New guidelines on treatment of mastitis (and blocked ducts)
Why have the guidelines changed?
There are always new studies happening to improve our understanding of medical care and aiming to improve outcomes.
Recently the Academy of Breastfeeding Medicine released "Clinical Protocol #36: The Mastitis Spectrum, Revised 2022" with updated guidelines on the management of mastitis and blocked ducts
Here we will explain the new method in an easy to follow way.
Old Method to treat Mastitis/Blocked Ducts
The old thinking to help was:
Heat: using heat packs to move the milk
Rest: rest as much as you can to allow your body to fight infection
Empty Breast: keep the breast as empty as possible with additional feeding or pumping sessions
We now know while this does work for some cases, for many it
can actually make the infection / inflammation worse
New Method
1-Rest
Breast rest: feed baby as usual but do not add additional breastfeeds or pumping sessions. Avoid use of pumps / milk collection devices.
Rest & Stress Reduction: The mother / parent should try to rest as much as possible (eat well, hydrate)
2-Reduce Inflammation
Anti-inflammatorys: Consider taking over the counter plain ibuprofen to reduce some inflammation in the breast (recommended dose as per the packed) unless you have personal reasons to avoid this medication
Ice: Use ice (wrapped in a cloth) or cold packs on the breast for 10 minute intervals (max every 30 minutes)
3- Medications
Painkillers: Plain ibuprofen and plain paracetamol
are both safe to take while breastfeeding.
Follow stated dose on the packets
Antibiotics: If you have bacterial mastitis you may need an antibiotic also. You can see your GP or maternity
hospital (within first 6 weeks postpartum) for assessment prescription
4- Things to avoid
Avoid: Any topical treatments (saline soaks, Epsom salts in milk collection device (such as a haakaa), caster oil, essential oils, etc) as they may make the mastitis worse or cause it to turn into an abscess
5-Support
Do not try to suffer through mastitis alone. There are lots of options for support. Ask for help from friends and family too so you can rest as much as possible.
Peer Support Groups : Cuidiu, Le Leche League, Friends of Breastfeeding
Postpartum Doula: DoulaCare Ireland doulas will mind you, make sure you can rest and helpguide you with this information
IBCLC: A Lactation Consultant can assess WHY you developed mastitis and helpyou put a plan in place
GP: Can check for infection and prescribe medications
Maternity Hospital: Can check for infection and prescribe medications (within first 6 weeks postpartum
If you are interested in why these drastic changes to advice have occurred and the science behind them look up "Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022". Be aware however that there are graphic images of infected breasts and abscesses in the protocol document.
Please feel free to share this information with parents, breastfeeding supporters and anyone you think would benefit. In DoulaCare Ireland we strive to ensure our clients always have the most up to date information that is available. We can support you through mastitis with guidance, information, empathy and nurturing support.
*This information is correct on the date of publication.