Breastfeeding, Mastitis

Breastfeeding is usually the best way to feed your baby. Breastfed babies tend to be healthier and less affected by disease. Breastfed babies may have better brain development and be less likely to be overweight than formula-fed babies. Breastfeeding also benefits the mother. Breastfeeding reduces the risk of breast cancer. It will give you time to be close to your baby and helps create a strong bond. It also delays the return of your periods, stimulates your uterus to contract back to normal, and helps you lose some of the weight you gained during pregnancy.

Breastfeeding should not be painful. If there is tenderness at first, it should gradually go away as the days go by. Poor latch-on and positioning are common causes of sore nipples. This is usually because the baby is not getting enough of the areola (the colored portion around the nipple) into his or her mouth, and is sucking mostly on the nipple. In general, nurse early and often, nurse with the nipple and areola in the baby's mouth, not just the nipple and feed your baby on demand.

CAUSES

  • It is common for many women to have a plugged duct in the breast at some point if she breastfeeds. A plugged milk duct feels like a tender, sore, lump in the breast. It is not accompanied by a fever or other symptoms. It happens when a milk duct does not properly drain, and the breast becomes inflamed (red and sore). Then, pressure builds up behind the plug. A plugged duct usually only occurs in one breast at a time.

  • A breast infection (mastitis), on the other hand, is soreness or a lump in the breast that can be accompanied by a fever or flu-like symptoms, such as feeling run down or very achy. Some women with a breast infection also have nausea and vomiting. You also may have yellowish discharge from the nipple that looks like colostrum, or the breasts feel warm or hot to the touch and appear pink or red. A breast infection can occur when other family members have a cold or the flu, and like a plugged duct, it usually only occurs in one breast. It is not always easy to tell the difference between a breast infection and a plugged duct because both have similar symptoms and can improve within 24 to 48 hours.

  • Using one position to breastfeed may not empty your breasts properly or completely and could lead to engorgement and mastitis.

  • Wearing a bra that is too tight may restrict the flow of your milk.

  • Mastitis develops because bacteria get under the skin through cracks in the nipple and into the breasts and an infection develops.

TREATMENT

  • Breastfeed or pump the breast more often on the affected side. This helps loosen the plug, keeps the milk moving freely, and the breast from becoming overly full. Nursing every 2 hours, both day and night on the affected side first can be helpful.

  • Getting extra sleep or relaxing with your feet up can help speed healing. Often, a plugged duct or breast infection is the first sign that a mother is doing too much and becoming overly tired.

  • Wear a well-fitting, supportive bra that is not too tight, since this can constrict milk ducts.

  • If you do not feel better within 24 hours of trying these steps, and you have a fever or your symptoms worsen, call your caregiver. You may need an antibiotic. If you have a breast infection in which both breasts look affected, or there is pus or blood in the milk, red streaks near the painful area, or your symptoms came suddenly, see your caregiver right away.

  • Even if you need an antibiotic, continuing to breastfeed during treatment is best for both you and your baby. Most antibiotics passed in your breast milk will not hurt your baby.

  • Increase your fluid intake especially if you have a fever

  • If mastitis is not treated quickly and properly, you may develop a breast abscess.

THRUSH

Thrush (yeast) is a fungal infection that can form on your nipples or in your breast because it thrives on milk.

The infection forms from an overgrowth of the candida organism. Candida usually lives in our bodies and is kept at healthy levels by the natural bacteria in our bodies. But, when the natural balance of bacteria is upset, candida can overgrow, causing an infection. Some of the things that can cause thrush include:

  • Having an overly moist environment on your skin or nipples that are sore or cracked.

  • Taking antibiotics, birth control pills, or steroids.

  • Having a diet that contains large amounts of sugar or foods with yeast.

  • Women with diabetes have a higher incidence of thrush and fungal infections.

  • Having a chronic illness like HIV infection, diabetes, or anemia.

These are symptoms of thrush:

  • Having sore nipples that last more than a few days, even when your baby's latch and positioning is correct.

  • Getting sore nipples suddenly after several weeks of normal nursing.

  • Pink, flaky, shiny, itchy, or cracked nipples, or deep pink and blistered nipples.

  • Shooting pains deep in the breast during or after feedings, or achy breasts. This may be from a candida infection of the milk ducts.

  • The infection can form in your baby's mouth from having contact with your nipples, and appear as little white spots on the inside of the cheeks, gums, or tongue. It also can appear as a diaper rash (small red dots around a rash) on your baby that will not go away by using regular diaper rash ointments. Many babies with thrush refuse to nurse, or are gassy or cranky.

HOME CARE INSTRUCTIONS

  • If you or your baby have any of the above symptoms, contact your caregiver and your baby's caregiver so you both can be correctly diagnosed.

  • You can get medication for your nipples and for your baby. Medication for a mother may be an ointment for the nipples, and your baby can be given a liquid medication for his or her mouth, or an ointment for any diaper rash.

  • Change disposable nursing pads often and wash any towels or clothing that have come in contact with the yeast in very hot water above 122° F (50° C).

  • Wear a clean bra every day.

  • Only use cotton pads.

  • Wash your hands often, and wash your baby's hands often, especially if he or she sucks on his or her fingers.

  • Boil any pacifiers, bottle nipples, or toys your baby puts in his or her mouth once a day for 20 minutes to kill the thrush. After 1 week of treatment, discard pacifiers and nipples and buy new ones. Boil all breast pump parts that touch the milk for 20 minutes daily.

  • Make sure other family members are free of thrush or other fungal infections. If they have symptoms, get treatment for them.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.