New Moms’ Breast Infection (Mastitis): Causes, Symptoms and Treatment

Breast Feeding

Photo by NIKOLAY OSMACHKO from Pexels

 

Mastitis is every breastfeeding mom’s nightmare, especially for new moms. So every mom deserves a beautiful gift on Mother's day.

Mastitis affects approximately 2 to 10% of postpartum American women even though this equates to as many as 50,000 to 400,000 women annually. It is known to be an underreported medical condition. When a woman decides to breastfeed her baby, she’s making a significant commitment that involves decisions about herself, her baby, and her family.

For most postpartum women, breastfeeding is an important milestone in their lives. It promotes mother-infant bonding and offers numerous health benefits for both the mother and the infant. A common and often under diagnosed complication is mastitis.

My Mastitis Nightmare Experience While Breastfeeding

I started getting fevers and the higher the fever got, I got a little more concerned. I went to the hospital to see the doctor several times, who diagnosed me with mastitis. It’s an infection in the breast tissue, not uncommon in breast-feeding women.

On the breast itself, I got a red area that’s a little hard, firm and very tender to the touch. And then the fever I really noticed and was quite high. In addition to the fever, I felt almost like I had the flu, body aches chills pain. Anyway, no matter how bad you feel with mastitis, it’s important that as nursing moms, you don’t stop what you are doing.

At that hurt time, I still needed to make sure that the breast did not continue to get engorged. So I needed to continue either nursing the baby or using a pump to get the milk moving. The milk itself was not infected and so it’s not required that you throw the milk away, but maybe many moms generally choose to do that.

During those painful days, I was very frustrated, and been doing quite a bit of pumping, and having to give my baby bottles, just out of necessity, just because it caused so much pain. I really should have taken a breastfeeding class ahead of time, but I had no idea that you needed to do that kind of thing?

I took for granted that breastfeeding is just a natural process, and that you might actually need to know all the tips other than just what I’ve been reading in all the books. So just to have that hands-on tutorial from somebody who knows what they’re doing is invaluable and didn’t know that ahead of time and really wished I would have.

What Cause Breast Mastitis? What Are Mastitis Symptoms?

For everybody at home, mastitis is an infection of the breast tissue that results in the breast being swollen, tender, red, warm, and they can get fever or chills. It really leaves moms feeling pretty crappy. You can actually get mastitis even if you haven’t been pregnant, but most commonly is going to occur in a breastfeeding woman, especially if she’s stopped breastfeeding or while she is breastfeeding.

Basically it can happen for a couple of reasons. If the breast isn’t emptied completely during feeding, then you can get clogging of a milk duct and then the milk can back up behind there and that can cause an infection. Or, you can get bacteria from mom’s skin or baby’s mouth that goes in through a cracked nipple for example, and get into the duct, any stagnant milk will serve as a breeding ground for that bacteria.

If you are trying to care for a newborn baby, you’d spent hours massaging, pumping, hand-expressing, nursing, applying hot/cold compresses, taking hot baths/showers while trying to get some sleep and care for a baby and feel utter crap and the clogged area still hasn’t resolved then… you’ll do pretty much anything for relief. As we all know, there are much nursing benefits for mothers & babies.

The benefits of breastfeeding for mothers include a faster and easier postpartum recovery, a decreased risk of osteoporosis, protection against ovarian cancer and a reduction in the risk of breast cancers. Breastfeeding also decreases cardiac risks and Type II Diabetes.

In the first few days of nursing, breast milk is preceded by colostrum, which transfers immunities naturally to the infant. This unique composition of breast milk is designed for each individual child, hoping to protect the gastrointestinal and respiratory tracts from pathogens, aiding in digestion and allowing for optimal physical and mental development. From a psychological and social point of view, breastfeed babies are more developmentally mature and secure in their environment with reported higher cognitive developmental values.

Detailed Recognition & Signs of Mastitis

Interruptions in breastfeeding could be caused by breast engorgement, plug ducts, mastitis and more seriously: a breast abscess. In addition, a history of breast surgery, chest surgery, or any injury to the chest wall can cause engorgement or plug ducts due to scar tissue. Any of these conditions can be detrimental to the mother and the babies overall health and well-being.

Mastitis is an infection of the breast connective tissue during the second phase of lacto genesis or milk production in lactating women. It is important to differentiate between the various complications that can occur in the new mother.

Engorgement, for some mothers, when her milk is coming in her breasts become extremely swollen, with generalized warmth, the mother’s temperature may reach 38.4 degrees Celsius, but generally she does not feel ill. This is the beginning of milk stasis, which can occur as a result of failure to change infant position to allow the emptying of all lobes of the breast, failure to alternate breasts at feedings, poor latch, or poor let down due to maternal nipple pain or improper pumping.

