Soreness in your breast during nursing? You might have mastitis. Here’s how to get back to breastfeeding without the pain.

Most mothers out there will develop a love/hate relationship with breastfeeding. On one hand, it can be considered one of the most natural and precious of bonding experiences between mother and baby; an almost sacred act of love. To quote David Suzuki, “A baby nursing at a mother’s breast is an undeniable affirmation of our rootedness in nature.” On the other hand, while there’s so much to love about nourishing and feeding your baby, it also comes with its fair share of hardships too. The many struggles that arise with breastfeeding – not to mention society’s perpetual squeamishness and stigma towards doing it in public – can make this supposedly pure and beautiful act unbearable.

The fact remains that while some mothers have no problems breastfeeding, enjoying the experience and weaning when they and their bubs are ready, many mums struggle to make it work. Being the sole source of nourishment for your baby is a lot to take on physically and mentally, and among the most dreadful of afflictions targeting breastfeeding mothers is mastitis, which occurs when there is an inflammation of breast tissue that is sometimes accompanied by an infection.

Bosom Bother

After nursing her daughter for four months with virtually no issues, mother-of-one Hazel C. started noticing tender and swollen lumps in one of her breasts. “I was still producing a healthy amount of milk, and my baby had no problem latching and consuming it. But there were times when she would only go for small amounts – I call it a snack round – before calling it a day,” she shares. “Plus, I wasn’t keeping up with my pumping as religiously as before since I returned to work.”

At first, she tried to get rid of the swollen spots using hot compresses, coupled with self-massages and a more rigorous pumping routine. When these failed to work, she signed up for a lactation massage. But not only did the lumps not go away, Hazel even developed flu-like symptoms like body aches, chills, and fatigue. This prompted her to check in with a breast specialist, who diagnosed her with mastitis. She was put on a round of antibiotics to clear up the inflammation and underwent manual drainage via needle aspiration to remove the pus, reduce swelling, and provide instant relief.

The Mastitis Misery

Hazel’s story and experience with mastitis may resonate with some mums out there. After all, up to 10 percent of mothers who breastfeed develop mastitis, according to the SingHealth Duke-NUS Breast Centre, and in some rare circumstances, this condition can also occur outside of lactation in non-breastfeeding women, known as Idiopathic Granulomatous Mastitis (IGM).

There are two main causes of mastitis. The primary cause is a clogged milk duct, which can happen when milk isn’t removed frequently or efficiently enough from the breast during breastfeeding or pumping, and the channel through which milk flows literally becomes so overwhelmed that milk builds up and is unable to flow out, resulting in the formation of tender lumps. Mastitis also occurs when bacteria enter the breast through a break or crack in the skin of your nipple or through the opening to the milk ducts in your nipple.

“A crack on the nipple from a poor latch or poor pumping can allow them to get inside the breast and create infection,” says Leigh Anne O’Connor, an International Board Certified Lactation Consultant (IBCLC). “As with a clogged milk duct, this can also lead to an inflammatory response.”

The red flags of mastitis can appear almost instantaneously. These include tenderness and/or swelling of the breasts, the presence of thickened breast tissue or lumps, pain or a burning sensation that keeps coming back during breastfeeding, red patches on the skin, or a fever of 38.3 degrees Celsius or higher.

Avoiding The Boobie Trap

Proper latching of the baby to the areola is the best way to​ prevent mastitis. This ensures that the baby gets a full, proper feed and the milk is effectively drained from the breast. “Avoid skipping or missing a feed. If you are unable to feed, drain your milk by expressing with your hand or a pump to avoid accumulation of the milk in the breast,” says Ms ​Cynthia Pang, Assistant Director of Nursing and Senior Lactation Consultant at the Lactation Clinic, KK Women’s and Children’s Hospital (KKH). “Ensure the breasts are well drained after a feed.”

It may also help to switch up your nursing position to help empty your breast completely of breast milk. Experiment using different techniques: a cradle hold may work for one breast while a side-lying position may work better for the other. Alternate between breasts, allowing your baby to completely empty one breast before switching to the other breast during feeding. Avoid exerting too much pressure on your breasts by swapping ill-fitting bras and tight clothing with lighter and less restrictive ones. Lastly, practise good hygiene habits such as cleaning your hands with soap and water before and after feeds, and keeping your nipples clean.

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The Cabbage Cure

Breast engorgement may be experienced by some new mums when their milk supply arrives a few days into giving birth, especially when more milk is produced than their breast can contain. While engorgement is temporary and can be easily treated, it can lead to mastitis when left unaddressed.

An effective (though unorthodox) solution? Cabbage leaves. Besides the cooling effect, cabbages also contain glucosinolates, which can help alleviate the swelling. A study conducted on 227 mothers with breast engorgement by Dr Wong Boh Boi, Deputy Director (Clinical) and Senior ParentCraft Educator from Thomson Medical Centre, revealed that those who applied cabbage leaves reported significant reductions in hardness and pain of breasts compared to those who used cold gel packs. That said, limit cabbage use to 20 minutes no more than three times per day as it can decrease milk supply.

The article was first published in the Parents World Magazine -Issue 72

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