This is the first of several features on common breastfeeding problems that will be excerpted from Amy Spangler's BREASTFEEDING: A Parent's Guide, during this month.

"Mastitis occurs infrequently, but can be quite painful," said Amy Spangler. "When a breast infection does occur, it is important for the mother to seek prompt medical attention from her primary care provider. This will lead to a speedy resolution and avoid further complications. In addition, a mother needs to know that she can safely continue to breastfeed."

SIGNS:

Women with a breast infection (mastitis) often describe flu-like symptoms, including weakness, headache, nausea, soreness, chills, and fever (greater than 101 degrees F or 38.4 degrees C). The breast can be red, hot, and painful.


CAUSES:

When breastfeedings are infrequent, delayed, or missed, or when babies are positioned incorrectly on the breast, milk collects in the breast and puts pressure on surrounding tissue causing engorgement. Engorgement damages the tissue and increases the risk of infection. When bacteria enter the breast through an opening in the nipple or a break in the skin, the damaged tissue becomes infected.


RECOMMENDED TREATMENT:

• Call your doctor. An antibiotic may be necessary. Take the antibiotic until it is gone even if your symptoms improve.
• Put warm water on the infected area before each breastfeeding to aid let-down and relieve pain. Warm washcloths, a warm shower or bath, or soaking the breasts in a pan of warm water works well.
• Continue to breastfeed frequently on both breasts. Breastfeed every 1-3 hours during the day and every 2-3 hours at night.
• Start each feeding on the uninfected breast until the let-down reflex occurs, then switch to the infected breast. Breastfeed only until the breast is soft. If necessary, hand express or pump to soften the breast.
• Apply cold packs after each breastfeeding to relieve pain and reduce swelling. Bags of frozen peas wrapped in a cold washcloth work well.
• Drink enough fluid to satisfy your thirst. Water and unsweetened fruit juices are best.
• Take acetaminophen or ibuprofen for pain.
• Get plenty of rest.

• Position the baby correctly on the breast and use 2-3 different breastfeeding positions each day.
• Do not delay or miss feedings, but if you do, or if the baby breastfeeds poorly, hand express or pump to soften the breasts and relieve fullness.
• Avoid bras that are too tight or that bind and bras with underwires.
• Wean gradually. Pump or hand express to soften the breasts and relieve fullness.