What causes mastitis and plugged ducts?

Plugged ducts and mastitis can be caused by:

  • Engorgement
  • Missed or infrequent feedings
  • Nipple damage
  • Shallow latch (caused by positioning, tongue-tie, or other challenges)
  • Pressure on a duct (from a strap on a bra, baby carrier, or purse)
  • Stress or fatigue
  • Infection
  • Rapid weaning

All plugged ducts and mastitis are worthy of your immediate attention!

Some strategies for treatment:

Keep up milk removal! Frequent milk removal on the affected side can help (at least every two hours). When breastfeeding, start on the affected side. If that hurts, nurse first on the unaffected side and then switch when letdown occurs.

During milk removal:

Massage gently from the affected towards the nipple.

Your goal is to drain the breast as completely as possible. If needed, pump or hand express after breastfeeding. If breastfeeding is too painful, pump exclusively.

Before removing the milk, get the milk moving. Strategies include:

Massage: If you have a plugged duct, think of that area as a blue marble. The rest of your breast is filled with white marbles. Gently try to move that blue marble around all the white ones. Be gentle, especially if you are in pain.

Heat: Heat before milk removal may help. A warm shower, soaking in a sink of warm water, or warm cloths may help to get the milk flowing. Take care to not damage your skin with excessive heat in a heating pad.

After feeding, consider reducing inflammation. Strategies include:

Cold. Cool packs can ease pain and reduce inflammation.

Anti-inflammatory strategies. Depending on your health care choices, you may want to explore over-the-counter anti-inflammatory medications (like ibuprofen*). You can also explore homeopathic supports, such as arnica, either orally or topically.

Between feedings.

Be sure to take good care of yourself! Rest, drink adequate fluids and eat well. Mastitis and blocked ducts are often a sign that you need some additional rest and self care.

Should I take antibiotics?

The current research suggests that many cases of mastitis resolve without antibiotics. If symptoms are mild and have been present for less than 24 hours, the Academy of Breastfeeding Medicine suggests trying the above strategies for 12-24 hours. If symptoms are improving, then they are likely to resolve with antibiotics. If they are not resolving or you are acutely ill, please seek medical attention.

Holistic treatments:

Some strategies recommended by the San Diego Breastfeeding Center:

  • Castor oil compresses – Castor oil used topically helps to move things under the skin.  Pour castor oil on a face cloth (it stains, so not on a nice one) and place the face cloth on your sore breast.  Place a heating pad over the face cloth, as the heat will help the body absorb the castor oil and move the blockage.  Check every 20 minutes and use as long as it takes to soften your breast.
  • Dandelion tincture.  Dandelion is a natural antibiotic and a great way to battle any infection.  Two droppers full, 3-4 times a day, can often do the trick.  The flavor is definitely intense, but well worth it!
  • Vitamin C and Echinacea.  Mastitis is your body’s way of telling you it’s time to slow down.  Both vitamin C and Echinacea boost your body’s immune system.  A safe dose to take is 3000-5000mg/day (mega dose to be used acutely during mastitis) of Vitamin C and 900mg of Echinacea per day (acutely).
  • Homeopathic belladonna.  These tiny little pellets can make a world of difference to reduce your temperature while battling mastitis.  Plus, you cannot overdose on homeopathy… if it isn’t working, then you just stop taking it.  2-3 pellets, under the tongue, every 30 minutes for up to 6 hours.

When will I get better?

Your symptoms should resolve quickly – within a few days. If not, seek medical attention. If at any point, you feel concerned – trust your instincts and consult with your health care provider.

* According to the Academy of Breastfeeding Medicine protocol: Ibuprofen is not detected in breastmilk following doses up to 1.6 g/day and is regarded as compatible with breastfeeding.

When should I seek immediate medical attention?

According to KellyMom, you should seek immediate medical attention from your health care provider if:

  • Mastitis is in both breasts.
  • Baby is less than 2 weeks old, or you have recently been in the hospital.
  • You have broken skin on the nipplewith obvious signs of infection.
  • Blood/pus is present in milk.
  • Red streaking is present.
  • Your temperature increases suddenly.
  • Symptoms are sudden and severe.

Sources: Academy of Breastfeeding Medicine, KellyMom, San Diego Breastfeeding Center

Disclaimer via the SDBC: Most herbal treatments have not been thoroughly researched, particularly in regard to lactation. Herbs are drugs, and some caution is necessary. I am presenting this data as is, without any warranty of any kind, express or implied, and am not liable for its accuracy nor for any loss or damage caused by a user’s reliance on this information.

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