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What can I do about my repeated cases of mastitis?

Keep breastfeeding your baby! You are taking steps in the right direction to determine the cause of these repeated breast infections. Breastfeeding is not supposed to be frustrating and painful. With a little bit of detective work, it is possible to determine solutions to resolve this situation.

Here are some of the factors that may result in recurrent breast infections:

  • Failure to fully recover from the initial case of mastitis can be a contributing factor to recurrence. See our FAQ on Mastitis (Sore Breasts) to review properly treating breast infections. When an antibiotic is used as part of the treatment, it is important to finish the entire prescription. If a previous antibiotic treatment was ineffective, having the baby's throat as well as the mother's milk cultured may determine the appropriate medication.
  • Fatigue and stress, whether from daily life or out-of-the-ordinary events such as trips, holidays, parties, and moves may result in sore breasts.
  • Anemia could be a contributing factor. A physical from your health care provider could determine if supplemental vitamins or iron is needed.
  • Cigarette smoking can contribute to lowered resistance to infection. In addition, it can inhibit let-down or the milk-ejection reflex. This may result in repeated breast infections as milk "pools" in the breast.
  • An overabundant milk supply can prevent baby from completely emptying the breast. Allow baby to finish the first breast before offering the second breast. If your breasts feel uncomfortably full, you may pump or express enough milk to relieve the fullness. (See our Oversupply FAQ for more information.)
  • If either nipple is sore, cracked or bleeding, this can be a point of entry for infection. If sore nipples are a recurrent problem, be vigilant about positioning and latch on. Contact your local Leader, a lactation consultant or your health care provider about other possible causes of sore nipples.
  • If you notice dried milk secretions covering one of the nipple openings, you might apply moist, warm compresses and express some milk until the opening is clear. Some mothers report that a thick yellowish plug emerges with gentle expression. (It will not harm the baby if the baby removes the plug through breastfeeding.)
  • Nipple shields can slow the milk flow and encourage infection. Use of pacifiers and artificial nipples can affect how baby sucks and contribute to nipple soreness and development of mastitis.
  • Some babies are reluctant to breastfeed or refuse the breast periodically, perhaps due to sensitivity or other factors. Irregular breastfeeding patterns may contribute to repeated breast infections. Your local Leader may be able to help you troubleshoot and determine possible causes for this.
  • Make sure your clothing isn't too tight-fitting, paying special attention to your bra. Some bras and bathing suits, especially underwire types, may put too much pressure on the breast. Even a heavy shoulder strap purse or frequent use of a baby carrier can cause problems. Frequently changing sides with purses or baby carriers may help.
  • The shoulder strap of a vehicle's seat belt can also cause a sore breast. A too tight strap could apply pressure to the breast. Also, the shoulder strap's pressure from a sudden stop may cause a sore breast. Other types of injuries that can result in sore breasts could be a kick or hit from a rambunctious toddler. These may result in blocked milk flow and so should be treated with rest, heat and frequent nursings.
  • Any history of breast surgery, breast lumps or injury to the breast can increase risk of infection.
  • One researcher suggests that eliminating saturated fats from the diet and taking one tablespoon of lecithin per day can lead to improvement for women with a history of plugged ducts and/or mastitis.
  • Excessive sodium intake may cause fluid retention, which can lower resistance to infection. On the other hand, a chronic salt deficiency can contribute to recurring mastitis.
  • Food intolerances and exposure to allergens can also be a contributing factor to recurrent breast infections.
  • Excessive repetitive movements of the upper arms are considered a risk factor in recurrent mastitis. Examples of this include vacuuming, cleaning shower stalls, washing windows and gardening.
  • Another area to check when researching recurrent breast infections is your sleeping position. It may help if you vary your position. If a breast is under pressure for too long, the ducts in that area may not be able to allow the milk to flow freely.

Some mothers have been successfully treated for recurrent mastitis with preventative long-term antibiotic treatment.

It might be helpful to ask family members and friends for help with household chores and meals so that you can devote time to taking care of yourself and your baby.

The comprehensive guidebook from LLLI, THE WOMANLY ART OF BREASTFEEDING is offered for sale by most Groups and from the LLLI Online Store. It has lots of helpful ideas for breastfeeding and ways to overcome repeated breast infections. Other helpful references from our catalogue are LLLI "Care Plan for Mastitis," and the pamphlet, "Sore Breasts."

Contacting an LLL Leader in your area or attending a meeting may help you uncover the causes of your repeated infections.

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