Mastitis is an inflammatory condition primarily associated with breastfeeding, that can present itself with a range of discomforting signs and symptoms. Recognisable by breast firmness, redness, swelling, and pain at rest or upon touch, mastitis can often come accompanied by a fever and an overall feeling of being unwell.

Previously, it was understood that mastitis could be attributed to a ‘milk plug’ or a ‘blocked duct.’ However, a recent change in the guidelines from the American Academy of Breastfeeding Medicine have brought about a significant shift in perspective.

The new approach redefines the cause of mastitis. It suggests that mastitis stems from the persistent narrowing of the milk ducts, causing a backup of milk flow, known as milk stasis. This stagnant milk then triggers inflammation in the surrounding breast tissue, leading to the development of symptoms. This inflammation can worsen, further narrowing the ducts and impeding the milk flow even more.

Let’s compare the old guidelines with the new

The advice for addressing mastitis according to the old guidelines typically included actions such as feeding to fully empty the affected breast, using a breast pump to empty the breast, deep tissue massages, and applying heat to the affected area. However, the new guidelines suggest a different approach for effective relief of mastitis.

The updated advice highlights the following:

• Instead of focusing on solely emptying the affected breast, the emphasis is on maintaining a balanced approach to breastfeeding between both breasts.
• The new guidelines advise against using a breast pump to ’empty’ the breast, as this may exacerbate the issue.
• Techniques such as gentle lymphatic drainage massage or therapeutic ultrasound, with the assistance of a physiotherapist, are recommended to reduce inflammation and enhance drainage.
• The use of a cold compress on the affected area can help alleviate discomfort.

Ballarat Women’s Clinic’s Physiotherapist Belinda Matthews specialises in assisting with the effective treatment of mastitis from the onset of symptoms using various techniques. These include employing therapeutic ultrasound to swiftly reduce inflammation and pain, utilising lymphatic drainage techniques to improve inflammatory drainage in the breast, and employing gentle breast mobility techniques to enhance milk flow. Additionally, light taping is used to promote lymphatic drainage and offer gentle support.

However, effective treatment of mastitis requires more than just physiotherapy. Seeking guidance from a lactation consultant is equally crucial. Donna Gedye, BWC’s Lactation Consultant (IBCLC), plays a vital role in supporting individuals dealing with mastitis.

Donna’s approach involves:

• Providing guidance on positioning and attachment during breastfeeding.
• Assessing and addressing any potential nipple damage.
• Crafting a breastfeeding plan to manage immediate issues related to mastitis and to prevent future occurrences of mastitis.

By understanding an individual’s unique breastfeeding history and any previous issues, Donna aims to maintain milk volume while treating symptoms and develop a plan tailored to facilitate an optimal breastfeeding experience.

Although mastitis is challenging, it is now being approached with a more nuanced understanding and a multidisciplinary treatment plan. BWC’s holistic approach, integrating both physiotherapy and expert lactation consultancy, aims to provide relief, support, and enhance overall breastfeeding experiences. If mastitis symptoms are present, seeking professional guidance promptly is essential for effective management and prevention of future occurrences.

To book an appointment with Lactation Consultant Donna Gedye or Physiotherapist Belinda Matthews, please call Ballarat Women’s Clinic on 03 5332 9940.

Written by Belinda Matthews, Physiotherapist and Donna Gedye, Lactation Consultant (IBCLC)