Mastitis may be a consequence of incorrectly treated milk stasis or of bleeding and festering nipple wounds. The breast affected by infection is perceptibly warmer, reddened and painful. The mum feels as if she had flu - she is weak, her muscles and head ache, and she usually has high fever and shivers.
Mastitis results from the same causes as those leading to raw nipples (incorrect way of breast grasping and suckling by the baby, fungal infection, bacterial infection, bleeding nipples, physiologically painful nipples) or to milk stasis.
Thus, similarly as in the case of those other problems, first check that your baby grasps and sucks the breast correctly, and whether you feed him in a correct position. Problems in the "breast-baby" area are the main (root) cause of problems with breasts, including mastitis.
What you can do
Although mastitis results from complications related to ignored milk stasis, its treatment is not the same. You must know that breasts with infection should not be warmed with warm compresses. Moreover, as the mastitis is a more serious condition, it is usually treated with antibiotic prescribed by a doctor, if the infection symptoms (fever, shivers, muscle aches) do not resolve after 24 hours.
During mastitis, you may also find the following tips useful:
Feed the baby from the affected breast as often as possible (start two or three feedings with the affected breast, then one with the healthy one, and then again two or three feedings with the affected one). Preferably, the baby should suck the affected breast intensively and as long as possible, to empty blocked ducts. Therefore, use these moments when the baby is hungrier (after longer nap or a walk) and give him that affected breast.
Change your feeding position, so the baby sucks milk from different breast areas. When you have fed your baby holding him in front of you, now place him under your arm to suck from the part of the breast with milk stasis (read more in the chapter Breastfeeding positions - seating or underarm positions).
After feeding, put a cooled nappy or a cold (but not icy!) gel compress on your breast. You can also use some frozen food (like peas) wrapped in a clean cloth.
Put slightly crushed and cooled white cabbage leaves on the affected breast (cabbage juice has astringent and anti-inflammatory properties).
When the baby does not want to suck the affected breast (because milk flows slower from it) or completely refuses to suck, extract some milk from the painful breast, but just enough to feel some relief. Extracting large amounts of milk will unnecessarily stimulate lactation and aggravate the situation.
To bring the fever down and soothe the pain, take medicines having analgesic, antipyretic and anti-inflammatory effect (ibuprofen or paracetamol).
Drink a lot, particularly, when you have fever and take antipyretic medicines. If you do not drink enough, you may become dehydrated.
Rest! Actually, it will be the best if you stay in bed with your baby. Rest and frequent feedings are the best cure.
When the rest does not help and you clearly have a problem with milk flow (it is a common cause of milk stasis and, in consequence, of mastitis), maybe your spontaneous letdown reflex is disturbed. This may happen, when oxytocin flow, responsible for milk flow, is blocked by weariness, nervousness or stress. If this is the case, ask your doctor to prescribe you liquid oxytocin (to soak cotton swabs and put into nostrils 5 minutes before breastfeeding).
Mum's condition should improve after 48 hours at the latest, following administration of an antibiotic. If this is not the case, probably that antibiotic needs to be replaced with another one. The doctor will order a culture and use its results to prescribe a correct medicine. Complete healing of mastitis is important, as ignored it can turn into breast abscess.
Is breastfeeding still possible?
Of course, it is! This is the most important part of the treatment. Some mums are afraid that milk from the affected breast is full of bacteria. Certainly, the baby will drink a lot of bacteria with your milk, but, at the same time, he will get antibodies that will cope with them; also, with mother's milk the baby will receive plenty of important components that cannot be replaced even by the best formula. Therefore, although now you feel very unwell, have fever and ache all over, do not stop breastfeeding. Persist, everything will be back to normal and you will enjoy breastfeeding again.