Preventing mastitis

Content provided by Healthwise

Preventing mastitis

Mastitis usually happens in nursing mothers when bacteria enter the breast through a cracked or sore nipple. This can cause an infection. Mastitis usually starts as a painful area in one breast. It may be red or warm to the touch, or both. Fever, chills, and body aches are usually present.

Good breast-feeding techniques can help prevent sore and cracked nipples that may lead to mastitis.

• Breast-feed regularly. Do not delay or skip feedings. Breast-feed at least every 1 to 3 hours or whenever your baby is hungry (feeding on demand). This helps keep the milk ducts empty. In the first few days after birth, you may have to wake your baby every 2 to 3 hours to breast-feed.
• Arrange a time and place to pump or express your breast milk if you have to wait more than 4 hours to breast-feed your baby. See a picture of pumping or expressing breast milk .
• Align your baby straight for breast-feeding. This means putting your baby's chest to your chest. The baby should latch on to the areola, past the nipple. Latching on incorrectly, such as only getting the nipple into the baby's mouth, may cause problems. Your nipples may become sore or crack. Also your baby may not empty the breast well. Massage the areola if your nipples are flat, and gently push the nipple outward with your thumb and forefinger. See a picture of proper latch for breast-feeding .
• Alternate which breast you offer first at each feeding.
• Use different breast-feeding positions to drain all areas of your breast. See pictures of different breast-feeding positions, including the Australian hold , cradle hold , cross-cradle hold , football hold , and side-lying position .
• If you start to have sore or cracked nipples, get help from your doctor or a lactation consultant.

Other tips to help prevent mastitis include the following:

• Air-dry your nipples after each breast-feeding session, to prevent irritation and cracking.
• Consider using a lanolin-based cream, such as Lansinoh, to keep your nipples healthy. This cream may also be used to ease pain in sore or cracked nipples. Lansinoh does not require a prescription and may be purchased over-the-counter.
• Eat healthy foods and drink plenty of fluids, whenever you are thirsty. Having something to drink while you are breast-feeding is a helpful way to get enough fluids.
• Get plenty of rest. Ask for help with daily tasks from friends and family members whenever possible.
• Make sure that your bra fits well and isn't tight and restrictive. This is especially important if you become engorged.
• When you are ready to wean your baby, stop breast-feeding gradually. Gradual weaning is best for both of you. It helps prevent your breasts from becoming too full of milk and gives your baby time to adjust to new eating patterns. For more information, see the topic Weaning.

Credits

Last updated:	January 17, 2008
Author:	Bets Davis, MFA
Reviewed By:	Joy Melnikow, MD, MPH - Family Medicine, Liisa Honey, MD, FRCSC - Obstetrics and Gynecology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC