Mastitis & Blocked Ducts: What, Why and How can I get rid of it?!
Mastitis is a painful condition that can affect women during their breastfeeding journey.
Did you know that mastitis is something that Physiotherapy can assist with?
First of all, What is mastitis?
Mastitis is part of a spectrum of inflammatory breast conditions, which begins with narrowing and “blockage” of the ducts that the milk travels in. When the ducts in a particular area of the breast become blocked, the surrounding breast tissue can become inflamed, resulting in heat, tenderness and redness, and often a lump can be felt. This is known as ‘inflammatory mastitis’. If left untreated, the inflammatory reaction can become system wide, resulting in fever and chills. If mastitis worsens, an infection and associated complications can occur (e.g. an abscess). Long story short, we need to identify and treat inflammatory breast conditions QUICKLY!!
If left untreated: Blocked ducts -> inflammatory mastitis -> bacterial mastitis -> abscess
Hang on, WHY does mastitis occur?
The first stage within the spectrum of inflammatory breast conditions, narrowing of the ducts, usually occurs when there is TOO MUCH milk in the breast, and that milk has begun to seep from the duct into the surrounding tissue (which then draws an inflammatory reaction to the area, causing swelling, which squashes and narrows the ducts!)
Common reasons for too much milk being in the breasts:
Skipped feeds
Baby slept longer than usual and didnt feed
Feeding from the same breast multiple times in a row
Hyper-stimulation (prompting the breast to make too much milk… often from over-pumping!)
Baby not effectively removing milk from the breast due to a poor latch
Stopping breastfeeding abruptly
Mastitis can also occur following nipple trauma, when bacteria enters through an open wound. It can also develop when there is an imbalance within the micro-biome of the breast, which can follow from the use of antibiotics.
Women who develop mastitis often have this in common with each other: they are run down!! Their body has simply not been up to the job of fighting off a source of local inflammation.
What can a physiotherapist do to treat it?
As physiotherapists, we are able to use Therapeutic Ultrasound to administer thermal energy to the area. This is a gentle type of heat and micro-massage that effectively reduces local inflammation and swelling.
Therepeutic ultrasound is recommended to be used daily until symptoms are relieved (usually 1-3 days in a row).
Your physio will also teach you lymphatic drainage massage and provide advice around self management (see below!)
What else can I do?
Self management strategies:
Using cold packs for comfort and to reduce inflammation (frozen peas in a sandwich bag, nappies filled with water and frozen, or purpose made breast packs - we sell Bare Mum ones at the clinic!)
Taking Non Steroidal Anti-Inflammatory medication (such as neurofen) to control inflammation. Please speak with your pharmacist for advice regarding pharmaceuticals.
Continue physiological feeding (AKA feeding on demand!) This is the most important thing to do! Mastitis does not change your milk, your baby cannot get an infection so there is no reason to stop or reduce feeds on the affected side. If exclusively pumping, only pump for what your baby is taking. Please consider seeing a Lactation Consultant if you need assistance with feeding!
DRINK LOTS OF WATER!
Rest! I know what you’re thinking, ‘I have a baby, what is rest?!’ But please outsource what you can to friends and family and focus on laying low while managing and recovering from mastitis!
Please DO NOT:
Wear ill fitting bras, especially with underwire
Massage firmly. This will increase swelling and inflammation, worsening mastitis!
Try and ‘clear the blocked duct’ by continuously pumping or feeding from the affected side.. this will only prompt more milk to be produced, worsening the problem!
Ignore it and hope it goes away!
At the first signs of inflammation in the breast, please phone Barossa Physiotherapy on 8562 3441. Advise reception staff that you require a mastitis appointment, and they will triage you to be seen as soon as possible by one our treating clinicians.
If you experience onset of symptoms on a weekend or public holiday, please call 0494 113 000 (if we don't answer, please leave a message and we will give you a call back as soon as we can *please note this call will come from a private number, and weekend rates apply to any appointments*)
See you soon in the clinic,
Mel Clayfield (Physiotherapist)
References:
Mitchell, K. B., Johnson, H. M., Rodríguez, J. M., Eglash, A., Scherzinger, C., Widmer, K., Miller, B. (2022). Academy of Breastfeeding Medicine Clinical Protocol #36: The mastitis spectrum, revised 2022. Breastfeeding Medicine, 17(5), 360–376. doi:10.1089/bfm.2022.29207.kbm