Mastitis – 3 Myths and how you can Manage it Better

Libby O'Sullivan

Did you know up to 1 in 3 women suffer from mastitis at some stage in their breastfeeding journey? If you have not suffered from mastitis yourself, you most likely know someone who has, which means you also know how awful it can be! Often women have pain, feel unwell and just don’t know how to fix it. It’s really no wonder mastitis is one of the most common reasons women choose to wean their bubs early!

One of the biggest issues with mastitis is how poorly we understand it! Often women get so much mixed advice from different sources that it can be hard to know where to start. Do you massage the blocked duct? Straight to the GP for antibiotics? Feed less? Feed more?

What a mine field!

To help clear up some of the confusion, I want to address 3 common myths I often hear about mastitis in the hope that we can all help manage it better in ourselves but also for the women around us!

MYTH 1 – Mastitis means there is an infection in the breast

Mastitis is actually a type of inflammatory breast condition that presents as 2 or more of the following:

  • local breast pain
  • redness
  • swelling
  • heat / local increase in temperature
  • fever / feeling of being unwell

Does this surprise you?  I quite often hear from women “It’s not mastitis because I don’t feel unwell / it’s not red / there’s no pain”. Well, it doesn’t have to be! Different women present differently. If you have any combination of 2+ of the symptoms, you may have mastitis.

Mastitis indicates that there is local inflammation in the breast tissue, but not necessarily an infection. Mastitis can be both infective and non-infective, and there is no real way we can tell this from the outside!

MYTH 2 – Massaging a blocked duct will help to clear it

Now I am definitely guilty of this one! It made sense to me when I was breastfeeding that if you have a blocked duct and you get in there and massage the c*#p out of it, that the blockage will be ‘cleared’ and the milk will then flow.

What I didn’t know then that I know now is that the ductal system is actually much more convoluted that that. It is very unlikely that the blockage in the duct is where you feel the lump, and there is no way of knowing where in the tissue the blockage could be!

So not only are you going in and massaging blind, but you are also at a very high risk of tearing the fragile milk ducts and causing further inflammation and pain.

So, is massage ever ok? It can be! Sometimes lymphatic massage towards the lymph nodes (not the nipple) can be effective in treating inflammation and pain, and in some cases massage toward the nipple can be useful in helping milk production and flow. But in the case of mastitis, firm massage of a blocked duct is not recommended

MYTH 3  – Antibiotics is the only treatment that works for mastitis

As you learned in reading myth 1, mastitis is not always infective. Just because you have a temperature, it doesn’t mean you have infective mastitis (and equally the absence of one doesn’t mean that it is non-infective!)

This means that antibiotics, although a very important tool, might not always be the single best course of treatment. And when they are prescribed and work, it may not always be for the reasons we think!

So what other options are there?

Physio of course!

Physiotherapists who have additional training in treating the lactating breast can play a huge role in helping to resolve lactation problems so women can keep breastfeeding (and receive all those wonderful associated benefits!)

Physios are often great problem solvers. So we can help by:

Assessing the condition and working out which factors may have contributed in the first place

Educating on how you can minimise other risk factors

Improving positioning for breastfeeding

Massage and teaching of self massage techniques to help improve lymphatic drainage

Using therapeutic ultrasound to reduce local inflammation

When should you see a physio?

You should see a suitable trained physiotherapist as soon as you can. We usually treat these as a priority, so even if we don’t have an appointment time available we will try to make room for you.

The earlier we treat you the better.

GLOW Physio has specialised training in treating mastitis and other inflammatory breast conditions. We have a therapeutic ultrasound machine that can be used in clinic and home visit appointments and we always work with your GP / midwife to ensure you’re getting the best care possible!