Breastfeeding for Beginners

Experienced Lactation Consultant  (IBCLC)  & Midwife 

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Mastitis

Mastitis is a fairly common but preventable complication of lactation. It is an inflammatory process that usually occurs in the first two to four weeks postpartum or due to sudden weaning. It can progress to the development of abscesses requiring needle aspiration or surgical intervention; the need for antibiotics; and sometimes unfortunately, early weaning due to the associated pain. The most common causative organism is Staphylococcus aureus which can enter through broken skin.

Common signs and symptoms:

  • Decreases in milk volume due to diminished lactose levels
  • Breast refusal due to increased sodium and chloride levels in the milk
  • Stinging pain in the nipple when feeding and afterwards
  • A nipple wound that won’t heal with crusting yellow to red exudate
  • A breast that appears swollen, red, warm and sore
  • Flu-like symptoms including chills, headache and a rapid pulse
  • Fever above 38 degrees
  • Redness of the breast and red streaks that may extend towards the axilla


Causes:

  • Milk stasis due to severe, prolonged engorgement or blocked ducts
  • Infrequent or inadequate emptying of breasts
  • A break in the skin i.e. nipple damage


Prevention:

  • Practice early, frequent breast feeding
  • Ensure that baby has a deep latch and is removing milk efficiently
  • Empty one breast before offering the second
  • Practice twenty-four hour rooming together to promote frequent feeding
  • Clear blocked ducts by heat, massage and breast compression during feeding/expressing
  • Express regularly if baby not feeding effectively
  • Ensure that milk continues to be removed while breasts are engorged
  • Avoid the use of dummies until breastfeeding is well established
  • Watch for early indications of mastitis
  • Avoid sudden weaning
  • Seek immediate assistance if concerned


Treatment:

  • Practice good hand hygiene before handling breasts
  • Broken skin may be cleaned with a saline solution
  • Continue to breast feed from both breasts
  • Begin each feed on the affected side
  • Ensure that the latch is deep and efficient
  • Warm water immersion for comfort prior to feeding
  • Feeding in the hands-and-knees position
  • Analgesics and anti-inflammatory drugs
  • Cold packs after feeds for about twenty minutes
  • If no improvement after twenty-four hours antibiotics will probably be required


Breast abscesses:
A breast abscess (photo below) may result as a complication of poorly managed mastitis. A well-defined and usually painful area of swelling will be observed at the site of the abscess. It is important that regular and effective breastfeeding or expressing for the baby continue. Weaning at this time should be avoided and the milk is quite safe to feed. Your doctor will arrange for needle aspiration or surgical drainage of the abscess and prescribe appropriate antibiotics.