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.
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.