Mastitis

This article is an excerpt from "The Nursing Mother's Problem Solver" by Claire Martin.

One doctor described mastitis as "a bunch of germs having a party in your milk ducts"-a wry description of an otherwise humorless affliction. Mastitis is a vicious infection that develops fast and, untreated, can quickly get worse. This is one party you don't want to throw.

The germs that cause mastitis can enter through the nipple when the baby falls asleep while nursing: The pores in your nipple are still open, giving the germs easy access. Other causes include a too-tight nursing bra or sleep bra, bunching your clothes under your arms while you nurse (that puts pressure on the milk ducts), opening your nursing bra flap just enough to let the baby get at your nipple (allowing the pressure of the flap to cause problems not only with plugged ducts and mastitis, but also with nursing), or frequently missing a regular nursing session.

Mastitis usually begins with symptoms like a sore, painful breast, accompanied by feeling punchy and feverish. Sometimes you'll find a small lump, warm to the touch, near your nipple. If you use a breast pump, you may notice that the milk from the affected breast is unusually thick, almost like cream soup; in rare cases, clots or clumps form in the collection bottle.

If you catch the symptoms early, you can stop them from developing into full-blown mastitis by applying warm compresses, massaging the lump (toward your nipple), resting in bed, and nursing and pumping as much as possible on the affected breast. You won't want to-it'll hurt-but mastitis hurts more.

Occasionally, mastitis shows up with no warning, like a party-crasher. You may feel as if you're getting a bad case of the flu- shivery, sweaty, with a terrific headache. Once you develop a fever and/or chills, you're dealing with mastitis, not a plugged duct. The solution is prescription antibiotics. The drugs take effect swiftly. You'll feel better within hours, and the infection will be resolved within 48 hours-but keep taking the drugs for the prescribed period, and try to get as much bed rest as possible for at least a couple of days after your symptoms are gone. Mastitis often recurs in moms who skip bed rest and resume their regular (overloaded) schedule too soon.

If the infection fails to respond to the antibiotics, go back to us immediately. You may need a different antibiotic. Several antibiotics are used to treat mastitis and other bacterial infections; Keflex, Dicloxycillin, Augmentin, and Cipro are widely used. If a second course of antibiotics doesn't work, ask us to do a culture and reassess the situation.

When you're taking an antibiotic, add acidophilus to your diet (in the form of supplements or yogurt with an active culture, not frozen yogurt) to help stave off yeast infections, which can provoke more plugged ducts. Ibuprofen will help reduce swelling and fever.

To relieve the pain, fill a cotton sock with dry (uncooked) white rice. Put it in the microwave oven for 1 minute. It will be hot when you remove it, but also moist-an ideal warm compress. Apply it to the affected part of your breast for at least 1 minute, preferably longer, before you nurse. (If it's too hot, use a thin cotton blanket or washcloth as a buffer.) The heat will help dilate your milk ducts and help empty the plugged duct(s).

Continue breastfeeding while you're under treatment. The often you nurse, the more quickly you'll clear any plugged ducts. Try varying the nursing position to make sure all the ducts are fully drained. It may (probably will) hurt, especially at first, but this is the best way to deal with mastitis.

Untreated, mastitis can get much worse. It can develop into a breast abscess-a nasty situation that's more complicated to treat, often requiring minor surgery-and you'll end up on antibiotics anyway. For the baby's sake and your own, nip mastitis in the bud as soon as you recognize the symptoms.

If you're squeamish about prescription drugs, you can try treating mastitis with colloidal silver, a natural substance composed of submicroscopic clusters of silver suspended in ionized water. Colloidal silver is a powerful and nontoxic antibiotic that is increasingly popular as an alternative medicine. The University of California/Los Angeles medical labs found that it killed every virus they tested.

However, even though the manufacturers of colloidal silver say that it's safe for pregnant and lactating women, use it prudently. A 1996 medical research report assessing the risks and benefits of colloidal silver found that indiscriminate use can lead to toxicity. Colloidal silver is sold through whole food and health food stores.

Should the mastitis persist (or return) after you've finished your course of antibiotics, ask us to culture your milk so the lab can determine what kind of bacteria is causing your problem.