Mastitis

Prevention

Mastitis is a condition which can develop if a milk duct in the nipple becomes blocked, and possibly from bacteria being introduced into the milk duct via the nipple and then trapped by the blockage. If, while the baby is sucking, the whole areola is not in the baby’s mouth, there may be uneven pressure on the milk ducts. When thisw happens regularly, one of the ducts may not be emptied for a few feeds, and the milk at the front may plug up the duct as it dries a little. This will cause a lump to start to form as the duct becomes swollen with milk. If the duct isn’t emptied within a day or so, the breast may become sore and if it goes longer, you may develop symptoms like flu with aches and fever. This is dangerous and can lead to a considerable amount of discomfort as well as the possibility of needing a doctor’s treatment for the infection which can develop. If it’s left unchecked for too many days, an abcess can develop where the surrounding tissue becomes extremely inlflamed,  and pus begins to collect in the lump. This may require a small surgical procedure to treat.

 

The best way to prevent mastitis is to make sure that your baby is properly attached, with the whole  areola in its mouth,  and completely empties the breast at each feed.  Good daily prevention includes massage of the breasts with coconut oil  in the shower or bath, or over a sink with warm salt water.

If there is too much milk to completely empty the breast, especially in the first 6 weeks, you can pump or hand express after the feed, and store it in the freezer for up to 3 months. It can be frozen in an ice cube tray and the 5 ml cubes can be stored in a ziploc bag. These can be defrosted later for use by babysitters etc.

 

After 6 weeks or so your supply will settle down and become more manageable and you will be producing just what you baby needs, but do continue to do the daily breast massage, as a duct can develop a blockage at any time.

Treatment

If after all of the preventative measures above, you still develop a blocked duct, you shouldmassage the breast with coconut oil, then hand express the breats until it is soft and empty. Stand in the shower or over a washbasin, with warm water pouring over the breast to help soften the tissue. Using a thumb, apply firm pressure from the back of the lump towards the nipple. Continue until the lump is gone. When you get out of the shower, apply an ice pack to the affected area. You may need to have several sessions to completely deal with the problem. Continue feeding as normal.

 

Evening primrose oil on the affected nipple and taken orally can help greatly to clear the blockage and keep it clear.

While breastfeeding, do not wear underwire bras or restrictive foundation underwear as anything which puts pressure on the breast can cause a blockage. Go bra-less for a couple of hours each day, and sleep without a bra at night to allow full blood circulation to the breast. At other times use a well-fitted nursing bra which has good support for the extra weight of the full-of-milk breast.

What is the Composition of Human Breastmilk?

Composition of Human Breast Milk

Human breast milk is the perfect food for human babies. The composition of human milk changes according to the needs of the child and the age of the child, as well as producing the amount needed on a supply and demand basis.

Human milk is also like a three course meal with an appetiser, a main meal and dessert.

When the baby first starts sucking, for the first 5 minutes or so, it will receive mostly what has been stored in the ducts. This can be about  5mils per breast of milk with a thinner consistency which is excellent for appeasing thirst. As your baby continues to feed from the same breast, the milk gets thicker and more full of nutrients, until by the time the baby has been feeding for 10-15 minutes the milk is like a dessert with carbohydrates, fats, proteins and all the nutrients to ensure that your baby grows and thrives. Your brain responds to the needs of your baby, producing the milk whenever it is needed and eventually producing it automatically at the times your baby would usually be hungry.

The more your areolas are stimulated by the skin to skin contact with the baby’s mouth, the more milk is produced.

The milk that comes last is called “hind milk” and is very important for the baby’s growth. If the baby doesn’t get enough hind milk it may not feel satisfied and may feel like feeding sooner.

Colostrum

 When your baby is first born, what it receives from your breast is called colostrum.

Colostrum is a substance similar to milk but with much higher amounts of fats and sugars. It also contains very important immune boosting elements so that your baby can adjust more easily to life outside the pristine environment of the womb. It is a protective and extremely nourishing substance which makes your baby immune to everything you are immune to. This immunity carries through for as long as you are breastfeeding exclusively and the baby is not eating solids or taking top up bottles of formula milk.

After about 3 days the colostrum will slowly change from a thick orange colour to a light yellow and then a cream colour as your body starts to produce milk. When your milk comes in your breasts will feel swollen and firm and you will get a tingling feeling under your arms and at the sides of the breasts. This is called the “let down” reflex which tells you that your milk is being pushed from the back to the front of the breast.

Nutrition in Human Breast Milk

Human milk contains  3-5%fat, it is rich in brain building Omega 3’s particularly DHA and AA. It Automatically adjusts to the needs of the human baby’s brain as it is developing. Rich in healthy cholesterol, and contains a fat digesting enzyme, lipase. These substances are almost completely absorbed in the baby’s digestive system.

Human milk  0.8-0.9% protein, composed of whey proteins which are soft and easily absorbed by the body. Mothers who deliver preterm have higher levels of protein in their milk to compensate. Human milk contain s lactoferrin which contributes to intestinal health, and Lysozome which is an anti-microbial and keeps pathological bacteria under control. Human milk is rich in growth factor proteins and brain and body building protein components. It also contains sleep inducing proteins which raise in level during the evening and night helping the baby to sleep better.

Human milk contains  6.9-7.2%lactose and oligosaccharides. Oligosaccaharides promote intestinal health. Lactose and oligosaccharides are carbohydrates which provide the energy for growth and are considered extremely important for brain development.

Human milk is rich in living white blood cells and immunoglobulins which protect the baby from illnesses and also contains protective antibodies that the mother has acquired through exposure to viruses and bacteria.

Vitamins and minerals in human breast milk are bioavailable, meaning that they are readily absorbed by the baby’s body . Human milk contains some of every vitamin and mineral that is needed for growth in the correct proportions to provide what the baby needs at each stage of development.

Human milk contains digestive enzymes amylase and lipase,  and is rich in many hormones that biochemically balance the baby’s body and make the baby feel good.

Human breast milk takes on the flavour of the foods that the mother eats, thereby introducing baby to the foods that the family eats.

 

Prepare for Breastfeeding

Preparation for Breastfeeding

When nearing the end of the pregnancy you can gently help your nipples to protrude into position for breastfeeding by simply pinching gently below the nipple with the forefinger and thumb. Then, holding onto the nipple, gently pull it out and turn it up and then down. Do this exercise several times with both nipples. If it is uncomfortable, be gentler as you perform the exercise. Gradually increase the number of exercises each day.

Avoid anything that is drying to the skin around the nipples, especially soap.

If possible, go bra-less for a certain portion of each day to allow the natural friction of your clothing, fresh air and sunlight to slightly toughen your nipples for breastfeeding.

The only washing that nipples need, even when breastfeeding, is your daily shower or bath. Spread some of your breast milk over the nipples after each feed. The milk has anti-septic properties as well as helping the nipple to stay moist, preventing them from drying and developing cracks.

Flat or Inverted nipples:

If you try the above nipple pulls and you find that your nipples react by retracting, then you may have inverted nipples. This is not uncommon in women who haven’t breastfed before. An effective technique for encouraging the nipple to protrude is the “Hoffman technique”. Draw an imaginary cross on the nipple. Place a thumb on each side of the nipple along one line of the cross, your thumbs should be directly at the base of the nipple, not the edge of the areola. Press in firmly against the breast tissue and pull the thumbs away from each other. You’ll be stretching out the nipple and loosening the tightness at the base, allowing the nipple to move up and outward. Dr. Hoffman recommends that you do this stretch five times in the morning along each line of your imaginary cross. This preparatory step makes it easier for you to grasp the nipple and do the pulling motion.