Inflamed breast

The symptoms described indicate a milk stasis. This problem can occur throughout the breastfeeding period, but most women are affected in the first few weeks. Possible causes: The breastfeeding technique is not optimal or the baby is not sucking hard enough. Breastfeeding periods may be too infrequent or too short. Leftover milk can thicken in the milk ducts, forming lumps that block the milk ducts. Clothing that is too tight and constricting makes it harder for the milk to flow. Stress inhibits the release of the hormone oxytocin. This is normally released when the baby sucks. It causes the smooth muscles around the milk ducts to contract and allow milk to be secreted. Excessive milk production can also lead to congestion in the milk ducts.

Due to the increased pressure during milk stasis, the permeability of the capillaries increases and more minerals (sodium, chloride) enter the milk from the serum. This can make the milk taste saltier, and some babies reject it. The transition to mastitis is fluid. This occurs when bacteria penetrate through small injuries (rhagades) in the nipple and areola. This is usually Staphylococcus aureus, which gets onto the mother's skin from the baby's mouth and throat. In such mastitis puerperalis, general symptoms such as fever, chills and a feeling of weakness occur in addition to the local symptoms. The affected breast shows clear signs of inflammation, is reddened and overheated. A yellowish, purulent discharge may emerge from the nipple, occasionally containing streaks of blood. The lymph nodes in the armpit enlarge.

The good news is that neither milk stasis nor mastitis harm the baby. So breastfeeding can and should be continued. If there is a milk stasis, the milk ducts must be completely emptied again. Midwives and breastfeeding counsellors can explain which measures help. They will show you the correct breastfeeding position and know how the mother can best put the baby to the breast. To relieve blockages in the milk ducts, the woman gently strokes from the painful area to the nipple to stimulate the flow of milk. Milk flows better when the breast is warm. Warm compresses are good, and taking a warm shower or shining a heat lamp on the breast also helps the milk flow.

It is recommended to let the baby drink at least every two to three hours. It is best for the woman to start with the affected breast so that it is emptied as completely as possible. This reduces the pressure in the breast. If breastfeeding from the inflamed breast is not successful, the milk can be pumped as an alternative. However, pumping for too long can increase milk production. After emptying the breast, cold is good for you. It reduces pain and swelling and causes blood vessels to contract. This reduces milk production. Compresses from the pharmacy, cooling compresses or wraps that are applied for 20 to 30 minutes are suitable for cooling. Women can use curd or cabbage leaves as a home remedy.

If fat clots in the milk are a cause of milk stasis, women can talk to their doctor about taking lecithin. The emulsifier can dissolve fat. Paracetamol or ibuprofen can help with the pain and fever. They only get into the breast milk in small amounts. Acetylsalicylic acid is contraindicated for breastfeeding.

If the milk stasis has developed into mastitis, fast action is required. In the early stages, cold treatments are the most important. A tight-fitting bra or tying up the affected breast will relieve the pressure. Drinking enough and resting will help the body fight the inflammation. However, if the symptoms do not improve within 24 hours, medical help is required. In the case of mastitis caused by bacteria, the doctor prescribes antibiotics. He chooses those that are compatible with breastfeeding, such as cephalosporins or penicillins. The pharmacy team can provide information on what to look for in individual medicines during breastfeeding. A good source of information, in addition to the specialist information, is the Embryotox database, which is also available as an app for smartphones (www.embryotox.de). If women still want to take a break from breastfeeding, it is best to discuss the procedure with their gynaecologist, midwife or a breastfeeding counsellor. It is important that the antibiotic is taken for a sufficiently long time to avoid a relapse. If the patient does not feel better within 48 hours despite taking the antibiotic, it may be necessary to switch to another drug.

If mastitis is not treated early and consistently, complications such as purulent ulcers, fistulas and even blood poisoning can develop. Abscesses can be palpated as lumps that give way under pressure. They are painful and, like fistulas within the mammary gland, usually need to be treated surgically.