Mastitis is one of the more serious breastfeeding problems, requiring medical attention. Blocked milk ducts and mastitis can be resolved easily, and if you deal with them early, you may prevent them from getting worse. Help to prevent mastitis from developing in the first place, through breastfeeding frequently and ensuring baby latches onto the breast correctly.

Blocked milk duct

Generally, a blocked milk duct presents as a tender, hard lump on the breast, which may or may not be red. Unlike mastitis, it is not associated with systemic (whole body) symptoms, such as fever. Blocked milk ducts frequently resolve spontaneously within 24 to 48 hours after onset. If left untreated, blocked ducts can develop into full-blown mastitis. So, if symptoms do not improve quickly, or if you start to feel unwell or develop a fever, seek immediate medical attention.

Sometimes, a small white blister on the end of the nipple forms. You can pierce the blister with a sterile needle. You then may or may not be able to squeeze out material trapped in the duct. If nothing comes out, don't worry. Opening the blister usually relieves nipple pain and it can result in the condition resolving quickly. However, seek medical attention if you are unable to open a blister yourself, or symptoms continue.

Even though baby may be fussy when feeding on the affected side, because milk flow may be slower than usual, it is important to keep feeding with that breast. You want to avoid long gaps between feeds, so wake baby up to feed if they are sleeping for longer than normal. If feeding is too painful, you can take paracetamol. You also can apply warmth to the breast before and during feeds.

Start breastfeeding with the affected breast, and check that baby is attaching to the nipple correctly. Position baby so that their chin points towards the blocked duct, as this helps to drain blocked areas. Gently massage the affected area towards the nipple while feeding.

After feeds, apply cold packs to the breast for comfort. Change nursing pads frequently and avoid wearing tight, constrictive bras.

Mastitis

Inflammation of the breast, or mastitis, is one of the more serious breastfeeding problems. Onset can be gradual or sudden. It can be caused by persistent blocked milk ducts, or by bacterial infection. It is important that you seek medical assistance as early in the process as you can.

When mastitis develops, it causes affected breast areas to become:

hard and swollen hot reddened painful or tender

There also are systemic symptoms, which include:

fever, (temperature above 38 degrees Celsius) flu-like aches and pains general malaise, feeling unwell

Do not be discouraged. Many women overcome mastitis and continue breastfeeding successfully. Importantly, it is not the time to wean. If you wish to stop breastfeeding, wait until the mastitis has cleared up, as abrupt weaning may lead to a breast abscess.

It is necessary that you continue breastfeeding to achieve frequent and complete emptying of the breast. Breastfeeding baby helps mastitis to resolve more quickly. It is quite safe for baby to feed and you should begin each feed with the affected breast. Sudden long periods between feeds are best avoided. If you find it too painful to feed, express milk by hand as best you can, and restart breastfeeding as soon as possible.

Medical treatment usually includes a course of antibiotics. It is vital that you take all of the tablets according to instructions. Resting in bed is essential, so where possible, try to get someone to look after you and take your baby to bed with you. Take paracetamol for pain relief if necessary. You can take ibuprofen instead of paracetamol. However, ibuprofen is an anti-inflammatory and, as the inflammatory response is part of the way in which the body heals itself, paracetamol is preferred.

Other ways to relieve symptoms are similar to those for the management of blocked ducts. Apply heat to the affected breast before feeds. You can use a warm cloth, hot water bottle (covered) or a warm shower. Then after feeds, apply cold packs to the breasts for comfort. If infection has developed through a cracked nipple, be sure to be vigilant with nipple cleanliness and care, avoiding contaminated nipple creams.

With correct care, breastfeeding problems will be resolved quickly. So be alert to the early signs of problems and ensure baby is attaching to the nipple correctly. Look after yourself and enjoy your baby!