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As a new mom you're naturally busy, but recently you've been rushing around more than usual and all of a sudden you feel like you have the flu. Bad timing, but it may not be what you think. You may have mastitis and not the flu.

Mastitis is an inflammation of the breast, with or without infection present. Mastitis usually comes on abruptly. Symptoms, typically lasting two to five days, include:

• tiredness
• swelling
• heat and intense
• pain, often in a wedge-shaped area of one breast, with flu-like symptoms such as exhaustion, fever of greater than 101, aching, chills, and...

As a new mom you're naturally busy, but recently you've been rushing around more than usual and all of a sudden you feel like you have the flu. Bad timing, but it may not be what you think. You may have mastitis and not the flu.

Mastitis is an inflammation of the breast, with or without infection present. Mastitis usually comes on abruptly. Symptoms, typically lasting two to five days, include:

• tiredness
• swelling
• heat and intense
• pain, often in a wedge-shaped area of one breast, with flu-like symptoms such as exhaustion, fever of greater than 101, aching, chills, and nausea

The Academy of Breastfeeding Medicine's "Clinical Protocol for Mastitis" states, "If symptoms of mastitis are mild and have been present for less than 24 hours, conservative management (effective milk removal and supportive measures) may be sufficient. If symptoms are not improving within 12 to 24 hours, or if acutely ill, antibiotics should be started."

Mastitis Survival Tips

Mastitis is an illness; get some rest!
Moms who are exhausted and/or stressed are more prone to mastitis. Get some help around the house and then crawl in bed with your little one and get some much-needed rest together.

Talk with your doctor about taking a pain reliever or anti-inflammatory. Most are compatible with breastfeeding, and relieving pain can also help with your milk ejection reflex.

Continue to nurse frequently, particularly on the affected breast.
Frequent breast "drainage," every two hours or so, is the most important and best treatment to help you heal.

Don't time your baby's feeds. Nurse on the affected breast first. If you find this too painful, start on the other breast, switching as soon as your milk ejects.

Keep your immune system healthy.
Eat a healthy diet and "drink to thirst," in other words, drink when you feel you need to. Your body needs extra fluids when you are ill and have a fever. And, don't smoke. Cigarette smoking can lower your resistance to infection.

Avoid pressure on your breasts.
If you suspect you have mastitis, or are prone to mastitis, avoid sleeping on your stomach, wearing a tight bra or tight bathing suit, carrying a heavy purse or diaper bag, or carrying your baby on your chest in a baby carrier.

Be prepared for a temporary decrease in supply in the affected breast.
Once the mastitis resolves, your milk supply should get back to near normal with frequent feeds.

If you are considering weaning, wait until symptoms of mastitis are no longer present.
Abrupt weaning can increase your pain, as well as your risk of developing a breast abscess.

Before Nursing

Soak your affected breast in warm water before nursing.
At least three times a day lean over a big bowl filled with warm water, submerging your breast for around 10 to 15 minutes. This can help relieve breast pain and get your milk flowing.

Follow moist heat with massage.
After soaking your breast, or applying warm, moist heat, use gentle but firm massage or kneading if you are able to tolerate it. Start at the outer quadrant of the breast and work toward the nipple.

During a Feed

Don't neglect good positioning and latch on.
Poor attachment equals inadequate milk removal. You know your baby is accessing your milk when you feel your baby's strong suck and hear swallowing after every couple of sucks, you feel your milk eject and/or notice your baby starts to swallow more frequently, you see a few drops of milk at the corners of your baby's mouth and your baby comes off the breast looking relaxed and satisfied.

Breastfeeding should always be comfortable. If you have problems with positioning, get hands-on help from a board-certified lactation consultant (IBCLC).

Your baby may refuse the breast.
If you have mastitis, it's normal for the milk in your affected breast to have a salty taste. Some babies don't seem to notice it at all and others are fussy or totally refuse that breast.

If your baby isn't happy with the salty taste, start on the unaffected breast. Once mastitis clears, the taste of your milk will return to normal.

If your baby misses a feed, or your breasts feel full, encourage your baby to nurse, or express your milk.
Insufficient milk drainage can cause noninfectious mastitis to progress to a full-blown breast infection, and infectious mastitis to the formation of an abscess.

Regularly nursing or expressing your milk also preserves your milk supply. ("Drained" breasts make milk quickly, while full breasts make milk slowly.)

Between Feeds

Apply cold compresses to reduce pain and inflammation.
Apply an ice pack, covered with a thin towel, to your affected breast for around 15 minutes, as needed. (Frozen peas work well because they conform to your breast.)

Safety Note

• Certain events can make you more prone to mastitis, including, but not limited to: stress, exhaustion, illness, anemia, missed feeds, longer times between feeds, return to work, rapid weaning, engorgement, overabundant milk supply, latch-on problems, cracked or bleeding nipples, use of nipple shields, thrush, breast surgery or injury, unresolved plugged ducts and incomplete recovery from a past bout of mastitis.
• Call the doctor if you feel progressively worse or have a fever for more than 24 hours. Mastitis does not always require antibiotics, but if your doctor prescribes an antibiotic, be sure to take the full course, usually 10 to 14 days.
• If you don't feel better in two to three days after treatment with an antibiotic, the World Health Organization recommends breast milk culture and sensitivity testing.
• When mastitis is not treated, it can progress to a breast abscess that will require aspiration.
• Rarely, mastitis that recurs in the same location is a warning sign of a breast mass. This type of recurrence should be evaluated by a breastfeeding-friendly surgeon.

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