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Breast Infections and Plugged Ducts

Breast Infections (Mastitits)

Breast infections most commonly occur 1-3 months after the delivery of a baby. Mastitis is an infection of breast tissue. It
usually occurs during breastfeeding, but can occur at other times. It occurs when bacteria, often from the baby’s mouth, enter a milk duct through a crack in the nipple causing painful inflammation and infection of the breast. Mastitis usually occurs in only one breast.

Symptoms

  • Breast may feel hot and look red and swollen in the area of the infection,
  • A cracked nipple with obvious signs of infection,
  • Pus and blood in her milk,
  • Red streaks from the infection site back into her breast,
  • Fever, feel achy or run-down,
  • Other symptoms such as nausea and vomiting may occur.

If you have these symptoms, please call the doctor for treatment.

Medical Treatments

The doctor may order an antibiotic to take for 7-10 days to treat the infection. You can and should continue breastfeeding even if you need a medication. Sudden weaning puts you at risk of developing an abscess, which is infection within an enclosed space that forms a collection of pus. This type of infection may require surgical drainage and antibiotics. Other treatment suggestions are listed below under “Comfort Tips”.

Plugged Ducts

The milk producing part of the breast is made of many milk glands and ducts that carry milk to the nipple. Plugged ducts usually occur because the duct is not draining properly and has become inflamed. Most of the time only one breast is affected.

Other causes may be poor latch, not removing enough milk from the breasts, wearing a tight bra, sleeping on one side or feeling run-down, tired or stressed.

Is it Mastitis or Plugged Duct?

Mastitis Plugged Duct
  • Comes on suddenly
  • Is localized
  • Part of breast is hot, red and swollen
  • Pain is intense and localized
  • Mother has flu-like symptoms (tired, aching, generally ill)
  • Mother has a fever.  Temperature 38.4ºC or more
  • Comes on gradually
  • May shift in location
  • Little or no warmth in area
  • Not red or slightly red
  • Pain is mild and localized
  • Mother does not have a fever.  Temperature is 38.4ºC or less

Comfort Tips for Dealing with Plugged Ducts and Mastitis

Treatment of plugged ducts and mastitis consists of frequent emptying of the breast, heat, gentle message, and rest.

  • Continue breastfeeding. Pump or hand express if feeding is too painful.
  • Breastfeed frequently and for longer periods to ensure your breast is emptied.
  • Before feeding, apply wet (moist) or dry heat to the affected area using a heating pad or hot water bottle. You can use other forms of moist heat: warm wet cloth, warm shower or bath, or leaning over a sink, basin, or tub of warm water and soaking the breast for about 10 minutes three times
    a day.
  • Heat increases circulation to the area and aids healing.
  • Massage may help the lump of a plugged duct to travel down the duct towards the nipple.
  • Feed on the affected side first at each feeding. Your baby will have a stronger suck to encourage letdown and this breast is the one your baby will most likely be able to empty. Frequent feedings will help the breast from becoming too full and keep the milk flowing freely. For mastitis, breastfeed the baby frequently on the affected side at least every two hours, including the night hours, as long as the breast is
    tender and warm to the touch.

Other Tips in General

  • Loosen your clothing, especially the bra. Go braless if possible or wear a larger bra. Sleep on your side or back without putting pressure on the sore breast.
  • Vary nursing positions to drain all areas of the breast more effectively. *Position the baby so that the chin points toward the affected area. Baby will drain the part of the breast the chin points toward.
  • Check your baby’s latch.
  • Wash any dried milk secretions on the nipple by soaking it with plain water.
  • Try to rest in bed with baby near you, as this will encourage frequent feedings to drain the breast.
  • Try to relax during this time and spend more time with baby close to you keeping supplies such as diapers, toys, books, phone, a glass and pitcher of water nearby to keep down the trips out of bed.
  • Drink lots of fluids as dehydration can increase the severity of infections

Sources:

  • La Leche League International’s “The Breastfeeding Answer Book” (1997). Nancy Mohrbacher, IBCLC and Julie Stock, BA, IBCLC.
  • Breast Infections and Plugged Ducts. Anne Smith, IBCLC. www.breastfeeding-basics.com
  • How To Avoid Infections While Breastfeeding. www.ehow.com/how_4246_avoid-infections-breasts.html
  • Best start (2018). Breast Infection (Mastitis). From https://resources.beststart.org/wp-content/uploads/2018/12/B34-E.pdf
  • Beststart (2018). Blocked Ducts. From https://resources.beststart.org/wp-content/uploads/2018/12/B33-E.pdf

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