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This article is an excerpt from "The Nursing Mother's Problem Solver" by Claire Martin.

One doctor described mastitis as "a bunch of germs having a party in your milk ducts"-a wry description of an otherwise humorless affliction. Mastitis is a vicious infection that develops fast and, untreated, can quickly get worse. This is one party you don't want to throw.

The germs that cause mastitis can enter through the nipple when the baby falls asleep while nursing: The pores in your nipple are still open, giving the germs easy access. Other causes include a too-tight nursing bra or sleep bra, bunching your clothes under your arms while you nurse (that puts pressure on the milk ducts), opening your nursing bra flap just enough to let the baby get at your nipple (allowing the pressure of the flap to cause problems not only with plugged ducts and mastitis, but also with nursing), or frequently missing a regular nursing session.

Mastitis usually begins with symptoms like a sore, painful breast, accompanied by feeling punchy and feverish. Sometimes you'll find a small lump, warm to the touch, near your nipple. If you use a breast pump, you may notice that the milk from the affected breast is unusually thick, almost like cream soup; in rare cases, clots or clumps form in the collection bottle.

If you catch the symptoms early, you can stop them from developing into full-blown mastitis by applying warm compresses, massaging the lump (toward your nipple), resting in bed, and nursing and pumping as much as possible on the affected breast. You won't want to-it'll hurt-but mastitis hurts more.

Occasionally, mastitis shows up with no warning, like a party-crasher. You may feel as if you're getting a bad case of the flu- shivery, sweaty, with a terrific headache. Once you develop a fever and/or chills, you're dealing with mastitis, not a plugged duct. The solution is prescription antibiotics. The drugs take effect swiftly. You'll feel better within hours, and the infection will be resolved within 48 hours-but keep taking the drugs for the prescribed period, and try to get as much bed rest as possible for at least a couple of days after your symptoms are gone. Mastitis often recurs in moms who skip bed rest and resume their regular (overloaded) schedule too soon.

If the infection fails to respond to the antibiotics, go back to us immediately. You may need a different antibiotic. Several antibiotics are used to treat mastitis and other bacterial infections; Keflex, Dicloxycillin, Augmentin, and Cipro are widely used. If a second course of antibiotics doesn't work, ask us to do a culture and reassess the situation.

When you're taking an antibiotic, add acidophilus to your diet (in the form of supplements or yogurt with an active culture, not frozen yogurt) to help stave off yeast infections, which can provoke more plugged ducts. Ibuprofen will help reduce swelling and fever.

To relieve the pain, fill a cotton sock with dry (uncooked) white rice. Put it in the microwave oven for 1 minute. It will be hot when you remove it, but also moist-an ideal warm compress. Apply it to the affected part of your breast for at least 1 minute, preferably longer, before you nurse. (If it's too hot, use a thin cotton blanket or washcloth as a buffer.) The heat will help dilate your milk ducts and help empty the plugged duct(s).

Continue breastfeeding while you're under treatment. The often you nurse, the more quickly you'll clear any plugged ducts. Try varying the nursing position to make sure all the ducts are fully drained. It may (probably will) hurt, especially at first, but this is the best way to deal with mastitis.

Untreated, mastitis can get much worse. It can develop into a breast abscess-a nasty situation that's more complicated to treat, often requiring minor surgery-and you'll end up on antibiotics anyway. For the baby's sake and your own, nip mastitis in the bud as soon as you recognize the symptoms.

If you're squeamish about prescription drugs, you can try treating mastitis with colloidal silver, a natural substance composed of submicroscopic clusters of silver suspended in ionized water. Colloidal silver is a powerful and nontoxic antibiotic that is increasingly popular as an alternative medicine. The University of California/Los Angeles medical labs found that it killed every virus they tested.

However, even though the manufacturers of colloidal silver say that it's safe for pregnant and lactating women, use it prudently. A 1996 medical research report assessing the risks and benefits of colloidal silver found that indiscriminate use can lead to toxicity. Colloidal silver is sold through whole food and health food stores.

Should the mastitis persist (or return) after you've finished your course of antibiotics, ask us to culture your milk so the lab can determine what kind of bacteria is causing your problem.

About the Author

Claire Martin is a parenting writer at the Denver Post. Her writing has won national and regional awards, and has appeared in publications such as the St. Petersburg Times, Good Housekeeping, and Sunset magazine. She lives in Denver with her husband and two daughters, both of whom were breastfed.

From THE NURSING MOTHER'S PROBLEM SOLVER by Claire Martin. Copyright © 2000 by Claire Martin. Reprinted by permission of Simon & Schuster, Inc.


PAGS is still offering the flu vacine clinics at both our Beverly and Salem offices. Please call our office to schedule your flu shot today.
Pediatric Associates (PAGS) is pleased to announce that Mark Mandell, M.D. has joined the leadership team of Steward Health Care Network as their Chief Pediatric Medical Officer. Dr. Mandell has been a pediatrician at Pediatric Associates for over 25 years and will continue to see patients in both the Beverly and Salem offices.
Congratulations to Dr. Campbell, Dr. D'Souza, Dr. Jalali and Dr. Mandell for being voted top pediatricans in Northshore Magazine (March 2017).  We have a great team at PAGS!

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