Mastitis can be classified into two primary types: adenitis and cellulitis. The onset of adenitis is gradual generally after a feeding. It occurs in one breast and swelling or localized heat may be intermittent. Pain in the breast is localized to one area and even with an elevated temperature the mother does not feel ill. Clinical signs and symptoms are less severe. Breast ducts are presumably blocked, resulting in milk stasis. Treatment measures do need to be initiated to prevent progression to cellulitis.

The more severe form of mastitis is cellulitis, which is where the inter lobular connective tissue has been infected. Symptoms may come on suddenly after about 10 days postpartum. One breast may have a pink tender hot swollen wedge-shaped area, a fever of 38.5 degree Celsius more greater with chills, and systemic flu-like aches may be one of the last symptoms. If untreated, abscesses or septicemia may occur.

One of my sister told me her scary experience of abscesses treatment.

“She sent me down to the breast bloodless drain, it was very disgusting, and it had two cups just filled of staph infection, and they tested it and everything was okay. I had to go in four times and have a needle stuck into my breast and had it drained. It hurt really bad, but I just kept nursing in on that side. Eventually it did go away.”

A breast abscess is more likely to occur with a history of mastitis or a history of breast injury. This may be related to the inflammatory process which results in remodeling of tissue. A breast abscess presents similarly to mastitis except that there is a firm area in the breast often with a fluxion which is an indication of the presence of pus in a bacterial infection.

An abscess can be confirmed with an ultrasound. Abscesses are treated with surgical drainage or needle aspiration, which may need to be repeated. Fluid from the abscess is cultured and antibiotics administered.

More and more hospitals have realized the benefits of having lactation specialists, yet new mothers may still have limited access to a lactation specialist, which can lead to a lack of awareness of personal hygiene and skin protective techniques, a lack of awareness of signs and symptoms of mastitis, and often improper self medication.

The infection usually begins when bacteria enter the breast tissue, as a result of some type of trauma sore, or cracked nipples may be one type of trauma. As a result of nipple trauma, feedings may be altered reduced or discontinued.

There are certain factors that contribute to bacterial access: breast and nipple trauma are first and foremost, poor hand washing techniques prior to breast feeding, improper breast hygiene, or improper cleaning of breast pump equipment are other contributing factors.

Bacterial growth can result from nipple trauma and exposure to bacteria. Things that can amplify bacterial growth are: plastic-lined breast pads and the abundant use of occlusive ointments.

Obstruction of ductal tissue may occur when restrictive clothing or improperly fitted bras are worn, anything that presses on the breast can cause obstruction, even sleeping on the stomach when breasts are filling with milk may create obstruction. Additional risk factors for mastitis include: tongue mouth position, ankyloglossia, having an infant with a cleft lip or palate or a short frenulum.

Breastfeeding Tips for New Mothers with Mastitis

Mothers may be advised to:

  • Apply warm packs prior to feeding or pumping;
  • Then ice packs afterwards for comfort;
  • Nurses should advise the mother to drink plenty of fluids;
  • The mother may take an analgesic such as acetaminophen or ibuprofen;
  • The mother should wear a well fitting comfortable bra that does not cause painful pressure.

Some women may present with pain and a breast mass as the main symptoms of mastitis rather than fever.

“I think it’s interesting that none of us had temperatures, and I don’t know what you guys ended up saying, but I told them that I had my appendix out in two hours before I was rushed in for emergency surgery. Before it ruptured, I still didn’t have a temperature. So I said to the doctor I don’t get temperatures, if I think it looks like mastitis, and the only reason you say it’s not is the temperature, then I want whatever you give people who have mastitis.”

Persistently painful breasts and non healing nipples should be directly examined by a primary health care provider, making sure though that they recognize that they are sick, the hardest part is to get women who are breastfeeding babies and have other babies are working that they’re sick.

A lactation specialist can ensure that preventive steps are taken by educating mothers to:

  • Use meticulous hand washing techniques;
  • Identify early warning signs of breast and feeding problems;
  • Plan for separation, for example returning to work;
  • Achieve latch techniques that are specific to each mother and infant
  • Practice proper pumping techniques.

Conclusion

When anticipating a return to work, the breastfeeding mother may want to obtain a quality breast pump establish a pumping schedule and store extra breast milk for the baby. This will also reduce the possibility of engorgement.

By understanding the contributing factors they’re associated with breast infections, nurses are in key positions to either prevent its occurrence or to help mothers live through mastitis.