Dr. Daniella Perri Blog
Postpartum Health & Wellness
Dr. Daniella Perri Blog
Postpartum Health & Wellness
Lactational mastitis refers to the inflammation of breast tissue during breastfeeding. Women are often told that they have a “clogged milk duct” or a “plugged milk duct.” In reality, the surrounding tissue is inflamed, and that pressure narrows the milk duct, causing poor milk flow.
If left unattended, this creates a breeding ground for bacteria to proliferate. A small percentage of women go on to develop an abscess (localized infection), which takes a lot more time to heal. The discomfort is also a deterrent for breastfeeding, which makes for unhappy babies and the unintentional switch to formula.
As a result, the challenges that women face ultimately lead to their breastfeeding journeys ending prematurely. However, there are many ways to treat mastitis! It’s good to know that mastitis doesn’t always mean that an infection is present. This can help differentiate what treatment options may be best for you so you can continue to breastfeed without hesitation.
Some common symptoms of lactational mastitis include localized symptoms such as pain in a specific spot in one breast, redness or a wedge-shaped pink area over the painful spot, and a palpable lump (“clogged duct”) that feels smooth and is tender to touch under the area of redness and swelling.
What does a “clogged milk duct” feel like?
Depending on the size of the “blockage,” you can feel either a pea-sized ball or a lump the size of a golf ball! It has a smooth feeling to it, and it is tender to touch because of the surrounding inflamed breast tissue.
When an infection is present, generalized symptoms may appear, such as overall malaise, fever, body aches, and chills. It feels like you are down with the flu! These symptoms will appear in conjunction with the localized symptoms mentioned above.
Based on the current definition of lactational mastitis, the Academy of Breastfeeding Medicine (ABM) revised their Mastitis Spectrum protocol and shifted from heat and deep massage to ice and inflammation reduction. Let’s explore some other treatment options!
The most common treatment strategy for recurrent mastitis (mastitis that keeps happening) is antibiotic administration. In fact, current research suggests that if a woman’s symptoms are mild or show resolution within 48 hours, she may not need antibiotic treatment at all. This is good news since antibiotics are ineffective against drug-resistant bacteria.
When symptoms are mild, there are a few best practices that you can follow. First and foremost, get lots of rest! As with any type of pain and inflammation in the body, it’s necessary to rest to allow the body to heal.
Whether there is an infection or not, continued breastfeeding/milk expression is completely safe for the baby, even if mom is on antibiotics! Gentle lymphatic massage (towards the armpit) can also help with milk flow by draining excess fluid in the breast tissue.
In some cases, overexpression could be a trigger for mastitis, but that could be something that you talk to your healthcare provider about.
If the discomfort from the tenderness is preventing you from resting, then over-the-counter pain-relieving medication like Ibuprofen can help. Give yourself permission to feel good and relax your body. Stress prevents healing!
Now more than ever, women are looking for alternative options to help with symptoms of mastitis. Current research suggests a few supplements that may help resolve mastitis and are completely safe to take while breastfeeding. They are also very easy to obtain online and at local health food stores.
Probiotics (L. fermentum and L. salivarius)
A meta-analysis of recent clinical trial data concluded that the use of probiotics containing Lactobacillus fermentum and Lactobacillus salivarius significantly reduced the bacterial count in human breastmilk, thus reducing the incidence of mastitis. Further studies demonstrated that supporting the gut microbiome can reverse symptoms of mastitis.
Allicin (from Garlic)
This is nature’s antibiotic. Emerging research demonstrates its potent antimicrobial activity, which has the potential to treat mastitis and prevent abscess formation. Not only does it act as an antimicrobial, but it also has the ability to reduce inflammation as well. A win-win situation.
Therapeutic Ultrasound Therapy
Low-intensity pulsed ultrasound has been demonstrated to reduce inflammation in breast tissue. In a recent case study, it was observed that a significant reduction in inflammation, swelling, and redness occurred after 5 consecutive treatments of 5 minutes each. The patient was able to continue breastfeeding comfortably.
The purpose of ameliorating the symptoms of lactational mastitis is to allow mothers to enjoy their breastfeeding journeys. Probiotics, garlic, and therapeutic ultrasound provide women with non-pharmaceutical treatment options. The aim is to prevent early cessation of breastfeeding to allow women to achieve their breastfeeding goals.
If you think you have a “clogged milk duct” or the start of mastitis, follow these steps:
Louis-Jacques, A. F., Berwick, M., & Mitchell, K. B. (2023). Risk Factors, Symptoms, and Treatment of Lactational Mastitis. JAMA, 329(7), 588–589.