MastitisBlocked Ducts/Blebs

Mastitis:Mastitis is a bacterial infection of the breast that usually occurs in breastfeeding mothers. Nobody knows exactly why some women get mastitis and others do not. Bacteria may gain access to the breast through a crack or sore in the nipple, but women without sore nipples also get mastitis.

Symptoms of mastitis are: • Flu-likesymptomsincludingfever,bodyaches,chills

• Severebreastpain

•Hardknotinbreastpainfultotouch

•Redareaonbreast

Risk factors for developing mastitis are: • Blockedducts

• Stress/Overlytired

• Latchproblems

• Droppingthenumberoffeedings/Engorgement

• Tightbras

• Opencrackednipples

• Historyofmastitis

Treatment:• Lactationconsultantscannotdiagnosemastitisbut

we can refer you to your doctor if we think your symptoms appear to be mastitis.

• Ifsymptomspersistmorethan24hours,antibiotictreatment should be started.

Antibiotics that work best for mastitis are: Dicloxacillin,cephalexin,cloxacillin,flucloxacillin,clindamycinandciprofloxacin.

• Continuebreastfeeding,unlessitistoopainful.You will need to express your milk if you are not breastfeeding.Restartbreastfeedingassoon as possible.

• Getplentyofrest.Eatwellanddrinkextrafluids.

• Ifnipplesarecrackedandbleeding,cleanwithsoaponce a day.

• Applyheatwithwarmwashclothstotheaffectedarea a few minutes before a feeding.

• Coldpackshelpwithswellingandpain,abagoffrozenvegetablescanbeused.

• Acetaminophenandibuprofenhelpthepain.Ibuprofenworksthebestforinflammation.

Ifittakeslongerthanacoupleofweeksforalumptogo away or get smaller, you should be seen by a doctor. Youcanstillbreastfeedwhileyouhaveamammogram,ultrasoundandevenabiopsy.

Blocked Ducts:A blocked duct is a swollen firm knot in the breast. Theskinovertheductwillberedandslightlypainful.Blockedductswillclearupin24-48hourswithtreatment.Babymaybefussyontheaffectedsideduetoslowermilkflow.Untreatedblockedductscanturninto mastitis.

Treatment:• Continuebreastfeedingonbothsides.

•Emptytheblockedductbypositioningthebabysohis chin “points” to the blocked duct area.

•Usebreastcompressionbygettingyourhandaroundthe blocked duct and apply steady pressure while baby is sucking.

•Applyheatwithwarmwashclothstotheblockedductareaforafewminutesbeforeafeeding.Icecanbe used for pain between feedings.

•Getplentyofrest.

•Ifyoualsohaveableb,seetreatment.

Continued on back

Mastitis/BlockedDucts/Blebs Continued.... Blebs:Ablebisablister-likeareaonthenipple.Itisunclearwhatcasusesblebs.Someideasare:

•Thickenedmilkblockingtheflowofmilk.

•Athinlayerofskincoveringtheopeningofamilkduct.

•Asmallcystformedattheendofamilkduct.

Treatment:• Iftheblebdoesnothurtyoucanallowittoclearup

on its own, it may take a few weeks.

• Applyadamp,warmwashclothorsoaknippleinwarm water.

•Wearacottonballsoakedwitholiveoiltosoftenthebleb,thismaybedoneforseveraldays.

• Trytopeelwaythethickenedskin.

• Trytoremoveanymilkleftintheductbysqueezingbehind the bleb. You might express a thickened string of milk.

Ifthesetreatmentsdonotwork,itmaybenecessaryfor you to see your physician so the blister can be opened.

Itisimportanttopreventinfectionsaftertheblebisopened so washing with a mild soap once a day is a good idea. You may also apply an antibiotic cream. Taketurnsusingapurifiedlanolintokeepthenipplesoft.Thiswillhelpstoptheblebfromcomingback.

Ifyouhaverecurringblebsyoumaywanttoreducesaturated fats from your diet or take a lecithin supplement.Lecithindosageis(1200mgcapsules) one capsule three to four times a day.

Wilson-Clay,B.andHoover,K.,TheBreastfeedingAtlas.Austin,TX:LactNewsPress;1999.

Newman,Jack“BlockedDuctsandMastitis”,January2005http://drjacknewman.com>

Mohrbacher,N.andStockJ.,TheBreastfeedingAnswerBook,ThirdRevisedEdition.Schaumburg,Il:LaLecheLeagueInternationalInc.;2003

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