, and you are not very ill, you can try to treat mastitis at home. (If these do not all apply to you, or you have questions or concerns, call your doctor.)

Below are some home remedies for mastitis. The goal with these is to both to fight off infection and clear any obstructions.

1. Rest

It’s difficult for any breastfeeding mom to rest, but it’s even harder for exclusive pumpers (as the “take the baby to bed and nurse” advice isn’t an option). Still, you have the “boob flu” and you need to take it easy just like you would if you had influenza.

Let everything that you possibly can go, and rest as much as you can. Ask for help.

2. Empty the affected breast as much as you can

Your goal is to keep the affected breast as empty as possible. If it makes it easier to get more pumping sessions in, you can hook yourself up for some sessions on just the affected side. Just make sure you don’t forget about the other side and get yourself a double case of mastitis.

Using a warm compress on your breast before you pump, and doing breast compressions while you pump may help you empty. Try massaging from the affected area towards the nipple.

3. Drink fluids

Make sure to stay hydrated and increase the amount of fluids you are drinking.

4. Take ibuprofen

It will help with the inflammation and pain and is safe for breastfeeding.

5. Try the potato remedy for mastitis

Per Dr. Jack Newman (who adapted the method from Bridget Lynch), applying raw potato slices to the affected breast may help provide relief. To do this:

• Wash 6 raw potatoes and slice them lengthwise. The slices should be thin.
• Place the slices in a bowl of water for 15-20 minutes.
• Put the potato slices on the affected part of your breast for 15-20 minutes.
• Discard and put new slices on; repeat this twice.

(Some women in our Facebook group have seen success with this method; they also suggested putting the potato slices in the refrigerator after slicing so that they would be cold when applied.)

6. Try dangle pumping

“Dangle feeding” means nursing so that your breast is pointed towards the ground to allow gravity to assist you with dislodging a milk obstruction.

If you’re exclusively pumping, that’s not an option, but you can still dangle pump! One way to do this by sitting in a chair and resting your head on a desk, and pumping in that position. Here is a great overview.

7. Eat raw garlic

Kellymom suggests eating between 2-7 raw cloves of garlic per day to fight infection:

Chop a clove into 5 or 6 pieces and then swallow the pieces whole like pills. Raw garlic acts as a broad-spectrum antibiotic, without the added antibiotic side effects of the development of antibiotic-resistant strains of bacteria, or the development of yeast infections or thrush.

It’s important that the garlic be raw, or this won’t work.

8. Try epsom salts in a Haakaa pump

A Haakaa pump is a manual breast pump that you suction onto your nipple. Some women in our Facebook group have seen success in clearing clogged ducts by putting 1-2 tablespoons of epsom salts in a Haakaa and filling it about halfway with hot water – enough so that the nipple is submerged in the water when it is suctioned on.

Once you have it on, you can leave it in place for 5-10 minutes.

If you don’t have a Haakaa pump, taking an epsom salt bath (making sure to submerge your breast) is another option that may help.

9. Take a hot shower

The heat from hot showers can help provide pain relief from mastitis and fight off infection.

You can also try to work out the blockage while you’re in the shower, either with a comb (run a wide-toothed comb through a bar of soap and gently massage it around the affected area), with a lactation massager, or just through breast massage.

Do I need antibiotics?

If your symptoms have been present for more than 24 hours (and are not improving), both breasts are affected, your baby is less than two weeks old, or you are very sick, call your doctor. It is likely that he or she will put you on an antibiotic, usually for 10-14 days. You should also continue to rest and keep your breasts as empty as you can.

Untreated mastitis can lead to an abscess (which can require surgery to resolve), so be sure to call your doctor if you feel sick for more than 24 hours or are really ill.

How long does mastitis usually last? Usually 1-3 days, though it make take up to a week for the infection to completely clear.

What are the early signs of mastitis?

If you have a clogged duct that you are working to resolve, make sure watch out for feeling more tired than normal, a low-grade fever, or just feeling “blah.” These are usually the first signs of mastitis.

Mastitis usually comes on quickly.

How can I make sure that this never happens to me and my boobs again? How can I prevent mastitis when pumping?

To avoid mastitis as an exclusive pumper, there are two things that you can do. You want to avoid obstruction of milk ducts (i.e., clogged ducts) by 1) sticking to a pumping schedule and 2) making sure that you empty your breasts completely.

In addition, if you do get a clogged duct, do everything you can to clear it before it becomes mastitis.

(The exception to emptying your breasts is when you are weaning – while weaning you should stick to a schedule but not empty your breasts, just very gradually decrease the amount that is “left” in them after pumping.)

If you are prone to getting mastitis, you might want to try lecithin to see if that helps – in some women, it helps thin the milk so that it doesn’t get stuck in your milk ducks. If you keep getting it on only one side, you could also try weaning from just the affected breast and continue pumping on your other side.

Have you had mastitis? Share your tale of woe with us, and what you did to resolve it.

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